The Pets We Loved

As I was wondering what to post about today, my eye fell on a cartoon I have printed out and taped to my desk wall. It has the image of St. Peter welcoming a new person to heaven- who looks to be in his 50s or 60s. Beside St. Peter is a very, very happy looking dog. The line below it says, "So, you're little Bobbie; well, Rex here has been going on and on about your for the past 50 years."

Rox, my heart dog, waiting at the window

I love that comic and I also like the Rainbow Bridge poem. I like to believe that such a place exists, where our loved animals wait for us after they've died. I want to believe it because I loved my pets so much and the loss was so profound when they left this this earth.

Animals can play such a strong role in the mental and physical health of humans. They bring comfort to people who are ill and/or who are dying. They are companion animals who help humans live a fuller life.

Pets can help lower blood pressure (as long as they're not destroying the furniture in the home!) and help ease the pain of anxiety and depression. A pet loves you for you. Not what you do, not who you are, but you.

Our Oscar, doing what he did best

For a while, I was a volunteer dog walker at the Montreal SPCA. I loved it. The dogs were so happy to get out and walk about. I got my exercise and I got to feel like I was doing something important. Some of these dogs were very sad cases, from sad backgrounds. Others were victims of circumstances beyond anyone's control. But for a few minutes, while I walked them, I could give them the love and attention that they needed and I got something back that doesn't even have a name. It was just "something."

Not everyone loves animals and pets. Some pet lovers say that this is the sign of someone that they couldn't be with. But I don't think it's so black and white. I think that as long as the person is kind and would never hurt an animal, either by doing something or not doing something, then whether they would love to have a pet isn't important. What is important is their respect for the animal's life and well being.

I live with and love someone like that. He doesn't care to have pets in the house. But when we did, he did everything that ever needed to be done to be sure that they were happy, safe, and healthy. And when the time came that they had to leave us, he mourned them as well.

Chance, a foster between Oscar and Dee

Rox was our golden retriever, my heart dog. We all loved him so much. He came to us when he was two years old - his family was "getting rid of him." What a wonderful dog he was. He left us way, way too soon, at the age of 7, from advanced stomach cancer. I still hear him, I still feel him. His soul will always be with us.

Oscar was my first greyhound. He came to us, also at two years old, straight off a racetrack in Massachusetts. He wasn't a successful racer, but he was a successful couch potato. He was so special. I wrote a book about him after he was taken from us all too early, at the age of five. Also from cancer.

Brood mom and brat, Dee

Oscar was followed by Dee. She was a nine-year-old greyhound who had been a brood mom. She had never really lived in a home. She lived with us for nine months and 17 days before she died. Not that I was counting.

No dogs followed these three. I would love to have another one. But as much as I do want another dog, part of me - a small part - kind of appreciates that my husband doesn't. Because I don't know if I can lose another one. I've lost dogs and cats as a child and then these three, along with a number of guinea pigs. It just hurts so much. I know that this pain appears because we love them so much, because they give us so much joy - but sometimes, the memory of the pain makes me wonder if I could ever do that again.

Just this side of heaven is a place called Rainbow Bridge.

When an animal dies that has been especially close to someone here, that pet goes to Rainbow Bridge.
There are meadows and hills for all of our special friends so they can run and play together.
There is plenty of food, water and sunshine, and our friends are warm and comfortable.

All the animals who had been ill and old are restored to health and vigor; those who were hurt or maimed are made whole and strong again, just as we remember them in our dreams of days and times gone by.
The animals are happy and content, except for one small thing; they each miss someone very special to them, who had to be left behind.

They all run and play together, but the day comes when one suddenly stops and looks into the distance. His bright eyes are intent; His eager body quivers. Suddenly he begins to run from the group, flying over the green grass, his legs carrying him faster and faster.

You have been spotted, and when you and your special friend finally meet, you cling together in joyous reunion, never to be parted again. The happy kisses rain upon your face; your hands again caress the beloved head, and you look once more into the trusting eyes of your pet, so long gone from your life but never absent from your heart.

Then you cross Rainbow Bridge together....

Author unknown... 

Do You Know What to Do in a Thunderstorm?

This past weekend, a young man was struck by lightning and died later in hospital. The man and his girlfriend were cycling and, according to news reports, they sought shelter under a tree when the storm passed over them.

We've all heard that you aren't supposed to be near a tree during storms, so why do so many of us do that - take shelter under one? It just seems logical to do so. It's raining, it's windy, and trees offer physical protection.

We don't see the lightning - it's not an immediate danger - so it's easy to forget about, I guess. Sadly, this ends up resulting in tragedy several times a year.

So, what should you do when you're caught in a storm and going into a safe building isn't an option?

The American National Weather Service has a webpage devoted to thunderstorm safety. Here are some of the tips if you are caught where there are no safe places to go:

Being stranded outdoors when lightning is striking nearby is a harrowing experience. Your first and only truly safe choice is to get to a safe building or vehicle. If you are camping, climbing, on a motorcycle or bicycle, boating, scuba diving, or enjoying other outdoor activities and cannot get to a safe vehicle or building, follow these last resort tips. They will not prevent you from being struck by lightning, but may slightly lessen the odds.
These actions may slightly reduce your risk of being struck by lightning:

• If camping, hiking, etc., far from a safe vehicle or building, avoid open fields, the top of a hill or a ridge top.

• Stay away from tall, isolated trees or other tall objects. If you are in a forest, stay near a lower stand of trees.

• If you are camping in an open area, set up camp in a valley, ravine or other low area. Remember, a tent offers NO protection from lighting.

• Stay away from water, wet items (such as ropes) and metal objects (such as fences and poles). Water and metal are excellent conductors of electricity. The current from a lightning flash will easily travel for long distances (See Figure 2 below).

People often ask if it is safe to take refuge in a car or truck. According to the NWS, the answer is yes, depending on the vehicle:

A safe vehicle is any fully enclosed metal-topped vehicle such as a hard-topped car, minivan, bus, truck, etc. While inside a safe vehicle, do not use electronic devices such as radio communications during a thunderstorm. If you drive into a thunderstorm, slow down and use extra caution. If possible, pull off the road into a safe area. Do not leave the vehicle during a thunderstorm. 
Unsafe vehicles include convertibles, golf carts, riding mowers, open cab construction equipment and boats without cabins.

And what if you are inside? Are you still in danger?

If you are in a safe building, one with wiring and plumbing, then you are generally out of danger when it comes to lightning strikes. You still need to take some precautions because you aren't 100% safe, but chances of being injured are low.

First, stay away from windows. It can be tempting to stand at a patio door and watch the lightning dance across the sky, but being by a window has a few dangers. A serious storm could dislodge items and send debris flying through the air, which could break windows. Trees could fall as well, so stay away from anything that could break.

It is also recommended that you:

• Stay off the phone
• Shut off (unplug if possible) computers, televisions, and other sensitive electronic equipment
• Don't take a shower or bath

While the third directive may sound odd, the reasoning there is if your building is struck by lightning, an electric current could be sent through the metal plumbing.

Do you know anyone who has been hit by lightning? My youngest son had a close call one summer; he was about 15 at the time, I think. He was out on a sailboat on what had been a beautiful day. There were no signs of storms to come when, out of the blue, a thunderstorm rolled over them before they had time to get to shore.

According to my son, there were lightening strikes that hit the water not far from the sailboat. He didn't know what to do and - thankfully - the storm rolled away as quickly as it had come in. Sailing isn't one of his favourite past times now.

Wordle Day - A Blogathon 2012 theme

Today is Wordle day for people who are participating in Blogathon 2012. The most word I thought were most common aren't what the wordle program thought. Interesting.

If you would like to make your own wordle, go to wordle.net

Here is my wordle for the blogathon:

Sunday Relaxing - Be Sure to Take that Relaxing Day

So, today is another Sunday. They do come around every seven days. :-)  Today will truly be a resting day for me because I've been quite busy over the past week. Rest is important for anyone, but it's particularly so for someone with fibromyalgia.

I heard about a chocolate festival taking place in Bromont, Quebec this weekend. It's about 90 minutes away or so. I did want to go, but I have to listen to common sense. If I go, I'm sure I'll cross over that line from very tired to fatigued. While being very tired is manageable, being fatigued isn't. So, I'll spend my day relaxing with my new sewing machine, reading, and taking it easy.

I wish I had a hammock. When I was in Mexico a year ago, my favourite activity was "hammocking." Just lying in a hammock and dozing, relaxing, listening to the sounds around me. The ultimate in relaxation, in my book.

It used to be that spending a day doing nothing was considered slothful, a sin. After all, idle hands and all that. But it's been found that true resting, taking time for yourself to be self-indulgent (within reason of course) is good for you. Relaxing helps you refocus, bring your thoughts back to where they can flow and be their own.

Relaxing doesn't mean that you have to nap or sit around doing nothing. Relaxing is what makes you happy, feel re-energized. This could mean playing physical games, going to the park and playing with your children, going for bike rides - anything that is not stressful for you.

I'm not Jewish, but I admire those of the faith who observe the Sabbath. By having a day when they do not do anything considered to be work, by staying away from electronics and the hub-hub of the modern world, they are left with time to pray, reflect, think, spend time with family. They know that they can - and will - do this every week. There has got to be something good for you there. With our 24/7 life, constant connections, many of us don't allow for that real down time.

My busy but fun couple of days

On Friday, I had the privilege of attending a day-long quilting workshop and we learned how to machine-piece a Mariner's Compass. This pattern is considered to be - and is - a difficult piece to make. It's a pattern that is often seen in prize-winning quilts and the onlookers may be heard to say, "wow, I'd love to try making a Mariner's Compass, but it's too hard."

The method I learned was a machine-pieced pattern and I learned it's not really that difficult, it's picky. You need to be very precise to get it right, but once you do get that precision, it works. Aren't so many of things in life like that? We rush through them and get so-so results, but if we take the time to think them through and do them properly, they work out in a much more satisfactory way. The wonderful instructor was Sheila Wintle.

The workshop I attended yesterday was on machine quilting. I don't like to machine quilt. I've been a hard-line hand quilter since I began quilting over 20 years ago. I've learned how to MQ and I have done it for baby quilts, placemats, and so on, but I don't enjoy the process. So, I decided I have the opportunity to learn from one of the best (Wendy Butler Berns), now was the chance. If I learned how to do it properly, maybe I would enjoy it a bit more.

What I learned was, as I said about rushing things - I was rushing things with the machine quilting. My results didn't make me happy before because I was rushing through it. I was equating machine quilting with speed quilting. It doesn't really work like that! So, although I am far from proficient now, at least I have a better idea of what to do and how to do it, and where I was making my worst mistakes.

So, this is why I need my down time today. As much fun as the workshops were, as well as taking tours around the wonderful quilt exhibit, it was tiring.

Relaxing is good. It's not a luxury. It's a must. I hope that everyone gets that chance to relax, if only a few moments, this weekend.

Happy Birthday to Me

Another year has gone by and it's birthday time all over again. Happy birthday to me!! Unlike many people who I hear bemoaning getting older, I celebrate it with all my heart. It hurts me to hear people feel badly about their age - after all, we all get older. Isn't that what we want? It sure beats the alternative.

I don't know if I feel this way because of my nursing background. I have worked with patients who died unexpectedly, years before anyone ever thought they would die and I have worked with seniors, with decades of living behind them and who have reached the end of their life. I've also worked in palliative care, where people know they are going to die and we did our best to make that passing as easy as possible. But I have also helped people get better and go on to live longer as we treated them and healed them, or we gave them tools to manage their illness so they could go on to live long and productive lives. As odd as this always sounds to me when I think it or put it into words, I've also helped save some lives by detecting sudden deterioration in patients, performing CPR, helping give life-saving medications, and more. It's a blessing to be allowed to do this.

Or maybe my belief has nothing to do with the nursing at all. Maybe I feel this way because I had a tough start and I let that tough start define me for too long. When I hit my forties, I said, "I've never been better." When I hit my fifties, I thought, "if I thought the forties were good, this fifty stuff is even better."

So far, 2012 has been amazing. I love what I do for a living. My mental health has never been better. I have learned to accept and love who I am for what I am. Although I live with fibromyalgia, I'm fine. I manage it and work with it. Of course, I'd rather not have it, but I do - so let's move forward.

I have loving friends. I have a fantastic family. I have supportive and wonderful writing colleagues who cheer my successes and support me when I'm disappointed.

I have plans, I have dreams - and as I turn 51, which will happily lead to 52, 53, 54.... I will continue to celebrate each and every passing year. Life is full of challenges, but they can be overcome. I'm proof of that.

Happy birthday to everyone, whenever your day is here. Celebrate it, don't mourn it. Without birthdays, there would be no you.

Montreal Children's Hospital Foundation Radiothon Today

No matter where you live, chances are you must have heard - at one time or another - a radiothon to help raise funds for a local children's charity, hospital or healthcare facility. Today, it is the turn of the Montreal Children's Hospital Foundation, in Montreal, Quebec, Canada.

Montreal is very fortunate to have not one, but two world-class stand-alone hospitals for children: CHU Sainte-Justine and the Montreal Children's Hospital. Both are excellent facilities that have saved thousands of children's lives and have helped families of those whose children cannot be saved.

As with most healthcare facilities, the MCH has a foundation that helps raise funds for the things that aren't provided for in the operating budget. These items range from state-of-the-art equipment to art supplies for the patients. Music therapy is funded by the foundation, as is so much more - all things to help the patients get better, if possible, and to make them feel as normal as possible - like children should feel.

So, why am I blogging about this here? Because as a writer, I play a small role in this radiothon. I was hired last year and again this year to help coordinate the appointments with the parents and to interview them to get an idea of what the MCH has meant to them. You see, when the radio hosts speak to the parents and/or child, they need to have a script of some sort, something that tells them why these people are sitting in front of them and a guide of what to ask them.

When people think of writing, they often think of writing articles or books, or - now with the Internet, writing for websites or blogs. But there are so many more opportunities to write, such as this one. Being a nurse helps tremendously with a task like this. As the parents speak with me, I know what they mean in their terminology, they don't have to explain everything. As a nurse, I can also identify with their hospital experiences, and as a mom, I can identify with the fear that a parent has when they have a sick child. While I have been very fortunate not to have any serious things happen to my family, I do know what it is like to worry when you hand over a child to a surgeon or your child is being tested for some unknown illness. It is truly frightening.

Some of the stories people will hear are heart breaking. Not all children survive their illnesses. Some are very frightening, no 5-week-old should be diagnosed with cancer. And some are inspiring, as parents and children relate their fight against illness and their successes.

If you would like to listen, the radiothon can be heard on the Montreal Astral Media radio stations, CJAD, CHOM-FM, and Virgin Radio. I would recommend listening to CJAD's feed because that is a talk radio station and they will be featuring more stories than the two FM music stations.

I'm honoured that my skills have allowed me to work on this project. I am such a lucky, lucky person.

My Blog - If I Had to Do It All Over Again

Being part of this blogathon means being offered the chance to write according to a theme on certain days. I blew off the last theme, haiku, because, well, I'm not imaginative enough for that. But today's theme is on if you were to start you blog over, how would you do it differently?

This was worth thinking about, particularly because I write mostly about health issues and there are so many health-related blogs around. So, I wondered - what would I do differently?

My first blog post was May 11, 2007 - And So I've Joined the Blogging World. I didn't realize or I would have thrown a 5th birthday party for it a couple of weeks ago. Ok, here's a belated Happy 5 Years blogging to myself:

Happy 5 Years Medhealthwriter.blogspot.com!

Now, to the point of today's post:

To come with ideas, I had to go back to remember and discover why I did what I did in the first place. For example, coming up with the name: Marijke: Nurse Turned Writer. And also, how did I come up with the medhealthwriter - which also became my domain name for my professional website (www.medhealthwriter.com).

I like Marijke: Nurse Turned Writer. An editor I know emailed me recently and told me that she liked my title - that it was short and directly to the point. In four words, I told anyone who was interested exactly who I am. And that is who I am. I think of myself as a nurse first, even though I no longer work clinically. I still use my nursing knowledge every day when I work for my clients and when I write for myself. So, I wouldn't change that.

What about medhealthwriter? Where did that come from? I had to come up with a domain name for my website and I wasn't sure what I wanted. Several of my writing and editing colleagues said that I should, must, use my name as my domain, as so many of them do. They said that it makes it easier for people to remember you and to find you. 

While this may be so if you have an easy to remember and/or spell name, I really felt that this wouldn't be the case with me. In fact, I feared that people would give up looking for me precisely because they either couldn't remember my name or they had no idea how to spell it. I needed something else that could be remembered and show what it is that I do.

I don't remember the website, but there was a place you could go to plug in words you would like to use in a domain name. It would show you if it was available. I knew I wanted something to do with medical, health, and writing, but of course - the usual combinations were already in use. 

I took the words and played with them, placing them in various combinations and if one was pleasing, I would check to see if it was available. Medhealthwriter.com was. That is what the site became. It can be a bit long to write or spell out when I am giving information. That being said, I think it's a small price to pay because I think it's a pretty good indicator, just like Marijke: Nurse Turned Writer, telling people what I do.

Ok, so those things I wouldn't change. What else did I do that might have been done differently. For sure, I would have gone with an independent blog, not blogspot. While this suits me fine enough, I dislike having to put blogspot in my blog URL. But it's not the end of the world and it definitely isn't enough of an issue for me to consider moving it. My page ranking is too high for various terms to risk playing with it.

Would I approach the information the same way? I think so. I was hired to work on medical problem-specific or health-specific blogs after I began this blog. Having a specific topic to blog about has its advantages; you're not grasping for topics. But it has its disadvantages; sometimes there is only so much you can write about a topic. 

My blog is a bit of everything health-related with some writing and personal topics thrown in to the mix. I like that. I like that there are some extremely popular topics on this blog that go as far back as 2007 that still get visited every single day as people discover them through Google and other search engines. Google "broken hips elderly" and you'll see what I mean.

Timing-wise, I was very regular with my posting for the first few years, but then I got busy working on other blogs, ones that paid. It came to a point that I started losing interest in this blog all together. That wasn't good. My posts, if I was lucky, came out once a month. Longer stretches sometimes. But what could I have done differently? I'm not sure. If I didn't want to post, I didn't want to post. 

I did have a blog roll for a while. I stopped that for a few reasons. I can't recall why though! Maybe I could reinstate that. I think one of the reasons was my blog was beginning to look cluttered and I didn't care for that. 

One thing I know for sure I won't ever change is the type of content. I get emails almost every week from people and questionable sites that want me to link to them - they'll provide the content thank you very much. But these sites are not ones I want to be associated with. If I link to a site, I want it to be a link that I want there because it explains something or it's a site that I recommend. 

Of course, the result is I make no money from this blog. It isn't monetized in any way. I probably could have made a good bit of money from it over the years. But that didn't interest me. I wanted to keep this a site that people may come to for unbiased information. Ok, well, not totally unbiased as I'll add my own comments in. But the information is as unbiased as I can make it, in terms of using reliable and credible sources.

So, what would I have done differently? Having read what I just wrote - I can see that I don't think I'd change anything. I like my blog. I like what it represents. I like what it has given me in terms of exposure for people who are looking to hire a health writer with a nursing background. I like that I can help people by writing on a particular topic. You know - I just like it.

I'm glad I took part in today's theme. It helped me realize why I do this blogging thing. 

Watch that Summer Heat

Not everyone is lucky enough to live in weather that is pleasant all year around - many of us live where it gets darned cold in the winter so we bask in the heat of the summer. If you live in an area as I do, in Montreal, it can get *very* hot in the summer; we can be the city of extreme weather come winter or summer.

Summer has finally arrived full force in our part of the world, so this brings to mind the annual problems we can have with heat and heat-related illnesses. It's a sad fact, but every summer, people die because of heat stroke, which is completely avoidable if proper precautions are taken. As well, many people end up getting seriously sunburned - another injury that is preventable.




Heat Exhaustion vs Heat Stroke

It's easy to confuse the two, but there is a big difference between them. Heat stroke is the more serious of the two but heat exhaustion can develop into heat stroke with shocking speed. Someone who is experiencing heat exhaustion may experience:

• Heavy sweating
• Cramping muscles
• Headache
• Being pale
• Fatigue, weakness
• Light headedness or dizziness, perhaps leading to fainting

They also may feel nauseated, begin to vomit.

This is a serious situation and the best thing to do for someone who is experiencing heat exhaustion is to get him or her out of the heat and into a cool place. If this isn't possible, a shaded area and/or somewhere with a breeze will help a bit, at least. At this point, as long as the person is coherent enough to swallow without choking, he or she needs water or a rehydration drink - not anything with alcohol or caffeine.

Cool sprinkles of water or a shower will also help make the person cooler. This does not mean a dunk in a cold swimming pool or in a cold shower. Cool is the word - not cold!

Heat stroke is the more serious of the two conditions. At this point, the body has overheated and can no longer cool itself off. That means, no more sweating. The body has decided that it takes too much effort to sweat and it can't afford to make that effort any more.

Signs of heat stroke include:

• No more sweating
• A higher than normal body temperature
• Red, dry skin
• Fast pulse
• Difficulty breathing
• Disorientation, agitation
• Seizures
• Coma

If you are with someone who has developed heat stroke, treat him or her as you would for heat exhaustion, but also call 911 for emergency help as this is a true medical emergency.

So, how do we prevent heat exhaustion or heat stroke? By being smart!

The most important thing to remember is to stay hydrated. That means drinking water or other non-caffeine or non-alcohol fluid even if you don't feel thirsty. Constantly drink the fluid to maintain your body's hydration levels.

Other tips include:

• Avoid strenuous activity, particularly outside. If you must work outside, try to avoid the hottest times of the day, usually between 11 a.m. and 1 p.m.
• 
  
• Wear light-weight clothing, a hat and sunglasses. Bring back the age of the parasol and use an umbrella to shield yourself from the sun.
• 
  
• While inside, if you don't have air conditioning, keep your blinds or curtains closed, particularly windows facing the sun.
• 
  
• Stay in the lower levels of your home if possible, as they are usually the coolest.
• 
  
• If you don't have air conditioning and your home is too hot, seek out shelter at a local mall. Call your city or official offices to find out if there are specific areas that are specifically designated as havens during heat waves.
• 
  
• Friends and neighbors - check in on people who are living alone, particularly the elderly and those with chronic illnesses. They are at increased risk of having difficulty managing the heat.

Stay safe this summer. While it may not always be so easy to avoid getting too hot, if you know what to do and what signs to watch for, you could avoid a tragedy.

Stilettos or flats - no compromise?

A Facebook friend posted a link to an essay in Saturday's Globe and Mail, titled Kick My High-Heel Habit? I'd rather you stab me with a stiletto. I wouldn't have read it otherwise. I would have seen the title and skipped over it, thinking that this was not something I'd like to read. But, since Kathe posted it, I read it - and then promptly wished I hadn't. Don't get me wrong - I'm happy that Kathe posted it and I'm glad I read it, but I wish I had not. I don't know if that makes any sense.

I wish I hadn't read it because stilettos annoy me. Platform shoes annoy me. Things that women do to their body to make themselves more attractive (or so they think) can cause serious and permanent harm, yet they feel that they must, or else they are not worthy. Worthy of what?

There is undeniable proof that wearing stilettos and four-inch heels is harmful. The stilettos put too much weight on two parts of the foot, a single spot on the heel and the toes. The high heels force your feet into unnatural and unhealthy positions, they throw your body out of balance, forcing tendons, ligaments and muscles to take on roles they aren't meant to. And, there is the accident factor. The twisting of ankles, the falling off the  platforms or heels - that has to count for something.

Have you seen the feet of celebrities who wear these types of shoes all the time? They're ugly. They're tough and veiny and misshapen. I recall an interview, long ago, of a celebrity who claimed she had to wear these shoes all the time because they were the only thing in which she felt comfortable. Of course that's the case. She altered the shape and function of her legs so that she cannot wear shorter heels. Of course shorter heels, or going barefoot, are uncomfortable.

And then, there's "the walk." Women can't walk in very high heels. They do a tiny step forward as they balance on their shoes, pushing themselves forward. A normal stride brings your body forward with your step. A tiny high-heel step doesn't allow for that as it doesn't bring the body forward. Your body stays behind and you must push it forward.

The British Columbia Podiatric Medical Association lists these conditions as women's foot health problems. It's obvious, that for a large number of them, women are causing these problems themselves:

Achilles tendinitis: inflammation of the Achilles tendon, the link between the calf muscle and heel bone. Those who wear high heels regularly can expect to acquire shortened tendons; switching to low heels for strenuous physical activity without appropriate warm-up exercises creates an ideal scenario for achilles tendinitis.
Bunions: misaligned big toe joints, which become swollen and tender. Bunions tend to be hereditary; however, biomechanical imbalances and shoes that are too narrow in the forefoot and toe may aggravate them.
Hammertoe: a condition in which the toe is contracted in a claw-like position. Although the condition usually stems from muscle imbalance, it is often aggravated by ill-fitting shoes, socks or hosiery that cramp the toes.
Metatarsalgia: general pain in the ball of the foot. It is often caused by wearing high heels.
Neuromas: enlarged, benign growths of nerves, most commonly between the third and fourth toes. They may stem, in part, from ill-fitting shoes, resulting in pain, burning, tingling or numbness between the toes and in the ball of the foot.
Plantar fasciitis: inflammation of the long band of connective tissue running from the heel to the ball of the foot; a main cause of pain at the rear of the foot. This condition is sometimes caused by shoes that cramp the feet, especially in the arch area.
Pump bump (Haglund's deformity): a bone enlargement at the back of the heel bone, in the area where the Achilles tendon attaches to the bone. The deformity generally is the result of faulty biomechanics causing increased motion of the heel bone against the shoe counter.

In my mind, there is nothing wrong with wearing these types of shoes sometimes - as dress up - an evening out, a special event. But to wear shoes like this all the time? Why?

Do you disagree with me? What is the highest heel you will wear? I am most comfortable at a 1 inch heel. I've worn a bit higher, but I end up hurting all over when I do that.

Do You Hear What I Hear?

On May 4, I wrote about vision and vision problems (May Is Health Vision Month). A friend asked me to address hearing and hearing problems sometime this month, so here is that post.

Like our vision, we tend not to think about our hearing unless there is a problem - but then it is too late. The human ear can put up with a lot, but it's also quite delicate, so you need to take care of it.

How does the ear work?

The miracle of sound is, to me, just that. How does the tap of my keyboard translate to the sound that I hear?

The ear has three parts, the outer part, which you see, the middle, and the inner. All play an important role. The outer ear acts like a funnel, collecting the sounds and funnelling them into the middle part of the ear. The part you see is the pinna and this goes into the ear canal.

The ear canal leads to the ear drum, which is where the middle ear begins. The drum vibrates in reaction to the sound waves. These vibrations are transferred to the three tiniest bones in your body, called the ossicles. The first bone, the malleus, is shaped like a hammer. The sound moves from the malleus to the incus, which is shaped like an anvil. Finally, the sound moves again from the incus to the stapes, which looks like a stirrup.

Once the sound has travelled through the middle ear, it reaches the inner ear, where the nerves take over. The vibrations enter the cochlea, which is a small, curled, fluid-filled tube. You can also find microscopic sized hairs lining the cochlea, which also vibrate with the sound, transferring this to the nerves, which go to the brain and tell you that you've heard a sound.

If there is any disruption in the any of the ear sections, your hearing can be temporarily or permanently affected.

Ear Wax

The most common problem with the outer ear is the build up of wax. This wax is perfectly normal and should not be removed. It is your ear's defence mechanism against things that shouldn't be in there. Cotton swabs and similar products are NOT for wax removal. If you use these, you run two risks: pushing the wax deeper and more compacted into the ear canal and/or two slipping and pushing the stick deeper into the ear, rupturing the ear drum.

For most people, ear wax isn't a problem, but some people do have too much of it. If this happens, it should be removed by a doctor or a nurse who has been trained to do so. ENTs (ear, nose and throat doctors) have a saying: never put anything in your ear that is smaller than your elbow.

People who wear hearing aids may be prone to impacted wax. This is due to the aid pressing into the ear canal constantly.

Infections

Infections can happen in the outer ear, most commonly, swimmers ear. Piercings in the lobe or pinna may also become infected if they are not cared for properly when they are fresh or if the holes get too irritated from the jewelry.

If the infection is in the mid-ear, otitis media, this could become serious if the infections are frequent.

Injuries


The ear drum can be punctured by inserting an object too deep into the ear, but also in other situations, such as severe infections or even on an airplane if the pressure is too hard on the ear.

The ears can be injured in other ways as well. Consistent very loud noise can destroy the tiny hairs in the ear, making it impossible for the sound waves to be moved along, for example.

Getting your hearing checked

If you suspect you have some hearing loss, the first thing to do is speak with your doctor. If there is cause for concern, you may be sent for a hearing test. If the test shows some hearing loss, you may then be sent on for a further hearing evaluation.

The American Speech-Language-Hearing Association has a handy check list that can help give you an idea if you should go for a hearing test. There is also a good explanation of the various hearing tests available.

It's never too late to prevent further damage to your hearing. If you use earplugs to listen to music, be aware of how loud the volume is. If you are in a noisy environment, wear protective equipment. Treat your ears with care because you may not notice a slow decline in hearing, but once it's gone, it's not likely you'll get it back.

Children's Play or Cardio Exercise?

Since I began my project, TheGamesWeUsedToPlay.CA, I've become more aware of blog posts, articles, and tweets about children, the lack of regular exercise, their not-so-healthy diets, and the health-related issues, such as obesity and type 2 diabetes. Some experts have said that this will be the first generation of children who will not have a longer life expectancy as the generations before them. If this is true, why are we allowing this to happen?

A tweet caught my eye on Tuesday, an article over at parenting.com on playing that counts as cardio (What Counts as Cardio?). Since when have we had to start thinking of the games our kids play as giving them a cardio workout? Is this a new trend now? 

While it's never a bad thing to get your children active, childhood play should be play that happens to be exercise, not exercise disguised as play. When that happens, there's an ulterior motive and the pure joy that play provides can be lost.

What do you think? Are we losing something by not giving our children the opportunity to play - on their own, without adult interference?

Second Act - My Move from Nursing to Writing

What made you go from nursing to writing?

How did you make the transition to writing?

Don't you miss nursing?

When did you decide to leave nursing and become a writer?

These are just a few of the questions I've been asked over the past few years when people learn that I changed professions when I was in my forties, taking a chance on a new life. I'm not unique in this position. All you have to do is have a look at SecondAct.com to learn about many women who have done the same and some in a much more dramatic manner. My writing seems rather tame compared to stand-up paddle boarding or becoming a model.

So, what happened to me and why? Or, "How I decided to be what I wanted to be when I grew up."

First, writing has always been something that I did well. In school, I prayed for essay exams, because even if I didn't know the subject completely, I was good at writing my answers in a way that often made it sound like I did.

This didn't always work, but I had a better chance skirting the questions this way than with multiple choice exam questions. Thinking back though, it might have been easier if I had just done the homework and studied a bit more...

All kidding aside, writing was something I liked to do and I knew I could do it. But, writing as a career never really seemed to be an option. I wasn't an outstanding writer and other than newspaper reporting or writing books, there didn't seem to be a viable way to earn a living using words. So, I did the next best thing. I chose a profession where I knew there would be work.

Although I enjoyed working as a nurse, I was frequently exhausted or not feeling well. Working shifts really didn't help matters either. Little did I know at that time that I was living with fibromyalgia. That diagnosis wasn't made until I was just shy of my fiftieth birthday.

In the mid 1990s, while I was head nurse at a summer camp for physically handicapped children, I saw a small ad in the Montreal Gazette. Someone was looking for a nurse with good communication skills and who knew how to use the Internet.

Hey! That was me! And I got the job.

It was a virtual job - the company had no offices. This is where I got my first taste of telecommuting. My children were in elementary school and I was working - full time - from home. Things couldn't get much better than that in my book.

Time passed, jobs changed. I continued to work as a nurse at various times to both keep my license and because I couldn't yet give up that part of my life. And then, the time came. When I was in my early forties, a set of circumstances occurred that pushed me into what I'd been wanting to do but dared not do: work full time as a writer.

Could I do it? 

Was I good enough? 

Would I find enough clients and jobs? 

What if I failed?

What's that expression: the proof is in the pudding? The first year I worked full-time from my home office, self-employed, hustling for work, I made more money than I did working full-time as an RN. Of course, in Quebec, that's not hard (sorry, still a bit bitter about nursing salaries here!).

Over the years, I cultivated some great, well-paying clients, said good-bye to some that didn't pay as well as I needed/wanted, and I've built myself a rather successful one-woman show. I've got some great clients and I have fun. I speak to incredibly interesting people, both fellow writers and people I interview for articles or projects.

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I go to workshops and conferences where I meet other writers and editors, and I learn more about my craft. Lately, I have been given the opportunity to teach others too.

Last month, I was in New York City attending the American Society of Journalists and Authors (ASJA) conference, where I spoke on a panel about writing for trade magazines. Next month, I'll be in Toronto at the MagNet convention, participating on another panel about taking your writing career to the next level.

So, could I do it? 

You bet I could! And I did.

Was I good enough? 

My clients sure think so. And I don't often seek out work anymore. Many times, clients will come to me.

Would I find enough clients and jobs? 

While sometimes I worry, because I think all self-employed people do, I have yet to find myself in a situation where I don't have enough work. Of course, self-employed people always have to market themselves, so that's what I do. And it's not as hard as I thought it was.

What if I failed? 

Well, I didn't. But if I had, would it have been so terrible? I always used to tell my children, "Don't tell me you can't do something unless you have tried to do it and you failed. Only then can you say that you can't."

So, am I a grown up now?

Fibromyalgia, It's Not Real/Yes It Is

"Fibromyalgia doesn't exist; it's just a catch-all that doctors use when they don't know what else to tell you."

Do you believe this statement about fibromyalgia (FM)? Some people do. I posted a question on a email list for a professional group I belong to, asking something from people who have FM. I received a lengthy email in response from a colleague I'd never met. Her email outlined for me why FM is not a real illness and doesn't exist, and that she got upset whenever she heard someone saying that they were diagnosed with it. She said it was a phase that she hoped would go away, because telling someone they had FM did more harm than good.

This person pointed out that there are doctors who have written online that it doesn't exist and she had taken the time to find some and then copy and paste their words into the email. Then, after this lengthy email, she told me she had to cut it short because she had to go out.

I thought long and hard before responding. The email had started with something along the lines of "I hope you don't mind dissention," and it ended with something like "I hope I haven't offended you."

I don't mind dissention, as long as we are polite about it, which she was. I didn't think I was offended, but I wasn't sure.

I tried explaining to her through my carefully worded response that anyone can write anything on the Internet. This is one of the great things about the medium, but also one of the great drawbacks. That being said, there is much research going into this illness that has been around for generations, but called by different names. The name "fibromyalgia" was only given recently, as researchers learned more about it.

Physical findings

There are physical findings in people who have FM, such as an elevated level of substance P, a neurotransmitter in the cerebral spinal fluid. Although the illness is far from being solved, this increased level of substance P is one tiny piece of the puzzle that explains why people with FM feel more pain than people who don't have it.

There are many illnesses or health problems that don't have obvious and identifiable causes. Migraines are a good example, as is clinical depression. However, they are accepted as the medical problems that they are. I ended my note stating that I wasn't quite sure why she felt she needed to send me her email as it had nothing to do with the original request. I didn't ask about a debate over FM, I asked if anyone who had FM had any questions that I could use in a project I am working on.

The response

Unfortunately, my response wasn't taken in the way I hoped it was. I am a big believer in discussion, but I don't believe in the "I'm right and you're wrong" approach without discussion. I am perfectly willing to discuss why people may not believe in FM, but I would hope that they would listen to the arguments as to why people do believe it does exist. They don't have to accept them, but some back and forth about the ideas is always appreciated.

This wasn't the case here. Instead, her response was, more or less, "I was afraid you'd react  this way but if thinking  you have something called fibromyalgia makes you feel better, that's ok." Well, I'm very glad she's ok with it. I'm sure I'll sleep better now. :)

I have no intention of engaging with the email writer any further. Perhaps I shouldn't have responded in the first place. I find it interesting that some people - because I know this person isn't alone - feel so strongly about proving that FM isn't real. What is it about the issue that makes them feel this need to evangelize their thoughts about FM?

Living with fibromyalgia

In case you haven't guessed by now, I do have fibromyalgia. I have had it a very long time, but was only diagnosed a little over a year ago. While the diagnosis hasn't changed how I feel physically, because there are no treatments, it has changed how I feel mentally and emotionally. Even though I knew the pain and fatigue was real, now I really know it. I am one of millions of people who have a similar problem. I am not alone. This isn't in my head. I wasn't a hypochondriac all this time. I wasn't looking for attention.

Managing FM means trying to live a healthy lifestyle and I am working on that. I'm trying to exercise despite the pain. I began a Tai Chi course a few weeks ago. My body is not liking it, but I'm sticking it out for the next few weeks. I need to get moving and get my life back.

Because I'm a writer, I've been able to do research and speak to experts on FM for articles I have worked on. I have a lot of information that I haven't yet used, so I am working on something that involves the questions people have about FM.

If you have FM or love someone who does, what questions do you wish had been answered earlier or what questions do you have now that still haven't been answered?

If you leave your questions here, in the comment section, I will be sure to add them to my file.



By the way, earlier this year, I began to participate in a chronic pain/fibromyalgia program offered by a local rehab centre (Fibromyalgia Rehab Program - It's Worth a Try). Unfortunately, it was a bust. Although the people who are part of the program mean well, as far as I was concerned, it was a waste of time and I dropped out after three weeks. So did just about everyone else in the program (there were five of us who started).

For the most part, we sat in a group and listened to the appropriate therapists talk about various issues, sleep, chronic pain, adaptations, etc., but it was all so very basic. There were no questions asked about what we may already have known, so the information wasn't tailored at all. It was just assumed that we knew absolutely nothing, but that wasn't true. The therapists just read from the handouts we received. Although we were encouraged to ask questions, we didn't really have any, because - again - it was all stuff we already knew.

We were only in the gym once a week, for about an hour or so, where the physio gave us a simple program to follow. While this would have been helpful, once a week is not.

So, the intent of the program was good, but as far as I am concerned, I can't see it being very helpful. It needs to be thought out better and presented in a more user-friendly manner.

Women’s Health: The Link between Starch Intake and Breast Cancer

This is National Women's Health Week in the United States and guest blogger Brian Flora has written this post to share with medhealthwriter.com readers:

There is growing evidence that nutrition can play an important role in cancer prevention. Nutrition is strongly associated with a person’s risk for the occurrence or reoccurrence of cancer. Researchers have now linked starch intake with breast cancer recurrence, according to results presented at the December 2011 CTRC-AACR San Antonio Breast Cancer Symposium. Researchers found that women who increase starch intake face an increased risk that their breast cancer will return.

Women's Healthy Eating and Living

Researchers followed 3,088 breast cancer survivors who participated in the Women’s Healthy Eating and Living—or WHEL—for seven years. Of these participants, scientists followed 2,651 women in the Dietary Intervention Trial. The study relied on dietary recall, in which researchers telephoned participants and asked for a report of everything they had eaten in the past 24 hours. This information was gathered when participants entered the program, and one year later.

Results from the study show a strong association between increased carbohydrate intake – more specifically, starch intake – and a higher risk for recurrence of breast cancer. Changes in starch intake accounted for about 48 percent of these changes in carbohydrate intake.

The Dietary Intervention Trial didn’t focus specifically on carbohydrates, although it did look at fruits and vegetables, fiber and fat intake in general. At the beginning of the study, participants ate an average of 233 grams of carbohydrates each day. The researchers found that women whose cancer came back in the previous year had eaten an average of 2.3 more grams of carbohydrates daily. Women whose cancer did not come back had reduced their carbohydrate intake by an average of 2.7 grams.

Specifically, women who had reduced starch intake the most had a recurrence rated of only 9.7 percent, as compared to women who increased their starch intake and suffer a recurrence rate of 14.2 percent. This increased risk seemed limited to women with low-grade tumors.

Further Evidence

Other studies have also revealed a strong association between nutrition and the recurrence of breast cancer. One such study performed in China showed breast cancer survivors who eat plenty of cruciferous vegetables have a lower recurrence rates than women whose diets did not include large amounts of these vegetables.

Cruciferous vegetables, including greens and cabbage, contain phytochemicals known as isothiocyanates and indoles, which help protect against certain types of cancer. This is dependent on the type and amount of cruciferous vegetable consumed.

The authors of the study pointed out that the Chinese eat cruciferous vegetables like turnips and bok choy, while Americans eat mostly broccoli and Brussels sprouts; further research will determine whether all cruciferous vegetables provide equal protection from recurrence of breast cancer.

What It All Means


While the association between food and cancer in general is well-established, these studies provide insight into the relationship between food and the recurrence of breast cancer. The American Institute for Cancer Research confirms that a diet rich in plant foods like fruits, vegetables, whole grains and beans helps lower the risk for many types of cancer. Researchers are investigating the roles specific nutrients play in reducing cancer risks but evidence suggests a healthy diet provides the best protection.

While scientists continue to discover the link between starch intake and cancer prevention, health professionals recommend eating fruits and vegetables like apples, cranberries, blueberries, broccoli and squash, along with green tea, grapes and tomatoes. More research will examine the link between starch intake and the recurrence of breast cancer. For now, consumers are encouraged to fill at least 2/3 of their plates with vegetables, fruits, beans and whole grains to replace starchy foods.

With this latest study, the effects of a healthy lifestyle versus those of an unhealthy lifestyle are highlighted. If you or anyone you know has a family history of breast cancer, or has undergone breast cancer treatment themselves, take a few minutes to think about changes that you can make to decrease your chances of becoming another statistic.

Relaxing Sunday & A Shout Out to Moms

Are weekends relaxing in your neck of the woods? What do you like to do with your time when you can relax? Are you a TV watcher, a reader, a napper? If you could do anything you like for the next few hours, just for you, what would that be?

I would have a tough time deciding. I am very fortunate that I have the time that I can take for myself when I want/need to. Sometimes I end up doing nothing, and that's ok too. Who says our days have to be filled, always busy?

When my husband and I sold our house in the suburbs and moved back into the city, I instituted a Sunday Family Dinner program. ;-)  My son and his fiancee come over sometimes - although I'd love it if they come more often - but the idea was to try to ensure that all three of my offspring all got together as much as possible on Sundays and they are always welcome to bring anyone who needs/wants a home-cooked meal with them. Sometimes I cook, sometimes my husband does. But it's nice having everyone together when we can.

This Sunday, this Mother's Day, I will be working on my quilting projects and spending time with my family. I don't know if I'll see my oldest son as I have to share him with his fiancee's family now, but I will talk to him. I don't mind. To me, birthdays, holidays, all these are just dates on a calendar. Maybe this attitude comes from my nursing days, when I had to work so many weekends and holidays.

I believe that we can make the day special on any day we want. If my children can't see me or do something with me on my birthday or Mother's Day or Christmas, then we'll make it another day and make it count. Why spend time being upset or sad? Why put this pressure on our family and ourself?

So to the moms out there, I send you a special hello on this day. To those of you who are missing your mom because she has died or is somewhere far away, I wish you peace.

And Now... Highway Proximity and Heart Attack Survival

Two days ago, I wrote a post on how commuting distances could affect your health (Does Commute Time Add to Health Risk?) and today's post is on how living close to a highway may make it harder to recover from a heart attack. Maybe I could start a theme on city and country living. ;-)

Have you ever lived near a highway or a busy roadway? I have and it can be stressful. The noise is constant and while you do (sort of) get used to it, it's always present. I've read of studies where living in this type of environment can contribute to high blood pressure as well as stress and anxiety. But there is a new study, published in the May 7th issue of Circulation, that has found that heart attack survivors who live less than 100 metres (328 feet) from a highway have a 27% higher risk of dying within 10 years of their original heart attack, compared with survivors living at least 1,000 meters away. That risk drops  to 13% for those living between 200 and 1,000 metres(656 to 3,277 feet) from the highway.

The important thing to note is that it wasn't just the noise and stress that was found to be the danger, it was the air quality, as people close to high ways are exposed to more particulate matter pollution.

You can read the full study as Circulation has made it available free to the public:

Residential Proximity to Major Roadway and 10-Year All-Cause Mortality After Myocardial Infarction

Tomorrow is International Nurses Day

Tomorrow, May 12, is International Nurses Day. A few years ago, it became a week of celebrating and appreciating nurses. I wrote about this two years ago, National Nurses Week is Coming Up and I didn't get much of a response. The funny thing is, I didn't think I would.

It seems to me, that unless you have spent a good bit of time in a hospital, it's hard to appreciate what a nurse really does. Just a few days ago, I wrote about five fictional nurses and, sadly, these fictional characters can be what people think nurses are really like.

In 2007, I wrote a post What do nurses really do? It still gets many hits, but I don't know who is reading it. Am I getting the message across? Or am I preaching to the choir when people find the post through Google?

Some people have told me that I have abandoned nursing by going into writing. Have I? Although I no longer work in a clinical situation, I still consider myself to be a nurse. Every year, for the past several years, I've worked at a major world-wide organization based in Montreal, filling in as the occupational nurse while the full time one goes on vacation. One year, it was for five weeks straight. And although I did enjoy the challenge of that type of nursing, I love writing and I'm good at it.

My nursing background is what gives me the knowledge behind my writing. I can feel confident with what I've shared because I have either experienced the situations or I have researched them and I know what to look for.

For sure, there are bad nurses in the profession, just like there are SOME bad teachers, bad computer repair folks, bad store clerks, bad bank tellers.... There are people in every profession who shouldn't be there, but they aren't the norm. There have been times when I've encountered less than stellar nursing care on a ward or unit, where there seemed to be several nurses who shouldn't be there. Again though, this isn't indicative of all of us. In my opinion - and it has been borne out by observation and experience - if there are several bad nurses in one area, one often only has to look at the management that allows the behaviour to continue.

Nurses can come in many forms, from the ones who help deliver a baby to those who help you as your life ends. We are in the schools (This Isn't Your Mother's School Nurse) and in the community. We are your parents, your siblings, your children, your friends. We are everywhere. But we're not always appreciated for what we have to offer.

What is the best way to thank a nurse who has touched you? While the gifts of candy and flowers are always appreciated, the best way to thank a nurse is by letting him or her know how you've been touched and by letting his or her superiors know what a good job has been done. We can be so quick to criticize and to climb the ladder when things go wrong, but it takes just a few moments to praise and to climb that ladder with thanks and kudos. You wouldn't believe the difference it makes.

Does Commute Time Add to Health Risk?

What is your work commute like? If you're like me, it consists of a few steps from your bedroom to your office, but that isn't reality for the vast majority of workers. Most people have to go out to work and that's a given, particularly with jobs that are hands-on.

For many years, the trend in housing has been to spread out away from the city cores. Suburbs blossomed and some people went further out, to live in rural areas, commuting back to the city for work.

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To them, the added commute time is the price they are willing to pay to live as far from the city as is possible. But is this such a good idea? Can the long commute be harmful to your health? Some researchers say yes.

A study published in the most recent issue of the American Journal of Preventative Medicine found that longer commuting distances were associated with health risks, such as decreased cardiorespiratory fitness (CRF) and increased weight. There doesn't seem to be a difference if the commute was by car or by public transit, because the basis of is is the lack of physical activity and the time that the commute may take away from a person's ability to participate in some sort of exercise.

The study of over 4,000 people in Texas found, "people who drove longer distances to work reported less frequent participation in moderate to vigorous physical activity and decreased CRF, and had greater BMI, waist circumference, and blood pressure. The association remained when physical activity and CRF were adjusted for, although to a lesser degree for BMI and waist circumference. Those who commuted more than 15 miles to work were less likely to meet recommendations for moderate to vigorous physical activity, and had a higher likelihood of obesity. Commuting distances greater than 10 miles were associated with high blood pressure."

What do you think? Do you agree? Or is this just an excuse and these people may  not have exercised anyway? When we lived in a suburb off the island of Montreal, it could take my husband anywhere from 30 to 60 minutes to get home, by car, from work. Yet, he still went to the gym almost every day. Now that we've moved back into the city proper, his commute is about 15 minutes, maybe 20 and he still goes to the gym almost every day.

I think there could be some merit in this. If you're a parent of young children and you already spend a lot of time away from them at work and with your commute, you may not have time for individual exercise. However, how about doing activities with the family? This way, you could get your physical activity and family time in together.

Canadian Health Care, Healthcare Access & Health Insurance, Part 1

On the first day of this blogathon, I asked people for suggestions on blog topics. Friend and colleague Jennifer Fink (Blogging 'Bout Boys) suggested that I write from the Canadian perspective of health care, healthcare access and insurance. So here I am. It's a touchy subject for many, so I'll see if I can explain how I see it without stoking any flames. There is a lot to cover, more than can be done in one blog post. So this is part 1 - a basic explanation of how the system works.

I have seen many sides of the Canadian healthcare system, from being a patient, a parent of a patient, a child of a patient, a nurse, and an administrator within a nursing department. While I know the system isn't perfect, I wouldn't give it up for anything.

from MorgueFile.com

Because of my work online, I interact with many Americans, of all socioeconomic and education levels. I've watched many discussions go on about the perils of socialized medicine and much misinformation that is spread because people don't know the facts but they believe they do. Unfortunately, spreading misinformation does everyone a disservice, everyone.

The Canadian medical system is national health insurance system run by the provinces and territories. The federal government, located in Ottawa, Ontario, distributes funds to the provinces. While medical care falls under provincial jurisdiction, there are some rules that the provinces must follow as per federal guidelines, the Canada Health Act. The provinces may add to the services. For example, a province may decide to have a drug insurance plan to ensure that all residents are guaranteed a minimum of medication availability.

Why Medicare Isn't "Free"

Canadians - and people in other parts of the world - often refer to Canadian health care as free. It's not. Our tax dollars pay for it, federally and provincially. We pay for it every day.

There is abuse to the system. People from other countries have been known to come to take advantage of the health system. Before the province of Quebec required photos on their Medicare cards, there were thousands of people who had fake ones or ill-gotten ones in their possession. People lent their cards to friends who needed to go to an emergency room or clinic. This added up to millions of dollars being stolen from the Canadian tax payer. When the cards became photo ID cards, the number of applied for cards dropped dramatically, said Medicare officials.

What Medicare Provides

Medicare allows Canadians and landed immigrants the right to see a doctor or healthcare professional in a hospital, clinic, or office without having to pay for it. Certain types of visits are not covered by the system though - there are limitations. If you have been hired for a new job and your employer wants a pre-employment physical - this is not covered by Medicare; the doctor must be paid as he or she cannot charge the system for this service. If you are travelling and you need vaccinations, this isn't covered. Many extras provided in a doctor's office aren't covered by the system either; each province is a bit different.

However, a yearly physical is covered. Blood tests done in a hospital and provincially approved clinics are covered, blood tests done in private labs aren't. Specialized nuclear testing in a hospital is covered, not in a private clinic. Physiotherapy in a hospital or healthcare facility is covered; physiotherapy in a private clinic is not - and so on.

The goal is to ensure that everyone is covered by a certain level of care. This doesn't always work as intended, unfortunately, as waiting lists for the publicly provided services can be staggering at times.

If you have been injured or are ill and you go to an emergency department or walk-in clinic, you must have your health insurance card with you. If you don't, you must pay for the services rendered, even if you can prove that you are a Canadian and a resident of the province. If this happens, you must apply to your health insurance board for reimbursement.

Glitches in the System

Ideally, the system was supposed to provide equal access to medical care across the country. But one of the drawbacks to the program and provincial control is associated with how much the provinces pay their healthcare professionals. A doctor in British Columbia gets paid more per patient visit than does a doctor in Quebec. Therefore, a Quebec resident who must see a doctor in BC may be required to pay an amount in addition to the fees the doctors claim from the Quebec health board.

Other glitches aren't as minor. Waiting lists are long for some procedures. Some parts of the country don't have certain types of specialists or equipment. While these are not acceptable, particularly for life-threatening issues, these aren't limited to Canada. I have heard from many Americans about waiting lists for specialists that are months' long. I've heard from others that they must travel to other parts of their state to be able to see a certain type of expert. In countries as big as ours, this need to travel, as frustrating and painful as it may be, is often inevitable.

Nurses are overworked and underpaid. This is a story, again, not unique to Canada. There is a nursing shortage - again, not unique to Canada. There are more and more demands on the available resources - need I repeat about it not being unique to Canada?

The Canadian system is far from perfect and we are working on trying to find solutions.

My next post on this topic will talk about how we work private insurance in with our national health insurance.