1. Daily Living

a) Alcohol :

• Single
• Male
• Having a mother or father who is or was alcohol dependent
• Starting to drink before age 15
• Not finishing high school

However, alcohol related problems can develop with anyone, regardless of their age, gender or social status.

Signs and Symptoms of Alcohol Problems

Alcoholics experience withdrawal symptoms, tremors, and cravings for alcohol after they have not had a drink for a while. They often have disruption in their work, family, and social life due to alcohol.

Problem drinkers can be harder to identify as they tend not to drink every day and can be successful functional adults who reject the notion that they have a problem. They rarely experience the symptoms alcoholics do. They may, however, engage in hazardous drinking such as driving cars or operating machinery while intoxicated, or having alcohol affect their lives negatively in other ways.

Diagnosis of Alcohol Problems

Up to 90% of people with alcohol problems are not diagnosed by their doctors because they hide the facts, or their doctors do not ask. If a doctor gets the correct information the diagnosis can be made just by listening to a patient's story.

Diagnosis of Alcohol Problems

Up to 90% of people with alcohol problems are not diagnosed by their doctors because they hide the facts, or their doctors do not ask. If a doctor gets the correct information the diagnosis can be made just by listening to a patient's story.

Medical Problems Associated with Alcohol

People who drink more than two or three drinks per day have a higher death rate than those who do not drink. People who drink daily have an increased risk of high blood pressure, liver disease, and cancers of the mouth, throat, liver, and breast.

Social Problems Associated with Alcohol Drinking also increases the risk for violence, and drunkenness is an important factor in deaths from falls, fires, drowning, and many murders.

Alcohol and automobiles are a very dangerous mix, with a large percentage of motor vehicle fatalities attributed to alcohol intoxication. Studies show that people's reflexes are dulled even when technically they are below the legal blood alcohol limit for driving. Sleep deprived people can be impaired if they have even one drink. If you drink, don't drive.

The social consequences of problem drinking are often as damaging as the direct medical consequences. Many drinkers report problems with friends, family, work or police due to drinking.

Pregnancy and Alcohol

Women who have had problems becoming pregnant may improve their fertility by stopping alcohol consumption. If you are pregnant or planning a pregnancy, it is recommended that you do not drink. The level of alcohol consumption that poses a risk during pregnancy, don't worry if you had a few drinks early in your pregnancy before you knew you were pregnant - it is unlikely to cause any adverse effects.

Children and Alcohol

Children should not drink until they are of legal drinking age. If you drink around your children, be a good role model and drink responsibly. Statistics indicate male teenagers are especially prone to risky behaviour if they consume alcohol.

Precautions When Drinking Alcohol

• Never drink to intoxication
• Pregnant women or those trying to become pregnant are advised not to drink
• Check with your pharmacist if you drink and are taking medications. Many prescription medications - especially sleeping pills, muscle relaxants, anti-depressants, and pain killer - and some non-prescription medications - such as antihistamines - are affected by alcohol
• Do not drink if you are very tired, if you must drive, or if you have to operate heavy machinery within the next 24 hours
• Do not drink if you are in charge of firearms, dangerous substances or equipment
• If you snore or have sleep apnea, drinking in the evening may worsen your condition
• If you have diabetes, use caution when drinking if alcohol has been shown to affect your blood sugar levels or the effectiveness of your medication
• Drinking can worsen many medical conditions, including inflamed or diseased liver (hepatitis or cirrhosis), stomach ulcers, inflamed stomach (gastritis), seizures, AIDS (or HIV positive) psychiatric disorders (such as depression) and weak heart muscles (cardiomyopathy). You should not drink if you have any of these conditions.
• People who should not drink any alcohol or should drink less than the current guidelines includes those with a history of drug or alcohol abuse, a strong family history of problem drinking and a family history of alcohol-related medical disorders such as inflamed or diseased liver (hepatitis or cirrhosis), and mouth or neck cancers

b) Constipation :

Constipation is characterized by difficult, uncomfortable, or infrequent bowel movements with stools that are hard or dry. It is difficult to define what a "normal" frequency of bowel movements is since each person's bowel habits vary greatly. If the number of bowel movements you normally have decreases, you may be constipated.

Lifestyle Modifications to Prevent Constipation

• Increase your fibre intake
• Drink plenty of fluids (at least one to two litres of water per day)
• Be physically active at least three times weekly (walking, running, cycling, and swimming are all excellent forms of physical activity)
• Do not ignore the urge to have a bowel movement
• Try to maintain a regular pattern of bowel movements
• Avoid drugs that can cause constipation. Talk to your pharmacist about the medication you take

Managing Constipation

Non-drug treatments are the preferred way to prevent and manage constipation. However, if you do get constipated and these are not enough, a laxative may help. The most effective way to prevent and manage constipation is to gradually increase the amount of fibre in your diet. Start with four to six grams of fibre per day and then increase your fibre intake to 10 to 12 grams per day over the next week. In the following weeks, aim for a total intake of 20 to 30 grams of dietary fibre every day.

Each of the following foods contain approximately 10 grams of fibre:

• 6 tablespoons of raw bran
• 4 to 5 shredded wheat biscuits
• 5 to 6 slices of whole wheat bread
• 1/3 cup of All-Bran cereal
• 3 cups of corn flakes or Wheaties cereal
• 3/4 cup of canned peas
• 2 cobs of corn
• 1 unpeeled pear (average size)
• 2 unpeeled apples (average size)

As you increase the fibre in your diet, you must also increase your fluid intake. Drink at least one cup (250 mL) of water with each serving of fibre. It may take a few days, or in cases of ongoing constipation, a few weeks before you notice the benefits of your changes in diet.

Constipation and Non-prescription Laxatives

Managing Constipation with Bulk-forming Laxatives

Bulk-forming laxatives such as fibre (Fibyrax), and psyllium (Metamucil, Prodiem) increase the fibre content in your diet. These laxatives absorb and retain large amounts of fluid, increase the bulk and soften the stool. This increased bulk stimulates the natural movements of the intestines and helps cause a bowel movement. Bulk- forming laxatives are usually effective within two to three days. They are well-tolerated, effective, and safe for longer-term use, and are recommended when:

• Straining should be avoided (after recent abdominal or lower bowel surgery, or a heart attack)
• An otherwise healthy person is constipated due to pregnancy, uncomplicated diverticular disease, or irritable bowel syndrome

They are not the best laxative, however, if immediate relief is needed.

Bulk-forming laxatives vary in price, texture, and taste (some have mint or orange flavoured taste and some have no flavour), and in the amount of sodium or sugar they contain.

Managing Constipation with Stimulant Laxatives

Stimulant laxatives may be a suitable choice if you need a rapid response. Stimulant laxatives work by irritating the inside lining of the intestines, causing them to contract. Products are available as both tablets and suppositories, and include bisacodyl (Dulcolax) and sennosides (Senokot). Tablets taken by mouth are effective within six to 12 hours and suppositories work within 15 to 60 minutes. Stimulant laxatives are not meant for long-term use and should not be taken for more than a week at a time.

Managing Constipation with Saline and Osmotic

Saline and osmotic laxatives work by holding water in the intestines to soften the stool. Saline laxatives that contain magnesium like Milk of Magnesia, Citro-Mag, and Epsom Salts work rapidly and are as effective as stimulant laxatives. Another rapidly acting saline laxative is the Fleet enema which contains phosphate. Saline laxatives are not meant for long-term use and should not be taken for more than a week at a time.

Osmotic laxatives such as lactulose (Chronulac) can also be effective. They may be more expensive than stimulant and saline laxatives but can be used over the long-term, whereas stimulant and saline laxatives should not.

Managing Constipation with Lubricant Laxatives

Lubricant laxatives such as mineral oil soften stools by holding the water in the stool, and work within six to eight hours. They should not be used over the long-term as prolonged use can result in decreased absorption of some types of vitamins. Lubricant laxatives can cause pneumonia if coughed up and breathed into the lungs. People who have difficulty swallowing should avoid lubricant laxatives.

Managing Constipation with Glycerin Laxatives

Glycerin suppositories are sometimes considered to be an osmotic laxative but actually work like stimulant laxative. They are effective when an immediate response is required (within 15 minutes to one hour) but are not meant for long-term use and should not be taken for more than a week at a time.

Complementary Treatments

Many over-the-counter laxatives contain herbs such as sennosides (Cassia senna) and cascara (Cascara sagrada). One herbal product, psyllium seed, is a commonly used bulk laxative. A typical psyllium dose is one to two teaspoons (5 to 10 mL) in a glass of water after meals.

Self Care for Children

If your child is constipated, give him or her more liquids, fruits, vegetables and other sources of fibre. For babies with constipation, one to two ounces (30 to 60 mL) of apple or prune juice may help. Do not give laxatives to children under six years of age without consulting your doctor or pharmacist first. If a medication is needed, try glycerin suppositories specially made for children. Stimulant and lubricant laxatives are not recommended for children unless directed by a doctor.

Self Care Precautions

Stimulant laxatives, glycerin suppositories, and stool softeners should not be used for more than one week at a time. Do not take laxatives if you have moderate to severe abdominal pain or cramping, nausea and vomiting, or bloating. See your doctor if you have any of these symptoms.

Chronic constipation
Bulk-forming laxatives are the best laxatives for people with chronic constipation as they are effective and safe to use for long-term treatment. If bulk-forming laxatives are unsuitable, ineffective, or not tolerated, try lactulose as this laxative can also be used long-term.

Constipation from chronic illness
While bulk- forming laxatives may be useful, an occasional dose of lactulose or stimulant laxative may help. People with a chronic health condition may also require occasional treatment with suppositories or enemas.

People with chronic pain who take narcotics
Constipation is a common side effect of certain narcotic pain relievers. A common regimen used to help avoid or treat constipation in these cases is a stimulant laxative plus a stool softener. However, some people may find that increasing fluid and fibre is enough to control constipation.

c) Foot Care :

Most people experience foot pain at some time in their lives. Often it's due to ill-fitting footwear and can be prevented. Women tend to have more foot problems than men because women often wear high heels and shoes designed for appearance rather than comfort. Fortunately, many foot problems caused by injury, aging, or heredity can be easily cared for at home.

General Foot Care
Buying new shoes.
Make sure your shoes are comfortable and fit properly when you buy them – don't expect them to break in later. Shop for shoes in the afternoon since feet naturally swell as the day progresses. Poorly fitting shoes can cause corns, ingrown toenails, and bunions.

Extra cushioning.
If part of the bottom of your foot is tender, a cushioning pad may help. A variety of forms and supports are available from your Pharmasave pharmacy. If you need advice, ask for help making your choice. If the pain persists, talk to your doctor.

Prevent ingrown toenails.
Trimming your toenails properly helps prevent ingrown toenails and infection. Use heavy, long handled scissors or nail clippers to cut the nail properly. Trim the nail straight across so that the end of the nail is a square and not a half-moon shape. Be careful not to trim it too close. Use an emery board or nail file to finish off the edge of the nail. Do not try to tear the nail off with your fingers.

Treat your feet.
Rest your feet by elevating them when sitting. This takes the weight off and improves blood circulation. A foot massage is also great for circulation and restoring vigour to tired feet.

Corns and Calluses
Corns and calluses are the skin's response to constant pressure or irritation, and are simply thickened and hardened patches of skin. A callus can be caused by flat feet, high arches, or being overweight. Corns usually appear on the toes. Both corns and calluses are only serious if they cause an infection.

If you have diabetes or have circulation problems in your feet, be on guard against signs of infections (such as redness, swelling, or pain), and seek medical attention if you think you have a corn or callus.

Lifestyle Modifications to Prevent and Treat Corns and Calluses
The best treatment for getting rid of a corn or callus is to change footwear. You can also get rid of a corn or callus by soaking your foot in warm water and then gently rubbing the skin off with a pumice stone. If you have a cracked callus, apply moisturizing cream afterwards.

Non-prescription Products
Corn bandages are doughnut-shaped bandages that remove the pressure from the corn so it will naturally fade. A protective padding known as a moleskin can also protect calluses and blisters from forming or developing further. You can also try chemical corn removers, which usually contain salicylic acid, to dissolve the corn. Apply the chemical corn remover as directed by the product's instructions.

Self Care Precautions
Be careful to not apply chemical corn removers to the normal skin around a corn, since it can cause irritation. Do not use chemical corn removers if you have diabetes or circulation problems in your feet.

When to Seek Medical Advice
If the corn or callus persists or you think you have an infection, see your doctor or a podiatrist. Sometimes people need custom-made shoe inserts (known as orthotics) to help support the foot. Orthotics are needed when corns or calluses come back again and again, and changing shoes does not stop them from forming.

Athlete's Foot
Athlete's foot is an infection of the skin on the bottom of your feet. It is caused by fungus and is often caught by walking barefoot in a gym or swimming pool area. The symptoms include itchy, red, irritated, and scaly skin, and small blisters.

Lifestyle Modifications to Prevent and Treat Athlete's Foot

• Keep your feet clean and dry
• Wash your feet daily and carefully dry the skin between the toes
• Change your socks daily
• Don't go barefoot in locker rooms
• If you find your footwear causes your feet to be moist, wear shoes that are well ventilated. Also wear socks (made from polypropylene or wool) that absorb moisture away from your skin and keep your feet drier
• Do not wear the same shoes every day. By alternating shoes, any fungus growing there will die after a day if the shoes dry thoroughly
• Take your shoes and socks off at home to let the air get at your feet (but consider wearing sandals so family members don't catch the infection)

Non-prescription Products
Anti-fungal creams are available from your Pharmasave pharmacy to treat athlete's foot. Apply the cream as directed by the product's instructions. Continue to use it for at least a week after the rash and itching disappear. If the symptoms come back in less than a month, either repeat the same treatment for four weeks or see your doctor for a prescription medicated cream.

Self Care Precautions
Anti-fungal creams can irritate your skin. If your rash worsens, stop using the product and discuss your condition with your doctor or pharmacist.

When to Seek Medical Advice
See your doctor if:

• The rash is severe or has an odour. You likely either have a severe case of athlete's foot or another type of infection
• The infection has gone underneath your toenails (this is difficult to treat and you will need prescription medication)
• You have diabetes and also develop a case of athlete's foot

Plantar (Foot) Warts
Warts are small, hard, flesh coloured dry lumps with a rough texture, that most people get at some time in their life. Although warts are not highly contagious, they are spread by touching warty skin (either your own or another person's) or from shed skin on a locker room floor. Plantar warts, which appear on the soles of the feet, may be painful and should be removed.

Lifestyle Modifications to Prevent and Treat Plantar Warts

• Don't scratch warts. This may cause them to spread
• Wear footwear such as sandals in locker rooms
• Don't touch other people's warts

Non-prescription Products
Successfully removing a plantar wart requires patience. You may need to spend 12 weeks or more regularly applying the wart-removal product. Over-the-counter wart removers such as Duoplant and Compound W contain salicylic acid that dissolves warts. Plasters which contain salicylic acid (such as Dr. Scholl's) are also available. When used properly, wart removers can remove 80% to 90% of plantar warts.

Soak your foot in hot soapy water first for a few minutes to soften the wart. Gently rub away dead skin with an emery board or pumice stone before applying the wart remover and then apply as directed by the product's instructions. If your skin gets sore, red, or irritated, stop applying the wart removal product for a few days. If the irritation comes back after starting treatment again, try a different product or see your doctor.

Self Care Precautions
Wart remover products will cause irritation, so apply them carefully to avoid touching the surrounding healthy skin. Put the wart remover on with a toothpick or match stick (the applicators provided often spread the chemical too far). Applying petroleum jelly around the wart first can stop the solution from contacting the surrounding skin.

When to Seek Medical Advice
If the wart becomes painful or if after 12 weeks of self- applied wart treatment it is not gone, talk to your doctor. He or she may use a freezing technique (liquid nitrogen) or other type of medication to remove the wart.

Diabetes and Foot Circulation Problems
If you have diabetes or another medical condition that affects the circulation in your feet, ask your doctor, podiatrist, or diabetes care specialist how to properly care for your feet. People with diabetes are more prone to foot sores, ulcers, and infections. However, a few minutes a day is all it takes to reduce the chances of future foot complications.

Here are some tips to help you avoid foot problems:

• Keep your feet clean by gently washing daily and thoroughly drying with a soft towel
• Avoid tight shoes and socks that reduce circulation
• Examine all the areas of your feet daily, looking for cuts, scrapes, corns, or signs of infection such as redness or swelling. If you have trouble seeing the bottom of your feet, use a small mirror
• Schedule regular appointments with a medical professional to examine your feet
• Trim your toenails properly (as discussed under "General Foot Care")
• Avoid extremes of heat and cold
• Get regular physical activity, but check with your doctor before starting a new exercise program and ensure the activity is unlikely to cause a foot injury

d) Cataract :

What Are Cataracts?

A cataract is a clouding of the lens of the eye. Like the lens of a camera, the lens of the eye focuses light rays into images on the back of the eye. Aging and other factors may cause proteins in the lens to clump together, forming cloudy areas. Depending on how dense they are and where they are located, cataracts can block the passage of light through the lens and interfere with sight. They usually develop slowly over several years, although in some cases loss of vision progresses rapidly. Cataracts are never reversible but are treatable. The exact cause of most cataracts remains unknown.

Who Gets Cataracts?

Cataracts are more common in people over 65 years old, and nearly everyone who lives long enough will develop cataracts to some extent. Women face a higher risk than men do, and people of African descent are at increased risk of becoming blind from cataracts.

Risk factors

• Diabetes is a risk factor for cataracts. In patients with type II (adult-onset) diabetes, cataract development is related to high levels of blood sugar.
• Some medications can cause cataracts if taken for long periods of time. These include oral corticosteroids (medications used for asthma and arthritis), and phenothiazines (medications used in psychiatry). Allopurinol, a gout medication, may also cause cataracts.
• Exposure to sunlight increases the risk for cataracts. The greater the exposure, the higher the risk.
• Smoking 20 or more cigarettes a day doubles the risk of developing cataracts, and they tend to be more severe.
• A history of heavy drinking may be a risk for cataracts.
• Glaucoma, a common eye condition, can contribute to cataract formation.
• Trauma to the eye, such as a cut, intense heat, or chemical burns can cause cataracts.

Symptoms
The early symptoms include:

• Cloudy vision
• Double vision
• Frequent changes in eyeglass prescriptions

Later symptoms:

• Images may take on a yellowish tint
• Reading may become difficult
• Driving at night may become difficult because of glare from the headlights of oncoming cars
• In advanced cases, the pupil, which is normally black, looks milky

Prevention
Although cataracts are not completely preventable, their occurrence can be slowed down with the following precautions:

• Reduce sun exposure. Avoid direct sun at the times it is strongest (from 11 a.m. to 4 p.m. daylight-savings time or 10 a.m. to 3 p.m. standard time), and whenever possible find a shady spot to enjoy the outdoors from. Remember that fog, haze, and light cloud provide little protection from the sun's rays. Wearing a wide brimmed hat and sunglasses that block out UV (ultraviolet) rays will protect your eyes and reduce your chances of cataracts in later years.
• Quitting smoking will likely decrease your risk of cataracts.
• Keep alcohol consumption to a moderate level (no more than two drinks per day to a maximum of 9 drinks per week for women and 14 drinks per week for men).
• Eat at least five servings of fruits and vegetables a day.

Diagnosis
Your doctor or optometrist can diagnose cataracts by listening to your symptoms and examining your eyes.

Treatment
With proper treatment, cataracts can be effectively managed and the risk of complications are dramatically reduced. Three methods of treatment are available: eyeglasses, contact lenses, and surgery for lens implants. There is no medication at present to slow or reverse the progression of cataracts.

The goal of treatment is

• To restore vision and improve quality of life

Here are five important steps you can take to help manage your health if you have cataracts:

1. Educate Yourself

Understand the cataract treatments available and the benefits and consequences of each.

2. Adjust Your Lifestyle

You can make a number of lifestyle modifications to possibly help prevent cataracts from worsening (see the Prevention section above).

3. Understand Your Treatment

Glasses and visual aids. Once common, cataract glasses are rarely used now because of more modern developments. Early cataracts may, however, be managed through stronger than normal glasses, magnifying glasses, or better lighting.

Contact lenses. Some people can manage early cataracts with contact lenses. However, there are several drawbacks:

• Many older patients have difficulty handling contact lenses, often because of arthritis of the hands
• Contact lenses can cause eye problems and hygiene concerns
• Lens damage and loss may result in frequent visits to the eye-care specialist Dangerous eye infections can occasionally occur in older patients with extended-wear contact lenses

Surgery. Most people choose surgery to treat their cataracts. Surgery is usually recommended if everyday activities have become difficult to perform because of vision problems. At times surgery is done because of problems driving at night (due to the glare from the oncoming traffic). Many older people experience significant improvement in quality of life after the operation with their improved vision.

Modern cataract surgery is a very safe surgical procedure. It involves taking out the old clouded lens and usually replacing it with a synthetic lens. This procedure is usually done under local anaesthesia. In a very small number of cases, some complications occur; your ophthalmologist will explain any possible complications if you are considering surgery.

If you have a medical condition like heart disease or diabetes, then as with all surgeries, you are more at risk for complications. If you are on medications, especially blood thinners, you may have to stop using them before surgery to reduce complications. Discuss this with your ophthalmologist.

Most people are able to leave the hospital or clinic within hours of the surgery because only local "freezing" is used on the eye. After the surgery, protective eye shields are usually worn temporarily. Patients are often told to avoid lifting and bending over for a few weeks to avoid undue pressure on the eye.

Sometimes people who have cataract surgery develop secondary cataracts. These are usually removed in a second operation using laser surgery.

4. Use Your Medications Properly

Take any medications given for your eyes exactly as directed. Discuss any concerns you may have about them with your doctor or pharmacist.

5. Monitor Your Condition

Attend regular eye check ups at your doctor's suggestion.

Children and Cataracts
About one in every 10,000 babies are born with cataracts, sometimes because of a genetically inherited disorder. Certain medical conditions during pregnancy, such as German measles and pregnancy-induced (gestational) diabetes, can also cause cataracts in the baby. Sometimes parents may notice a "lazy eye" that does not move in coordination with the other eye. Surgery is done to correct infant cataracts.

If a child has diabetes, Down's syndrome, or if a child is on long-term corticosteroids for asthma or another medical condition, he/she is at increased risk of cataracts and should undergo an eye exam regularly as directed by their physician to check for cataracts.

When to Seek Medical Attention
As vision changes can be due to many different causes, see your doctor right away if you have sudden vision changes. See your doctor soon if you have gradual vision changes.

e) Depression :

Clinical depression is the most common of all psychiatric diseases. People sometimes confuse clinical depression with feelings of unhappiness. Everyone feels unhappy or sad from time to time. Sadness is a natural reaction to a disappointment or loss, lasting from a few hours to a few days.

Clinical depression, however, seriously impairs one's ability to function and enjoy life and social relationships, and if untreated can lead to feelings of despair, physical complaints, and possible even attempted suicide.

Clinical depression is thought by many experts to be a disease involving an imbalance of brain chemicals known as neurotransmitters. In over half of cases, a person who has been clinically depressed in the past develops another episode of depression. The average length of time that a person suffers from depression is six months.

Who is Affected by Clinical Depression

One in 10 people will experience an episode of clinical depression in their lives, although they may not recognize or admit it. Only 40% of depressed people contact a health professional. Women are more prone to depression than men, and the average age of onset is the late 20s. However, an episode of depression can happen at any age, including infancy.

Children and Depression

Children can suffer clinical depression at any age. The frequency of depression in children (ages 6 to 18) is estimated to be about one in 50. Diagnosis is more difficult in children as they are likely to show their depression in different ways than adults. Children, for instance, may constantly complain of boredom, have poor grades at school, or have frequent angry outbursts. If you suspect your child has clinical depression, contact your school psychologist or a physician specializing in children's health problems.

Risk Factors for Clinical Depression

Although sometimes no causes are identified, the following factors are known to increase a person's risk of clinical depression:

• A sudden loss, such as a job loss or the death of a loved one
• A history of sexual abuse
• A family history of clinical depression
• Prolonged or severe stress caused by financial problems, unemployment, or chronic illness
• Recently giving birth. Women sometimes go into what is known as postpartum depression after delivery
• Medical conditions such as thyroid disease, diabetes, mononucleosis, Parkinson's Disease, vitamin B-12 deficiency, and multiple sclerosis
• Medications such as sedatives, sleeping pills, oral contraceptives, beta-blockers (heart and blood pressure medication), corticosteroids, and some anti-ulcer drugs
• A lack of sunlight during the winter months. This can cause a form of depression called Seasonal Affective Disorder (SAD)

Symptoms of Depression

With clinical depression, a person has symptoms that are usually not present when someone is simply unhappy or "blue".

In some people depression just presents as sleeping problems and/or irritability. A person with any of these symptoms for two weeks or more may be clinically depressed and should be seen by a doctor. Often a person returns to their normal self, but some people stay depressed for long periods of time or experience recurrent episodes of depression.

Depression - Symptoms - Psychological

Someone who is clinically depressed:

• Feels sad or empty most of the day, nearly ever day (children and adolescents may be irritable)
• Has a markedly diminished interest in pleasurable activities for most of the day, nearly ever day
• Has a diminished ability to think, concentrate, and make decision
• Has feelings of worthlessness or inappropriate guilt almost every day
• Has recurrent thoughts of death or suicide or has possibly made a suicide attempt

Depression - Symptoms - Physical

Clinical depression is also often accompanied by the following physical symptoms:

• Loss of appetite or loss of weight (the opposite may also be true with an increased appetite and weight gain)
• Fatigue or loss of energy almost every day
• Restlessness or unusual slowness (which is usually more apparent to others than the depressed person)
• Problems with either getting too little sleep or sleeping too much

Diagnosis of Depression

A doctor or mental health professional diagnoses clinical depression by talking to the person and conducting a medical examination. Sometimes medical tests are performed to rule out physical diseases that may mimic symptoms of depression such as diabetes or thyroid disease.

Preventing Depression

Although no specific medical guidelines exist for preventing clinical depression, these suggestions may be helpful for maintaining a healthy emotional state:

• Try to maintain a healthy lifestyle that includes regular physical activity and a good diet
• Try to reduce sources of chronic stress at work or at home as much as possible
• Take the time to maintain good relations with friends and family
• Make time in your busy life for leisure and rest

If you have been diagnosed with clinical depression in the past and have had recurring episodes, medication and cognitive therapy (a form of short-term psychotherapy) can help prevent relapses.

Managing Your Depression

While in a clinical depression, people often have excessively negative thoughts. A person suffering from depression needs to remember that he or she may be unnaturally pessimistic about the chances of recovery and should be reminded that most people recover from depression with proper treatment.

The Goals of Treatment Are:

•  To reduce the severity and the duration of the depression

•  To help prevent a future relapse of depression

•  To lower the risk of osteoporosis (in women) and heart attacks - long standing depression is a risk factor for these conditions which hopefully is reduced with treatment.

Steps to Help Manage Depression

Educate Yourself to Help Manage Depression The more you learn about clinical depression and how it can be treated, the more control you will feel over your situation. If you take any medication regularly, ask your pharmacist if it could be contributing to your depression.

Talk to a health care professional to find out more about the various forms of therapy and medication that are used to treat depression.

Adjust Your Lifestyle to Help Manage Depression Try some self help approaches
Set realistic goals every day, even if they seem small. Make a commitment to yourself to go grocery shopping, call a friend, or take a short walk; this will help keep you active. Make an effort to strike up conversation with family or friends even it if is difficult at first. If you are having trouble making decisions, try, with the help of family, friends, or health professionals, to make a schedule as to how long you can realistically postpone them.

Participate in regular physical activity
Regular physical activity (such as a brisk walk, jogging, or cycling) has been shown to reduce the symptoms of depression. Check with your doctor before starting an exercise program.

Watch your diet
Try to maintain a healthy diet - even if you may not have an appetite. Avoid alcohol since it can make depression worse.

Understand Your Treatment to Manage Depression

Depression - Antidepressant medication

Antidepressant medications work to correct the biochemical imbalances in brain chemistry that are largely responsible for clinical depression. About two of three people with clinical depression improve when they take their medications. People who have experienced three or more episodes of major depression in the last five years should consider long-term treatment with medication.

Many types of antidepressant medications are available today. Some are more useful in certain types of depression, but the differences mainly lie in the side effects. Usually a common medication such as fluoxetine (Prozac) is tried first. If it is ineffective after a four to six week trial, or if side effects develop that are too disagreeable, then an alternative medication is used. If a family member with depression has responded well to a certain medication, chances are good that another member of the family will have a good response as well.

Depression - Psychotherapy

Psychotherapy is a form of psychological treatment that can help people understand what is contributing to their depression and help them learn ways of coping. It can be either short- or long-term and is generally given by a psychiatrist, psychologist, or doctor. Psychotherapy is often used in conjunction with antidepressant medication.

Cognitive therapy is a type of short-term psychotherapy. It is specifically designed to help people correct negative thinking and beliefs. During a therapy or educational group session, exercises are conducted to help people recognize negative thoughts and show how they influence feelings. Cognitive therapy is especially effective at preventing relapses in depression.

Use Your Treatment Properly to Manage Depression

After you and your doctor agree on a treatment program, you should follow all aspects of treatment - even if you may not feel like doing some of the things your doctor suggests. If you are having difficulty with side effects or are uncomfortable with taking medication, talk to your doctor or pharmacist. Depending on the cause and severity of your depression, therapy may last from two months to several years. If you are experiencing difficulty in psychotherapy or cognitive therapy, discuss the issues with your therapist.

Monitor Your Depression

Regularly scheduled visits with your doctor to monitor you condition are essential to help determine when your treatment can be tapered off or stopped. Continuing to touch base with your doctor after a treatment episode is complete can help prevent a relapse.

Warning Signs of Potential Suicide

A person who is seriously depressed and is contemplating taking his or her own life may or may not deliberately show signs of intent. Signs of clinical depression that should be considered as warning signs of suicide include:

• Withdrawal from friends and family and a strong desire to be alone
• Threats of suicide, especially with a thought-out plan of action such as deliberate medication overdose
• The giving away of cherished belongings
• Moodiness

These are just guidelines. If you are at all concerned that someone you know may be considering suicide, seek help from a mental health counselor, nurse, or psychologist, doctor, or another worker trained in suicide assessment. Any mention of suicide must be taken seriously.

If a person is too depressed to function or is suicidal, a period of time in the hospital may be required for intense therapy to relieve the depression.

Pregnancy and Depression

Up to 85% of new mothers may become depressed for a time during the first six months after having a baby. In most cases, these "postpartum blues" are a short-lived episode of mild depression. However, one in ten women experience a more severe and long-standing depression known as postpartum depression and need treatment in the form of psychotherapy or medication. Talk with your doctor if you are feeling down after giving birth.

The following are important items to have in your Family Health First Aid Kit:

•  Sterile adhesive bandages in assorted sizes - for simple cuts or abrasions

•  Butterfly bandages and narrow adhesive strips - to hold the edges of a cut together to allow it to heal

•  Individually wrapped, sterile gauze pads (2" and 4") - to control bleeding or secretions and prevent contamination

•  Hypoallergenic adhesive tape - to hold a dressing or splint in place

•  Roll of absorbent cotton - as padding for a splint

•  Sterile roller bandages (2" and 3"), at least 3 rolls - to lend support to sprained or sore muscles

•  Cotton-tipped swabs

•  Thermometer

•  Anti-itch lotion or cream - for relief of insect bites, itching and minor skin irritations

•  Eye drops

•  Syrup of ipecac - to induce vomiting only if instructed by a poison control center, emergency personnel or doctor; keep a one-ounce bottle on hand for each child under age five

•  Antiseptic ointment, spray or towelettes - for cleansing wounds

•  Antibiotic ointment - to prevent infection of minor wounds

•  Bottled water - to rinse wounds or to drink

•  Face mask - to protect against smoke, dust or allergens

•  Latex gloves - for protection when providing emergency help to an injured individual

•  Clean towel - for a pillow or as a wrap for ice

•  Chemical ice packs

•  Emergency phone numbers - doctor, pharmacy, poison control, etc.

•  First aid handbook

b)Burns

What are the categories of burns?

The treatment of burns depends on the depth, area and location of the burn. Burn depth is generally categorized as first, second or third degree. A first degree burn is superficial and has similar characteristics to a typical sun burn. The skin is red in color and sensation is intact. In fact, it is usually somewhat painful. Second degree burns look similar to the first degree burns; however, the damage is now severe enough to cause blistering of the skin and the pain is usually somewhat more intense. In third degree burns the damage has progressed to the point of skin death. The skin is white and without sensation.

Regardless of the type of burn, the result is fluid accumulation and inflammation in and around the wound. Moreover, it should be noted that the skin is the body's first defence against infection by micro-organisms. Damage to the skin can predispose the burn victim to both infection at the site of the wound as well as internally.

What is the significance of the total body area affected?

In addition to the intensity, the total area of the burn is significant. This is usually measured in terms of percent of total body burnt. The skin acts as a barrier from the environment, and without it, patients are subject to infection and fluid loss. Burns that cover more than 15% of the total body surface can lead to shock and require hospitalization for intravenous fluid resuscitation and skin care.

How important is the location of a burn?

Burn location is even more important than the above factors. Burns of the neck or signs of burns to the nose or mouth require emergent guarding of the patient's airway, as swelling may results in life threatening obstruction. Burned tissue shrinks and can cause damage to underlying structures. Burns that extend circumferentially around body structures require surgical release of the tissue, often referred to as escharotomy. Finally, all eye burns require special attention as soon as possible. Burns to the eye may lead to clouded or lost vision.

1. First remove any constricting jewellery, such as rings.
2. Do NOT use butter or oils on a burn.
3. The effected area should be dowsed with cool water as soon as possible. It can be cleansed gently with chlorhexidine solution. Do NOT apply ice or cool to near-freezing temperatures (this can cause additional tissue injury).
4. A tetanus booster should be obtained if not administered within the previous 5 years.

First degree thermal burns can be treated with local skin care such as aloe vera. Many topical antibiotics and antiseptics are available in the drug store for minor burns.

All second and third degree thermal burns need immediate physician evaluation. Special topical antiseptic creams are used for more serious burns, including silver sulfdiazine, silver nitrate, and mafenide acetate creams.

Burns can be caused by heat (thermal), as well as by electricity, and chemicals.

What about electrical burns?

Any significant burn resulting from electricity requires immediate physician evaluation. These burns often result in serious muscle breakdown, electrolyte abnormalities, and occasionally kidney failure. The actual site of damage can be internal and may not be visible on the skin surface.

What about chemical burns?

The treatment for chemical burns is similar to thermal burns except copious amounts of water should be used to irrigate the effected region. Contaminated clothing should be removed. Do NOT attempt to neutralize the burn with a reciprocal chemical. This may cause a chemical reaction that could result in a thermal burn too! Many chemicals have, in addition, specific treatments that can further reduce the resulting skin damage. If in doubt, call your local Emergency Room

What is a bruise?

You fall off your bike, bang your shin on the coffee table (that you swore you would move months ago) or run into a wall and wake up with a wallop of a bruise. What is a bruise and what can you do about it? A bruise, or contusion, is caused when blood vessels are damaged or broken as the result of a blow to the skin (be it bumping against something or hitting yourself with a hammer). The raised area of a bump or bruise results from blood leaking from these injured blood vessels into the tissues as well as from the body's response to the injury. A purplish, flat bruise that occurs when blood leaks out into the top layers of skin is referred to as an ecchymosis.

Why do bruises occur more frequently in some people than in others?

The injury required to produce a bruise varies with age. While it may take quite a bit of force to cause a bruise in a young child, even minor bumps and scrapes may cause extensive bruising or ecchymosis in an elderly person. Blood vessels become more fragile as we age and bruising may even occur without prior injury in the elderly.

The amount of bruising may also be affected by medications which interfere with blood clotting (and thus cause more bleeding into the skin or tissues). These drugs include many prescription arthritis medications called non-steroidal anti-inflammatories (e.g. ibuprofen/Advil, Nuprin and naproxen/Aleve ) as well as over-the-counter medications, such as aspirin. Warfarin (Coumadin) is often prescribed by doctors specifically to prevent clotting in patients who have had blood clots in their legs or heart. Warfarin can cause particularly severe bruising, especially if the level of the medication becomes too high. Cortisone medications, such as prednisone, promote bruising by increasing the fragility of the tiny blood vessels in the skin. In addition, patients with inherited clotting problems (such as in hemophilia) or acquired clotting problems (such as in patients with liver diseases like cirrhosis), can develop extensive bruising or even life-threatening bleeding.

What does a bruise look like and why does it change color?

Bruises follow a predictable pattern and it is possible to tell by looking at a bruise how old it is. When it first appears, a bruise will be reddish looking, reflecting the color of the blood in the skin. By 1-2 days, the reddish iron from the blood undergoes a change and the bruise will appear blue or purple. By day 6, the color changes to green and at day 8-9, the bruise will appear yellowish-brown. In general, the bruised area will be repaired by the body in 2-3 weeks after which the skin will return to normal

What if the bruise doesn't get better or the area stays swollen?

On occasion, instead of going away, the area of a bruise will become firm and may actually start increasing in size. It may also continue to be painful. There are two major causes for this. First, if a large collection of blood is formed under the skin or in the muscle, instead of trying to clean up the area, the body may wall the blood off causing what is called a hematoma. A hematoma is nothing more than a small pool of blood that is walled off. This may need to be drained by your health care practitioner.

A second and much less common problem occurs when the body deposits calcium, the material that makes up the majority of bone, in the area of injury. The area becomes tender and firm. This process is called heterotopic ossification or myositis ossificans.

This condition is diagnosed by x-ray and requires a trip to your health care practitioner.

What is the treatment for bruising?

There are a couple of things that you can do to prevent or minimize bruising after an injury. First, try a cold compress. Put ice in a plastic bag, wrap the bag in a towel (applying the ice directly to the skin can cause frostbite), and place it on the injured area. Commercial ice packs are also available, but a bag of frozen peas makes an excellent substitute. It moulds to the shape of the injured area and can then be re-frozen and used again (but don't eat them!!). The cold reduces the blood flow to the area and therefore limits bleeding into the skin and reduces the size of the bruise. The cold also decreases the inflammation in the area of the injury and limits swelling in this way as well. If possible, elevate the area above the level of the heart. The lower an extremity is below the heart, the more blood will flow to the area and increase the bleeding and swelling.

Avoid taking the medications listed above that can contribute to bruising. If you have any questions about whether or not your medication can contribute to bruising, ask your health care practitioner. Do not stop any prescription medications without first contacting your health care practitioner.

Finally, pressure applied to the area (by hand, not with tourniquets) can reduce bleeding.

People who take medicines that reduce clotting ("blood thinners") or have clotting abnormalities should seek the advice of a physician or other health care provider immediately, as should the elderly or those who have experienced significantly severe trauma

a ) Easy Nutrition :

You've heard it all before about what NOT to eat. Now you need to know what to do that works for you. It's gotta be easy and fast.

Fruit totally works.

You just pack it and go. Sure, you know you have to eat other stuff but when you need something quick it's the best. Getting enough fruit (and most people don't) is part of a balanced diet that includes vegetables, whole grains, dairy products and both plant and animal protein sources. Good nutrition makes you feel good, look good and helps you do what you want to do. Fruit has amazing stuff in it called anti-oxidants and phytochemicals. These natural factors really work for you and give max protection against getting sick.

Into sports? Fruit is the perfect energizer that will help you perform.

Want to stay at a healthy weight? Fruit will fill you up without tons of calories.

In a rush in the morning? You can make a super fast no hassle breakfast. Combine a banana, yogurt or milk and maybe blueberries or strawberries and blitz it in the blender. It tastes awesome and you can drink it on the way to wherever.

It's your body so you choose. If you want the benefits of fruit, go for at least 2 or 3 servings a day. A serving example is one apple, banana or orange or half a cup (125 ml) of REAL juice (not pop). If you are diabetic, maybe talk with your dietitian or doctor before changing your diet around too much.

b) The two smartest health decisions you can make :

There are no big secrets to helping yourself stay healthy. Two large factors are to stop smoking, and be more physically active. Understanding just how beneficial they are to your overall health picture may help you, or someone you care for, start to make these changes. They're definitely for the better.

•  Quit Smoking
Smoking is the largest preventable cause of death and disease in Canada. It causes close to one in five deaths. Stopping smoking is about the best possible thing you can do for your body--and you can quit if you're determined. You'll notice changes fast when you do. In as little as a month, you'll find you can exercise longer, and you won't catch colds or flus as frequently. The long-term benefits are huge. You're at less risk of heart attacks, strokes, cancer, lung disease, impotence, osteoporosis (brittle bones), infertility in both men and women--and excess facial wrinkles. When you smoke, it's not just yourself you're hurting. Your partner and children have a higher risk of lung cancer, and spouses are more at risk of heart attacks. You're also putting your children at risk of sudden infant death syndrome (SIDS), asthma, middle ear infection and respiratory infections. Also, your own kids are more likely to smoke if they see you puffing away.

•  Exercise More
Exercise is essential to good health. Only one in five people are active enough, and one in eight die earlier than they should because they didn't get enough regular physical activity. The benefits of a regular exercise program are enormous. Experts agree it can help prevent major diseases such as heart disease, stroke, high blood pressure, type II diabetes (adult onset), osteoporosis (a condition of thin, brittle bones in older people), colon and breast cancer, obesity, osteoarthritis, depression, anxiety, and possibly prostate cancer too. Exercise also helps you feel better in other ways. It reduces fatigue, muscle tension, the effects of stress, and your chances of catching a cold. It also helps you sleep better, and improves your immune function and stamina.

a) Nutrition :

Eating well is the foundation of good health. The old saying "you are what you eat" is true, so it's only natural that we should all strive to build our bodies with the best materials we can. Not only is eating well crucial for the proper growth and functioning of our bodies, a healthy diet protects from many diseases as well. The risk of heart disease, stroke, osteoporosis, and many forms of cancer can be lowered by a good diet. As well, high blood pressure can often be prevented or controlled by a healthy diet, and a good diet will also help keep weight down.

Nutrients

Food is composed of protein, carbohydrates, fat, fibre, and vitamins and minerals, all of which perform specific functions in our bodies.

Protein is the building block of our bodies and makes up our muscles and other tissue. Foods that supply protein include whole grains, beans, nuts, dairy products, meat, poultry and fish.

Carbohydrates are the sugars and starches that provide our bodies with the fuel they need to move and function. Whole grains, beans, fruits, and vegetables are all sources of carbohydrates. Canada 's Food Guide to Healthy Eating recommends that 55% of our calories come from carbohydrates, which means over half of what we eat each day should be from the carbohydrate family.

Fats are needed by our bodies to provide energy and insulation from the cold. However, most of us get too much fat through our diet. No more than 30% of calories should come from fat. Most red meats, many dairy products (such as whole milk, cream, and most types of cheese), nuts, fried foods, and most processed foods are all high in fat. High proportions of fat are also found in butters, oils and most salad dressings.

Fibre moves the food along the bowels and absorbs harmful chemicals from the bowel. It is only found in plant foods. Grains, beans, fruits, and vegetables all contain fibre. Vitamins and minerals are micronutrients that our bodies need for normal growth and function. All natural foods, including fruits, vegetables, meat, and dairy products contain vitamins and minerals. Highly processed foods such as chocolate bars and sugary foods contain little or no vitamins or minerals.

Tips for Healthy Eating

Choose foods that are low in fat.
High-fat diets (especially a diet high in animal fats and cholesterol) can cause heart attacks and strokes and may cause some cancers. Avoid fatty meats (such as ground beef), high-fat dairy products (such as cheese, cream, and whole milk), fried foods and high-fat baked goods (donuts, most muffins, and pastries). Instead, eat more lean meats such as chicken or turkey (without the skin), fish, and beans, for protein sources.

Choose foods that are high in fibre.

Fibre protects against heart disease and stroke and is an important part of our diet. However, most people only get about half of the recommended amount of fibre. Whole grains, beans, fruits, and vegetables are all high in fibre.

Eat lots of fruits and vegetables.

Increase your intake of dark green and orange vegetables and orange fruits. They are very low in fat and are full of vitamins, fibre, and phytochemicals (the nutrients found only in plant foods that protect your health). Research shows that people who eat lots of produce have a much lower incidence of heart disease, high blood pressure, stroke, diabetes, colon cancer, and osteoporosis than people who eat meat.

Ensure you get enough calcium.

Calcium helps prevent osteoporosis, lowers blood pressure, and may protect against colon cancer. Foods that are rich in calcium include low-fat dairy products (such as skim milk, low-fat yoghurt, and low-fat cheese), broccoli, kale, almonds, and figs. Many people, especially women, don't get enough calcium in their diet. If you cannot get enough calcium through your diet, you may need to consider taking calcium supplements. Talk to your pharmacist or doctor about how much calcium you should be getting. Limit the amount of salt and salty foods you eat.

High salt intake has been linked to the development of high blood pressure in some people. Although limiting use of the salt shaker will help, much of our salt intake is hidden in processed foods, such as soup and frozen foods, so check the labels for salt content.

Moderation is key.

There is no harm in occasionally having treats that are high in fat or sugar provided you do not overdo it. If you are going to have the occasional high-fat meal, enjoy it and don't feel guilty. One unhealthy meal won't make a difference to your overall health if you generally eat well.

Recommended Daily Servings
Canada 's Food Guide to Healthy Eating gives the following recommendations for daily food intake for adults and children over age four. The range of servings reflects differences in people's size and activity level. Higher amounts are for more active or larger people, while the smaller amounts are for smaller or less active people. Children and teenagers usually eat more servings for their size because they are growing.

Fruits and vegetables.

Five to ten servings a day from the fruit and vegetable category are recommended. Examples of one serving are one medium-size piece (apple, banana, carrot or potato), 1/2 cup (125 mL) of fresh vegetables, 1 cup (250 mL) of salad or 1/2 cup (125 mL) of juice.

Grains.

Try to get five to twelve servings a day of bread, cereals and grains. One serving is equal to one slice of bread or 3/4 cup (175 mL) of hot cereal. Two servings equal 1 cup (250 mL) of pasta or rice, or a single bagel, pita bread, or bun.

Dairy.

Two to four servings of dairy a day are recommended. Pregnant women should aim for three to four servings. A typical serving size is 1 cup (250 mL) of milk, 2 oz. (50 g) of cheese or 3/4 cup (175 mL) of yoghurt.

Meat, fish, and meat alternatives.

You should get a total of two to three servings of meat, fish, and meat alternatives a day. Serving sizes are 1/2 to 1 cup (125 to 250 mL) of beans, 1/3 cup (100 g) of tofu, 2 tbsp. (30 mL) of peanut butter or 2 to 4 oz. (50 to 100 g) of meat, fish or poultry.

Weight Reduction
The best way to lose weight is to exercise regularly – at least a half hour of moderately intense physical activity, such as brisk walking or swimming, most days of the week.

Reducing the amount of fat you eat and alcohol you drink are healthy choices that can help you lose weight. However, losing weight through dieting alone is often only a temporary solution, and the weight does not tend to stay off. If you want to lose weight by dieting, make sure you get all the essential nutrients your body needs, especially calcium.

Meal Replacements
Meal replacements are canned liquid products, such as Ensure, that are high in calories and packed with vitamins and minerals. They are generally reserved for people who have difficulty eating enough food, such as people with cancer, people who have recently had surgery, people who have lost a lot of weight, or people who have difficulty swallowing. They should not be used in place of healthy nutrition in the way of snacks or extra calories for athletes, although some people occasionally use them this way. Consult your doctor or a dietician before using these products regularly.

Pregnancy and Nutrition
During pregnancy, good nutrition is especially important to support the mother and fetus. Women who are pregnant or planning to become pregnant need adequate folic acid intake (one of the B-complex vitamins found in dark leafy greens, kidney beans, and whole grains) to help reduce the possibility of birth defects of the spinal cord. Women who are not confident that they are getting enough folic acid in their diets should take a daily folic acid supplement of 400 micrograms starting at least one month before pregnancy. Talk with your doctor or pharmacist before starting folic acid supplements.

Women also have increased calcium, iron and Vitamin D needs during pregnancy. Your doctor or health care practitioner can help you plan a diet that ensures you get the quantities of food servings you need.

Children and Nutrition
Good nutrition made up of a healthy and varied diet is important to your child's health.

Children often prefer highly-processed and high-sugar foods (such as hot dogs and other processed meats, and sugary treats) which have little nutritional value. Limit the amount of processed food you give your children; instead give them vegetables, fruits, and grains for snacks and meals.

For children up to age four, separate nutrition guidelines exist. Talk to a dietician or a nurse at your local public health clinic for these guidelines, or if you have questions about children's nutrition.

Self Care Precautions
Do not severely cut back on the amount of food you eat without first discussing proper nutrition with a dietician or your doctor. You may deplete your body of important micronutrients.

Most of us have encountered that claim at some point in our lives, usually while contemplating a mound of unpalatable peas or spinach. And even as children we knew it was the vitamins in those unappealing greens that were the important thing.

Essential vitamins are nutrients we have to get from food because our bodies can't produce them from scratch. And although we only need tiny amounts of these compounds every day, they are required for many of our body's vital functions.

For children, vitamins are crucial for the demands of their growing bodies. And for all of us, vitamins help our blood to clot, our eyes to see and our teeth and bones to stay healthy and strong.

In general, we can get all the vitamins we need by just eating a healthy and balanced diet. But supplementing that diet with a daily multivitamin is probably a good idea, especially for adults. There is growing evidence that some vitamins may play a role in helping prevent cancer, heart disease, osteoporosis, and other chronic diseases.

Here's a look at some of the main vitamins and what they do.

Vitamin A
We're all familiar with the claim that eating carrots – a source of vitamin A – is good for our eyesight, especially in dim light. Vitamin A is also important for the health of our white blood cells, bones, skin, and the tissues that line the inside of our bodies. We get vitamin A from a wide range of foods, including dairy products, fish oils, fruits and vegetables. If you use supplements, avoid taking too much of this vitamin as an overdose can cause some unpleasant reactions. Talk to your Live Well pharmacist to learn about the appropriate amount for you.

Vitamins B6, B12 and Folic Acid
Folic acid is an important vitamin, especially for pregnant women, as it significantly reduces the risk of some birth defects. Together with vitamins B6 and B12, folic acid may also play a role in reducing the risk of heart disease, colon cancer and breast cancer. Folic acid is found in green, leafy vegetables and is added to many foods. Vitamins B6 and B12 are obtained from a variety of foods, including chicken, eggs and fish.

Vitamin C
Vitamin C was only discovered in 1932, but people have known about the importance of citrus fruits in our diet for hundreds of years. Vitamin C is essential for the health of our bones, teeth, gums and blood vessels, and plays an important role in fighting viruses. Although some people have argued that megadoses of vitamin C can prevent colds, research has failed to prove that claim. Vitamin C is found in most fruits and vegetables.

Vitamin D
Unless you take a 15-minute walk in the sunshine every day (and who in Canada can manage that?) chances are you're not getting your daily, recommended dose of vitamin D. Although you can also get it from dairy products, cereal, and fatty fish like salmon and tuna, to make sure you get enough vitamin D it may be a good idea to supplement your diet with a multivitamin. For kids, vitamin D is essential for the healthy growth of bones and teeth. Not getting enough can cause rickets and such conditions as bowlegs and knock-knees. Among adults, insufficient vitamin D is associated with osteoporosis and an increased risk of some cancers.

Vitamin E
Although many people have thought vitamin E might help prevent heart disease, dedicated research has not proven that claim. Still, there is support for a connection between vitamin E healthy hearts. In our diet we get vitamin E from such foods as corn, nuts, leafy greens, and vegetable oils.

Vitamin K
Vitamin K is necessary for helping our blood to clot and for making our bones strong. A deficiency in this vitamin is linked to an increased risk of bone fractures. Recent studies have shown that although most adults get their vitamin K requirements from their daily diet, a significant number of children in North America don't get the amount their growing bodies need. Vitamin K is obtained from many different foods, including leafy green vegetables and cooking oils.

c) You Are What You Eat :

It's true -- the food on your plate plays a significant role in your health. Poor nutrition can cause heart disease, stroke – and one in three cancer cases.

Why risk it when eating a healthy diet is so easy?

Learn to love your broccoli. Vegetables and fruits are nutrition powerhouses, packed with vitamins, fibre and health-giving nutrients that can help prevent heart disease, high blood pressure, and some cancers.

Cut back on fat, especially animal fat. Say "no" to fried foods, red meat, whipping cream and your morning cream cheese danish.

Consume enough calcium (especially if you are a woman). Low-fat dairy products, canned salmon (eat the bones too!) and tofu are all good sources.

Eating a variety of different foods will make meals more intriguing, and will help your health. Canada 's Food Guide recommends that anyone over four years old should eat the following every day. Choose the number of servings based on your age, weight, and how active you are.

• 5 to 10 servings of fruits and vegetables. A serving means a medium size apple, banana, carrot or potato, half a cup of fresh vegetables or juice, or a cup of salad.
• 5 to 12 servings of bread, cereals and grains. One serving is a slice of bread or 175 mL/3/4 cup of hot cereal. Two servings is 250 mL/1 cup of pasta or rice or one bagel, pita bread or bun.
• 2 to 4 servings of dairy products (3 to 4 if you're pregnant). A typical serving size is 250 mL/1 cup of milk, 50 g/2 oz. of cheese or 175 mL/ 3/4 cup of yoghurt.
• 2 to 3 servings of meat, fish and meat alternatives. A serving is 125-250 mL/1/2 to one cup of beans, 100g/1/3 cup of tofu, 30 mL/2 tablespoons of peanut butter or 50- 100g/2 to 4 oz. of meat, fish or poultry.

d) Eat Well :

What you put on your plate plays a hugely important part in the state of your health. We really are made up of what we eat, and the better the bricks and mortar, the stronger the building. Besides, sensible nutrition does more than help you stay at your peak. It can also lower your risk of heart disease, stroke and cancer, and often control--or even prevent high blood pressure and high cholesterol. Eating healthily also helps keep your weight down, and reduces the chances of osteoporosis (brittle bones).

What's healthy, and what isn't? Just pick up a magazine or turn on the TV--there's plenty of information around, Confused? You don't have to be. If you want to put easy, tasty, and healthy meals on your table, all you need do is follow a few simple guidelines:

• Choose high-fiber foods which help protect against heart disease and colon cancer. Most of us only eat about half as much fiber as we should. The foods to look for? Whole grains, beans, fruits and vegetables.
• Heap your plate with fruits and vegetables. Delicious, low fat and packed with vitamins, fiber, potassium and phytochemicals (health-protecting nutrients found only in plant foods), they're a nutritional power-house. Yet only one in five of us eats enough. Aim for at least five servings a day. More is better. Even adding two servings of fruit or vegetables a day lowers the risk of stroke in most people by 25 percent. Pile on the vegetables if you want fewer health problems. Research shows vegetarians have less heart disease, high blood pressure, strokes, diabetes, colon cancer, or osteoporosis, and are less likely to be overweight.
• Get enough calcium. Many don't, especially women. Calcium helps prevent osteoporosis, lowers blood pressure, and may protect against colon cancer. You may already be getting enough by eating low fat dairy products, or other calcium sources such as broccoli, oranges, canned salmon with bones, and tofu made with calcium. If not, consider taking calcium supplements. Your doctor or Pharmasave pharmacist can advise you.
• Choose a low-fat--and low cholesterol--option whenever you can. Too much fat in your diet increases your risk of heart attacks and strokes, and may cause colon and prostate cancer. The foods to cut back on? Fatty meats, high fat dairy products, fried foods and high fat baked goods. In their place, try lean meats, poultry, fish, dried beans, peas and lentils. All are good protein sources.
• Go for variety. Try kale or papaya instead of your usual fruits and vegetables. Experiment with different grains like barley, millet, or quinoa. And treat yourself once in a while. If you generally keep a careful eye on what you eat, an occasional slice of Triple Threat chocolate cake, or a burger and fries, won't affect your overall health.

e) Physical Activity And Fitness :

Everyone needs physical activity for the best health, but with all the convenience of modern living and the fact that most of us do non-active work. The good news is that you don't have to spend a lot of time, or exercise intensely to reap the benefits of physical activity.

Regular physical activity will make you feel better and can help you in almost every aspect of your health. It reduces the risk of heart attack, stroke, diabetes, osteoporosis, depression and anxiety, and certain forms of cancer such as bowel and breast cancer. Regular physical activity also reduces the effects of stress, can lower blood pressure and cholesterol, and may also reduce pre- menstrual symptoms. Regular physical activity will also brighten your mood and help you think more clearly.

Exercise Basics
How much do I need?

The more exercise you do, the better, but even a small amount can have health benefits. Most people should aim for 30 to 60 minutes of moderate effort activities (such as brisk walking, swimming, yard work, or cycling) most days of the week.

You can accumulate your daily time total through 10-minute segments through the day if that is more convenient for you. So if you aim to be active for one-hour per day, six 10-minute exercise sessions can solve the problem of finding one whole hour to exercise in. Try shorter periods of activity such as walking up stairs instead of taking an elevator, or walking instead of driving the car.

Which exercise should I choose?

Choose an activity with an intensity and frequency that you are comfortable with. For example, if you haven't exercised in years, you might want to start with easy walking, then gradually increase the speed you walk, the distance you walk, or start to include hills on your walk.

The Three Areas of Physical Activity
Your fitness plan should include a balance of activities from three major activity areas:

• Endurance
• Flexibility
• Strength

Endurance
Endurance activities will help your heart and lungs and your overall sense of well being.

Light-effort activities such as easy walking, light gardening, or stretching need to be done for 60 minutes all or most days of the week to give you health benefits. With these activities you should start to feel warm and have a slight increase in your rate of breathing.

Moderate-effort activities such as brisk walking, swimming, yard work, or cycling should d be done 30 to 60 minutes most days of the week. Why not turn a coffee break into 10 minutes of brisk walking? With moderate activity you should be definitely feeling warmer and breathing quicker.

Vigorous activities include jogging, hockey, basketball, and aerobics, to name a few. Because of the increased intensity, you only need to spend 20 to 30 minutes four days a week doing these activities to keep healthy. You should feel warm or be perspiring, and be somewhat out of breath when you are finished.

The times and intensities of endurance activities can vary considerably. In general you need to spend more time with light activities than with vigorous activities. Be sure to wear comfortable gear, and when necessary, safety equipment (such as a bicycle helmet for cycling).

Flexibility

Flexibility activities keep your joints and muscles healthy and mobile and also help prevent sports injuries. Stretching, yoga, dance, Tai Chi, and golf will all help you maintain flexibility.

It is best to do flexibility activities four to seven days a week. If you are doing stretching exercises, it is best to warm up your muscles first by doing a light warm-up like easy walking first. Get advice from a fitness professional or a reputable book for guidance on how to stretch safely.

Strength

Strength activities help your bones and muscles stay strong. Climbing stairs, heavy yard work that includes lifting, and weight training will all help you build strength.

Aim to do strength activities two to four days of the week with a full day of rest in between heavy workouts. If you are weight training, try for eight to ten repetition with the last repetition causing a feeling of tiredness in your muscles. If you are not sure which muscle groups to use or how to start, most community and recreation centres have fitness staff that can give you some advice.

Exercise Safely
Start gradually. If you are not used to physical activity, start at an easy pace for no more than 10 to 20 minutes for the first week or two and build up to your goal by increasing time or intensity by 10% each week.

Don't over-exert. Beginners should keep their heart rates below 70% of their maximum heart rate. Advanced exercisers should stay below 90%. To determine your maximum heart rate, subtract your age from 220.

Warm up. Begin all activity with a warm-up (your activity at half your normal intensity) for five minutes and then gently stretch the muscle groups you are using.

Drink up. Make sure you are drinking enough fluids. Don't wait until you are thirsty. Drink at last two glasses of water before you start, then more during and after activity.

Don't over-heat. Limit your activity if it is very hot and humid.

Cool down. End with a five minute cool-down session (such as slow walking).

Tips to Stay Motivated for Physical Activity
Keep at it. The secret to getting health benefits from exercise is to participate regularly for the long term.

Find a partner. This can make your exercise time more enjoyable and you are much less likely to skip if you know someone is counting on you to show up.

Be prepared for lapses. It is inevitable that travel, illness, or unexpected events will occasionally cut into your activity time. Don't be discouraged; a few missed sessions will not set you back. Continue as soon as you can.

Keep track of your progress. Seeing improvements in your progress is great encouragement and will increase your chances of continuing. Expect the greatest rate of improvement in the first three months.

Rewards yourself. If you have stuck with your schedule for a long time, reward yourself with a gift or dinner.

Plan and organize. Write your activity times in your calendar so that they have pre-planned and dedicated times.

Avoid boredom. Change your routine every two or three months if you like. It really doesn't matter what kind of activity you do, as long as you do enough of it.

Get help. Consult a personal trainer or coach to help stay with your program if you are having problems sticking to your plan.

Physical Activity and Pregnancy
As long as you are healthy, you can and should be physically active during pregnancy. Among its many benefits, physical activity may reduce the chances of complications during labour, prevent constipation and varicose veins, give you a sense of well-being, and leave you in better shape after labour. In general, low-impact exercises (like walking and swimming) are best. Dangerous sports (such as contact sports, waterskiing, scuba diving, and downhill skiing) should be avoided. Talk with your doctor or midwife about activities that are right for you before you increase your activity level.

Physical Activity and Children
Two of every three children do not get enough exercise, which may contribute to later weight gain and other medical conditions, so parents should encourage more physical activity in your child's daily routines. Limit television, video games and computer time. Be creative and involve your children in active pastimes that give you a workout as well, like cycling or a game of tag.

Physical Activity and Aging
"You're never too old to become physically active. Much of what we consider as normal aging - increased weight, less energy, less endurance, and poor sleep habits - are actually due to a lack of physical activity over a lifetime. Exercise, even started later in life, can reverse or delay some of the physical aspects of aging."

When to Seek Medical Attention
Stop exercising immediately if you have chest pain or unusual pain anywhere, unusual shortness of breath, feelings of being lightheaded, erratic heart beats, or unusual fatigue. As these symptoms may signify heart attack, you may want to consult a doctor. If they persist call an ambulance.

a)Angina :

Angina (also called angina pectoris) is chest pain caused by a temporary decrease in the supply of oxygen to the heart. If the lack of oxygen in the heart muscle is severe or prolonged, the angina progresses to a heart attack, which causes permanent damage to the heart muscle. Angina is most commonly caused by fatty deposits forming along the walls of the arteries that carry blood to the heart. This restricts the flow of blood to the heart muscle.

Angina may occur for other reasons such as:

• Abnormal heart rhythms that reduce the heart's pumping action.
• Low levels of hemoglobin (anemia), the oxygen-carrying molecule in the blood, can reduce the amount of oxygen to the heart.
• Some thyroid conditions such as an overactive thyroid (Grave's disease).

Though angina may occur when a person is resting, it is more likely to occur during physical activity, exposure to cold air, or when a person is emotionally upset.

Who Gets Angina?

Angina is most common in men and women over 55 years of age, especially those who have heart disease risk factors. Angina rarely happens to younger adults.

Risk Factors for Developing Angina

• Smoking
• Regular exposure to second hand smoke (such as living with a smoker)
• Diabetes
• High blood pressure
• Family history of premature heart disease or stroke. (If your father or brother has heart disease or stroke before age 55 or your mother or sister before age 65, this is considered premature.)
• Being overweight by greater than about 30 lbs (13.5 kg) over ideal body weight or having a waistline greater than 100 cm (40 inches)
• Being physically inactive
• Having high cholesterol
• Having chronic stress and/or few social supports in your life
• Poor dental hygiene
• A history of clinical depression

Symptoms

Pain, severe or mild, is typically described as either a crushing feeling ("like having an elephant on your chest") or tight feeling ("like a band around your chest"). The pain is usually centred behind the breastbone. The pain may radiate to the jaw, throat, shoulder, back, or arm. This pain may also be accompanied by shortness of breath.

Diagnosis

A doctor diagnoses angina by listening to a person's story, examining them, and then ordering the appropriate tests such as a heart tracing (ECG) or treadmill stress test. In this test, a person walks briskly on a treadmill while the examining physician looks for signs of angina on the heart tracing.

Prevention

Lifestyle Factors

• Quit smoking
• Engage in physical activity such as regular aerobic activity (brisk walking, jogging, swimming, or biking) for a minimum of 30 to 60 minutes, most days of the week. If you are over 65 or have an illness, check with your doctor before starting or increasing your exercise program.
• Keep weight in normal range.
• Take time to relax and participate in leisure activities. Stress and social isolation can worsen the risks of angina. Research shows that meditation can both reduce high blood pressure and angina pains.
• Any episodes of clinical depression should be identified and treated. If you're feeling down or depressed, talk to your doctor. There are a number of things he or she can suggest to help you.
• Have your blood pressure checked once a year.

Diet and Supplements

• Eat foods that are low in fat and cholesterol, and high in fibre.
• Eat a variety of foods and be sure to get at least five servings a day of fruits and vegetables.
• Eat a diet rich in folic acid (such as dark leafy greens, dried beans, whole grains, and orange juice). Folic acid may help reduce heart disease risk.
• Increase your intake of soy products. They help to reduce cholesterol.
• If you eat out, ask your local Heart and Stroke Foundation for a list of Heart Smart restaurants in your area.
• Drink moderately (two drinks or less per day to a maximum of 9 drinks per week for women and 14 drinks per week for men). Moderate alcohol consumption may provide some protection for people over 35 with heart disease risk factors. However, do not start drinking or increase the amount you drink in order to help your heart.

Medications

• Cholesterol-lowering medications help prevent angina in some people

Concurrent Medical Conditions

If you have high blood pressure, diabetes, high cholesterol, clinical depression, or you are overweight, work with your doctor and pharmacist to keep these conditions under control through lifestyle modification or medication.

Managing Angina

The Goals of Treatment Are:

• To reduce the symptoms of angina
• To reduce the complications that can develop from angina, such as heart attacks

Here are five important steps you can take to help manage your health after a heart attack:

1. Educate Yourself

Consider attending a course to learn about diet, exercise, and medication that will help you have a healthy heart.

2. Adjust Your Lifestyle

You can make a number of lifestyle modifications to help prevent worsening of angina and reduce the risk of future heart attacks (see the Prevention section).

3. Understand Your Treatment

Medications
Nitroglycerin is a medication that relaxes the arteries of the heart, permitting more blood and oxygen to get through any blockages. It can be used on a regular basis as a skin patch or paste. It can also be sprayed under the tongue as needed for relief from angina pain. If you are taking nitroglycerin in the form of tablets, be aware that they lose their strength after the bottle has been open for three months.

Other medications, such as beta-blockers (i.e. atenolol, metoprolol) and calcium channel blockers (i.e. amlodipine, diltiazem, nifedipine), are taken on a daily basis to help the heart work less hard and reduce the amount of oxygen used, which helps prevent angina.

Taking acetylsalicylic acid (ASA, Aspirin®) daily can also reduce the risk of heart attacks. Check with your doctor or pharmacist before starting any regular ASA use.

Surgery
If medications cannot control angina, some people have surgery to open the heart's arteries. In open-heart surgery, the heart's blocked arteries are replaced by blood vessels taken from elsewhere in the body. This surgery is named coronary artery bypass graft (CABG). Another form of surgery is angioplasty. Here a very small catheter is passed through the leg's artery up into the heart and the arteries are stretched open to permit more blood flow to the heart muscle.

4. Use Your Medications Properly

It is important to take medication exactly as prescribed to receive the full beneficial effect. If you are having any difficulty with side effects or are uncomfortable with taking medication, talk with your doctor or pharmacist before stopping them.

5. Monitor Your Condition

If you have been diagnosed with angina, it is very important to see your doctor regularly. Your doctor will schedule regular visits to monitor your condition.

Pregnancy and Angina

Being pregnant is not a risk for angina.

Children and Angina

Children are not at risk for angina.

Emergency Symptoms and Treatment

If your chest pain lasts longer than 15 minutes or you still have chest pain after using your nitroglycerin spray or tablets for three doses as prescribed, you may be having worsening angina or a heart attack. Any suspected heart attack is an emergency, so call for medical attention immediately. Delays in seeking medical treatment for heart attacks costs thousands of lives every year. If there is any doubt, contact medical help as fast as you can as chances of surviving a heart attack are very good if medical care is accessed quickly enough.

If you are with a person who stops breathing, start cardio- pulmonary resuscitation (CPR). If a member of your family has angina or is otherwise at risk for heart attacks you may want to take a CPR course.

Symptoms of a heart attack include:

• Prolonged pain, severe or mild, typically described as a crushing feeling in the chest (like a heavy weight on your chest) or tight feeling in the chest (like a band around your chest). The pain is usually centred behind the breastbone and may radiate to the jaw, throat, shoulder, back, or arm. In women, the pain may be more vague.
• Shortness of breath
• Nausea, indigestion, vomiting, or sweating
• Anxiety
• Increasing episodes of angina (short episodes of chest pain), especially those not brought on by exertion, or relieved with medication

Sometimes a heart attack can occur without the usual symptoms. Seek medical attention immediately if you have upper abdominal pain or heartburn for more than half an hour — especially if you are over age 50. The chances of surviving a heart attack are very good if you are treated quickly.

b) Quitting :

Facts and Stats

· Tobacco smoke contains over 4,000 chemicals, including at least 50 that cause, initiate or promote cancer. These include tar, ammonia, carbon monoxide, oxides of nitrogen, and benzopyrene.

· Although the amount of chemicals in each cigarette is small, it is cumulative - the amount stored in the body actually increases with each puff of a cigarette.

· There is a little bit of chemical in each cigarette puff, and there are over 10 puffs per cigarette. Over a year, at one pack of cigarettes a day, a smoker will inhale 73,000 puffs of dangerous chemicals.

· Research has found that children of smokers were almost twice as likely to smoke as children with parents who never smoked.

These reasons alone should be enough to make you never touch a cigarette again. Did you know that the day after you stop smoking your body begins to rid itself of tobacco toxins? Unfortunately, smoking is extremely addictive; some people try again and again to quit, but end up back smoking after a few days or months. However, by choosing the right method, having a lot of determination and support you will be able to stop smoking for good. There are many options to choose from when you decide to quit smoking and it may take a few tries. The important thing to remember is: don't give up!

Taking the First Step

Talk to your physician or Live Well Pharmacist about your decision to quit smoking. Together you can determine which smoking cessation method is right for you.

Patch It

A nicotine patch continuously delivers a small amount of nicotine through your skin to help take the edge off the effects of quitting. However, because you don't get large amounts of nicotine and it is delivered continuously (instead of the peaks and valleys in nicotine levels that occur with smoking), you may still have cravings to smoke or experience some withdrawal. People typically start with a patch strength that delivers close to the same amount of nicotine as they usually get smoking. After 4-6 weeks, step down to a lower strength to slowly wean off.

Nicotine Gum

The gum works by replacing nicotine when you get a craving you can't ignore. Rather than lighting up, you chew a piece of gum. It has little pockets of nicotine so with each chew you get the nicotine that you would get with one puff. One piece of gum is about equal to one cigarette in nicotine and duration. The act of chewing gum can be a soothing distraction. Don't chew it like bubble gum, though; proper technique requires a couple bites, parking it between your cheeks and gums for 30 seconds, and repeating the cycle until the craving passes. Each piece only has enough nicotine to last 30 minutes.

Inhaler

Oral inhalers are a newer form of nicotine replacement therapy. The inhaler delivers nicotine into the mouth and produces a sensation in the back of the throat similar to that produced by tobacco smoke. This form of cessation sends nicotine to the bloodstream in a matter of minutes, and dosage can be adjusted to individual withdrawal symptom levels. Using the inhaler also helps with the “hand to mouth” habit many smokers rely on. It is important not to smoke cigarettes or use other forms of tobacco if you decide to use an oral nicotine inhaler.

c) Quit Smoking :

Nothing pays as many health benefits as quitting smoking, and it is the most preventable cause of death and disease.

Anyone can quit if they are determined and ready to do it. There is no one best way of quitting smoking – different methods work for different people, and you may have to try several different approaches before you find the one that works for you. Some people have to try their preferred approach several times before they quit for good. This brochure reviews the many good reasons to quit smoking and gives practical ideas to help you quit.

The Risks of Smoking

Cigarette smoke contains over 4,000 chemicals, including cancer-causing and toxic chemicals. The nicotine in tobacco causes addiction and acts as a stimulant (in lower doses), increasing heart rate and blood pressure. The degree of addiction a person has depends on how much and how long he or she has smoked.

The long-term risks of smoking are well documented. Smoking causes heart attacks and strokes. It also causes cancer. Lung cancer is mainly a disease of smokers, and cancer of the throat, mouth, lips, voice box, esophagus, pancreas, bladder, cervix, and leukemia can also be caused by smoking. Smokers are more susceptible to chronic bronchitis, emphysema, ulcers, and osteoporosis (brittle bones). Smoking also causes premature facial wrinkling and impotence.

There are also a number of short-term risks related to smoking. Smokers suffer from more colds and flu, worsened asthma, and shortness of breath. Smoking may also cause temporary infertility for both men and women.

Smoking damages not only your health, but also the health of those close to you. The spouses and children of smokers are at an increased risk of lung cancer. Spouses also have a higher risk of heart attacks. There is an increased risk for sudden infant death syndrome, asthma, middle ear infection, and respiratory infections in children of smokers, and the children of smokers are much more likely to take up smoking when they get older.

The Benefits of Quitting

Health Benefits

• Coronary heart disease risk is halved one year after quitting; after five years, risk returns to that of a person who has never smoked
• Stroke risk is reduced to almost that of a non-smoker after five years
• Risk of cancers of the mouth, throat, esophagus, bladder, and cervix are halved about five years after quitting
• Risk of death from lung disease is reduced to almost normal 15 years after quitting
• Ulcer risk is reduced after quitting
• For women who quit before pregnancy or during the first trimester, the risk of a low-birth-weight baby is reduced to that of a woman who has never smoked

Other Benefits

• Better health for your children
• Improved physical condition and improved sports performance
• Greater ability to taste food and an improved sense of smell
• Significant cash savings
• Improved smell of home, car, breath, and clothes
• Decreased fire hazards

Understand Why and When You Smoke

Why people smoke involves a complex mix of psychological reasons and physiological addiction to the nicotine. By understanding why you smoke, you can find alternatives to smoking and help yourself quit. For example, if you smoke to relax or relieve tension, try unwinding through physical activity, relaxation tapes, breathing exercises, or social activities. If you smoke in social situations, avoid bars and try to temporarily socialize more with friends who don't smoke. If you smoke to do something with your hands, have a substitute object to play with like a pen or lollipop.

Lifestyle Modifications to Help You Quit

Gradually cut down before you quit.
This will reduce your withdrawal symptoms and increase your chances of success.

Be prepared for withdrawal symptoms.
When you first quit, you can expect symptoms such as tiredness, irritability, light-headedness, coughing, and poor sleep. These symptoms are usually mild and only last for three to ten days. Prepare your environment.
Throw out all cigarettes, matches, and ashtrays on the night before you quit.

Enlist support.
Tell everyone and ask for their support - including your smoking friends.

Make a plan.
Have a specific plan of what method of quitting you will use. Decide if you are going to quit "cold turkey" or use a product such as nicotine gum or the patch.

Know when to quit.
Carefully choose your time to quit - avoid high stress periods. Weekends are a good time to quit because you are likely to be more relaxed. Set a date and prepare.

Increase physical activity.
Invigorating physical activity will help take your mind off your desire to smoke and has been shown to increase quitting rates. Try to exercise or simply go for a walk most days of the week for half an hour or more. This will also help minimize any weight gain after you quit.

Plan to eat well.
Eat healthy low-fat foods such as vegetables and fruits. Eating well will also help you avoid gaining weight after you quit.

Prepare your mind.
For the first few days to a week, you should be prepared to think of yourself as being "in rehab." Acknowledge that you are undertaking a difficult challenge and congratulate yourself at the end of every smoke-free day.

Non-prescription Products to Help You Quit

Some people quit successfully with the "cold turkey" approach, unaided by any other methods, but it does not work as well for most people who smoke more than a pack a day. Below are some non-prescription products that can help reduce your physical craving for nicotine.

Nicotine gum (e.g., Nicorette) doubles your chances of successfully quitting. The gum must be used properly to be effective. When you have a craving, chew the gum until you get a peppery taste and then "pouch" the gum in your upper cheek so the nicotine can be absorbed into your system. Repeat the chewing and pouching whenever you have a craving to smoke. You can use nicotine gum regularly for three to six months and then gradually reduce. On rare occasions, people may experience mild nausea or indigestion from swallowing saliva with nicotine in it.

Nicotine skin patch (e.g., Nicoderm, Habitrol). The skin patch delivers nicotine to your body by allowing it to be absorbed through your skin. It is placed on a hairless part of the body, usually the upper part of the inner arm, and worn at all times except when asleep. The patch doubles your chance of being smoke-free after one year, compared to people who quit without the patch. Discuss with your pharmacist which strength and brand of patch is right for you to start with.

The patch can sometimes cause redness, itching, or a burning sensation on the area of skin that it is applied to. On rare occasions it can cause other side effects such as difficulty sleeping and nausea. If you have any new symptoms while on the nicotine patch, talk with your pharmacist. Never smoke while you are on the patch. If you must restart smoking, remove the patch first. It is also best to remove the patch when engaging in vigorous exercise as the amount absorbed through the skin may increase to toxic levels. Treatment with the patch usually lasts for eight to twelve weeks, but can safely continue for longer periods if necessary.

The nicotine patch should not be used by people with skin conditions or by people with medical conditions such as a recent stroke or having had a heart attack in the last week or two. Check with your pharmacist if you have heart problems, chest pains, or any other medical condition, such as diabetes.

Complementary Treatments

Some people find hypnotism and acupuncture helpful, though no definitive research has shown them to be better than quitting unaided. If you choose these routes ask about the price, drop-out rate, and what percentage of people have stayed smoke-free after one year.

The product "Butt Out!" is available in capsules containing a powdered form of Lobelia, an herbal product that has been approved for use with smoking cessation.

How to Stay an Ex-Smoker

After you have quit, the temptation to start smoking again may be strong. Here are some tips to keep you on track:

• Congratulate and encourage yourself
• Review the benefits you are reaping
• Be prepared for the odd rough time and don't give in to "having just one"
• If you do fall off the wagon, don't be tough on yourself. Most successful long-term quitters experience a relapse. It is not a failure or an excuse to continue smoking. Dust yourself off and try again

Problems After Quitting

Sometimes people who quit smoking experience difficulties such as weight gain or depression, but there are solutions.

Weight gain. As nicotine affects the body's metabolism some people may temporarily gain weight after stopping smoking (average weight gain is 1.8kg or 4lbs). Make dietary, exercise, or lifestyle changes to decrease weight gain. Consider nicotine gum or patches as a strategy to delay weight gain while you increase your exercise and modify your diet.

Depression. As nicotine is a stimulant, some people become depressed or blue after quitting. If you feel low, discuss this with your doctor and he or she can determine if treatment is necessary.

Smoking and Pregnancy

Smoking can be damaging to an unborn baby. Pregnant women should quit as soon as they find out they are pregnant. Nicotine replacement products are not recommended for pregnant women or women who are breast-feeding.

Smoking and Children

Smokers who are parents of children should remember that second-hand smoke has many negative side effects on children. Children of smokers are at an increased risk of lung cancer, asthma, middle ear infection, and respiratory infections. Sudden Infant Death Syndrome occurs more frequently to the children of smokers. Also, if you smoke, you are modeling unhealthy behaviour for your children, and the children of smokers are much more likely to take up the habit later in life.

Self Care Precautions

People with recent stroke, recent heart attack, worsening cardiac chest pain, and serious heartbeat irregularities, among other medical conditions should not use nicotine replacement products. Check with your pharmacist if you have heart problems, chest pains or any other medical condition such as diabetes, hyperthyroidism, peptic ulcers, or high blood pressure.

The nicotine patch should not be used by people with generalized skin conditions, and nicotine gum can sometimes worsen jaw problems. Though very rare, these products can also cause fast heart beats, chest pain, shortness of breath, or fainting sensations. Stop using these products if you get any of these symptoms and see a doctor immediately.

When to Seek Medical Attention

If you don't succeed in quitting smoking with non- prescription products, there are some prescription medications that may help. Talk with your doctor about these and other choices.

Smokers continue to endanger the lives of the people around them, including those they love the most, by exposing them to second hand smoke.

A common misbelief is that the only way toxic chemicals from cigarettes enter the body is by inhaling. But that's not the case. It's the burning end of a cigarette and the exhaled smoke that contain the dangerous chemicals we breathe. Even after a cigarette is put out or the smoker leaves a room, the toxins remain – in the air, on food, furniture, drapes, carpet and skin.