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THE TADDLER InThisIssue:

Regular

What’sHappeningatTaddleCreekFHT?

Spring 2019

DoYouSufferfromNomophobia?

Cont’d on page 2

SeniorEyecareWhattoKnowAboutTravelVaccines

By:AnsehDibaji,LeadSocialWorker 1

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VitaminsThatCanBeHarmful

“Allmen’smiseriesderivefromnotbeingabletositinaquietroomalone”-BlaisePascal

Doyousufferfromsmartphoneseparationanxiety?Ifso,youmayhaveacaseofnomophobia(anabbreviationof“nomobilephonephobia”).ItmaybedifNiculttoknowifyoursmartphoneuseisproblematic.Youmayhaveheardofsomepeopletalkingorwritingabouttheirexperienceofgoingona“digitaldetox”or“smartphonefast”duetoaperceptionofhavinganaddictiontotheirdevices.Forthosewhocanaffordtohaveasmartphone,itcanquicklybecomeanindispensableandirresistibletoolofinstantgratiNication.Wenowuseoursmartphonesmorethancomputerstoaccessthenews,weather,maps,emails,texts,music,towatchvideos,orderfood,networksocially,videochat,makepurchases,playgames,etc.Itmaynotbethetoolitselfthatisproblematic,butthefactthatitconnectsustotheInternetandprovidesaccesstoanendlessamountofapps,andfunctionsasamini“slotmachine”inourpockets.

TristanHarris,aformerGoogleemployee,suggeststhatsocialmediaappsareconceivedandengineeredtobeaddictive.Henotesthetechniquesthatdesignersemployforappsareakintogambling.UserscontinuetoobtainrewardsbyunceasinglycheckingtheirsmartphonesandseeingnotiNications,similartogamblerswhocontinuallypulltheleverofaslotmachineanticipatingapayout.Theslotmachineandsmartphoneoperateonavariablereinforcementschedule;wedonotknowwhenwewillberewardedwiththeprizeoranotiNication.

Researchsuggeststhattherearesimilarneurobiologicalresponsesbetweencompulsivesmartphoneuseandaddictiontosubstances.SomeresearchlookingatMRIscansofbrainsmonitoredtheactivityinthenucleusaccumbens(therewardcentreofthebrain).Theresearcherswereinterestedinseeinghowsocialmediauseaffectedthebrainandtheyfoundthattherewardcentreofthebrainwasoftenmoreactivatedafterreceivingpositivesocialmediafeedback.Smartphonesgiveustheabilitytoconnect,andassocialanimals,weneedandcraveconnection.Wehaveaneurotransmittercalleddopaminethatisassociatedwithreward-motivatedbehaviour.WhenwereceiveanotiNicationbecausesomeone“liked”aFacebookpost,wegetadopaminehitandassociatethedoseofpleasurewiththeuseofthesmartphoneandtheapp,andunderstandably,weseekmoreofit.AtechdesignerbythenameofLorenBrichterdevelopedthepull-to-refreshmechanism,usedtoupdateappslikeTwitter.

MentalHealthCorner:DoYouSufferfromNomophobia

Measles:WhatYouNeedtoKnow

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The Taddler Spring 2019

Cont’dfrompage1(DoYouSufferfromNomophobia?)

Cont’d on page 3

Inoneinterview,Brichternotesthat“pulltorefreshisaddictive,Twitterisaddictive…WhenIwasworkingonthem,itwasnotsomethingIwasmatureenoughtothinkabout....IhavetwokidsnowandIregreteveryminutethatIamnotpayingattentiontothembecausemysmartphonehassuckedmein”.

ProblematicsmartphoneandInternetuseaffectschildren,youthandadults.ACAMHsurveyin2016foundthat86%ofOntariostudentsvisitsocialmediasitesdailyandabout16%spendNivehoursadayormoreonsocialmedia.AnotherstudyfromtheUSfoundthatyoungpeoplewhorelinquishedtheirphonesfoundthattheyperformedworseonmentalexerciseswhentheywerein“withdrawal”andexperiencedphysiologicalsymptomslikeincreasedbloodpressureandheartrate.

Interestingly,theyouthinthestudyalsofeltasenseoflossoftheirextendedself(theirphones).Ourphonesmaywellhavebecomeanextensionofourselves;itwouldexplainwhytheygoeverywherewithusandwhysomepeoplereportanxietywhentheirphonebatteryisloworexperiencethephenomenonofphantomphonevibration.Accordingtothe2013MobileConsumerHabitsStudyconductedbyHarrisInteractiveintheUSforthemobilecompanyJumio,12%ofrespondentsreportedthattheyusetheirsmartphoneintheshowerand9%reportedusingitwhilehavingsex.Mostdisturbingwasthat55%reportedusingtheirsmartphonewhiledrivingandweknowthatdistracteddrivingisamajorcontributortocollisions.

Thereisenoughresearchtosupportthetheorythatcompulsivesmartphoneuseishighlycorrelatedwithdepressionandanxiety,whilesomewouldarguethatitismorethanacorrelation.AresearchstudypublishedinthejournalClinicalPsychologicalSciencebyJeanTwengeandcolleagueslookedatscreentimeuseinadolescentsintheUSbetween2010-2015.TheyfoundasigniNicantrelationshipbetweenincreasesindepressionandsuicideandtheriseinnewmediascreentime.TheauthorsspeciNiedthatnoothervariables,includingtheeconomy,familyNinances,peerpressureorhomeworkcouldexplainthedramaticincreaseinmentalhealthissuesduringthattime.Famously,SteveJobs,co-founderofAppleandcreatoroftheiPhone,didnotlethiskidshaveiPadsandhadstrictlimitsonscreentimeandtheuseoftechnologyinhishome.

Doyouknowhowoftenyouuseyoursmartphone?Increasingly,wecanusetechnologytotrackandlimitouruseoftechnology.In2018,AppleannouncedanewfeaturefortheiPhonecalledScreenTime,whichtracksusageandallowstheusertosetparameters.Thereareothertrackingappsaswell.Yourlifeiswhatyoupayattentiontoandwhatyoupracticegrows.Itmaybeinterestingtotakeaninventoryofhowmuchyouareusing

yourphoneandwhy.Doesyourphonegointothebedroom?IsyourphonethelastthingyoulookatbeforebedandtheNirstthingyoucheckuponwaking?Doyouscrollwheninagroceryline-uporwhilewaitingtoordercoffee?Doyouhaveyourphoneonthetableduringmeals?Haveyouexperiencedphantomphonebuzzinginyourpocket?Whenyoupickupyoursmartphone,areyouawarethatyouaredoingit?Therearenorightorwronganswers,andclearly,itisnotyourfaultifyoudohaveahardtimedisconnectingfromyourdevice.Itisimportanttoacknowledgethatourculturehasaprofounddiscomfortwithquietandstillness.Constantdistractionandinterruptionisencouragedandthereispressuretobedigitallyconnected24/7,whichincreasesstress,anxiety,andisdetrimentaltooursleep.

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The Taddler Spring 2019

Whatmaybeapersonaladdictiontotechnologyhassocietalimplicationswithregardstoourcollectivementalhealth,howourchildrenandyouthdevelop,howweviewrelationships,andourdemocracy.Inthisdayandage,itisindeedaradicalactofself-caretoconsciouslydisconnectfromourdevices,“hack”ourinternalhumanoperatingsystemandimplementbetterboundarieswithregardstohowweusetechnology.

References:Carbonell,Xavier&Panova,Tayana(2017)AcriticalConsiderationofSocialNetworkingSites’AddictionPotential.AddictionResearch&Theory,25:1,48-57,DOI:10.1080/16066359.2016.1197915

CentreforAddictionandMentalHealth.(2016).One-thirdofOntariostudentsreportelevatedpsychologicaldistress,CAMHsurveyshows.Retrievedfrom:http://www.camh.ca/en/hospital/about_camh/newsroom/news_releases_media_advisories_and_backgrounders/current_year/Pages/One-third-of-Ontario-students-report-elevated-psychological-distress.aspx

Clayton,RussellB.&Leshner,Glenn&Almond,Anthony(2015).TheExtendediSelf:TheImpactofiPhoneSeparationonCognition,Emotion,andPhysiology.JournalofComputer-MediatedCommunication,20,119-135.https://doi.org/10.1111/jcc4.12109

Dar,Meshi&Morawetz,Carmen&Heekeren,Hauke(2013).NucleusAccumbensResponsetoGainsinReputationfortheSelfRelativetoOthersPredictsSocialMediaUse.FrontiersinHumanNeuroscience,7,439,DOI:https://doi.org/10.3389/fnhum.2013.00439

Ghose,Tia(2015).WhatFacebookAddictionLookslikeintheBrain.LiveScience.Retrievedfrom:http://www.livescience.com/49585-facebook-addiction-viewed-brain.html

Harris,Tristan(May18,2016).HowTechnologyisHijackingYourMind–fromaMagicianandGoogleDesignEthicist.Medium.Retrievedfrom:https://medium.com/thrive-global/how-technology-hijacks-peoples-minds-from-a-magician-and-google-s-design-ethicist-56d62ef5edf3

Hughes,Nicola&Burke,Jolanta(2018).SleepingwiththeFrenemy:HowRestricting‘BedroomUse’ofSmartphonesImpactsHappinessandWellbeing.ComputersinHumanBehavior,85,236-244DOI:https://doi.org/10.1016/j.chb.2018.03.047

Lewis,Paul(October6,2017).“OurMindsCanBeHijacked”:theTechInsidersWhoFearaSmartphoneDystopia.TheGuardian.Retrievedfrom:https://www.theguardian.com/technology/2017/oct/05/smartphone-addiction-silicon-valley-dystopia

Panova,Tayana&Lleras,Alejandro(2016).AvoidanceorBoredom:NegativeMentalHealthOutcomesAssociatedWithUseofInformationandCommunicationTechnologiesDependonUsers’Motivations.ComputersinHumanBehavior,58,249-258.Retrievedfrom:https://www.researchgate.net/publication/290788504_Avoidance_or_boredom_Negative_mental_health_outcomes_associated_with_use_of_Information_and_Communication_Technologies_depend_on_users'_motivations

Rodriguez,Salvador(July11,2013).MostAdultsAlwaysHaveSmartphoneCloseby,1in10UseitDuringSex.LATimes.Retrievedfrom:https://www.latimes.com/business/technology/la-ei-tn-smartphone-nearby-1-in-10-use-during-sex-20130711-story.html

Twenge,JeanM.,Joiner,ThomasE.,Rogers,MeganL.&Martin,GarbrielleN.(2017).IncreasesinDepressiveSymptoms,Suicide-RelatedOutcomes,andSuicideRatesAmongU.S.AdolescentsAfter2010andLinkstoIncreasedNewMediaScreenTime.ClinicalPsychologicalScience,6,3-17.https://doi.org/10.1177/2167702617723376

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The Taddler Spring 2019

WHAT’S HAPPENING AT TADDLE CREEK

By: Sherry Kennedy, Executive Director

Cont’d on page 5

This column lets you know about TC FHT programs, events and announcements.

By:BruceProuty,PearleVisionOwnerandmemberofTCFHT’sSAVI(SeniorAdvisory

VolunteerInitiative)Committee

SeniorEyecare

Agingandlossofclosevision,whatcanbedone?

Aswegetolder,whyisitthatsomanyofourfriendsneedglassestoseecloseup?Eventhosewhoneverhadglassesbefore?Weallgetstifferandsomewhatweakeraswegetolder.Withage,thenaturalabilityoftheeyetofocusoncloseritemsalsoweakens.Iusedtoteasemydadwhenhewasreadingthepaper,ashehadtoholditfurtherandfurtherawaytoseetheprint.

Sowhatcanyoudo?YourNirststepisyouryearlytriptotheoptometrist’sofNice.Theoptometristwilldeterminewhatlevelofreadingassistanceyouneed,afteracarefulexaminationofthehealthofyoureyes.Likeyouryearlydentistappointment,thereisafeeforyoureyeexam,howeverOHIPcoveragebeginsatage65.Yourprescriptioncanincludeasetofsimplereadingglasses,bi-ortrifocaleyeglasses,orthenewerprogressiveandcomputerglasses.

Whatdoprogressivelensesdodifferently?

Abifocallenshasalittlelineonthelens.Abovethelineyoucanseefar,belowthelineyoucanreadupclose.ThebifocallenshastwoNixedfocalpoints,atrifocallenshasthreeNixedfocalpoints.Unfortunately,thelinesmakeyoulookalotolderthanyoumightwanttobethoughtof.Aprogressivelensstartswithyourdistanceprescriptionatthetop,andthroughthemagicofmodernalgorithmsandcomputer-controlledlensgrindingmachines,thedistanceprescriptionis“progressively”changedthroughanarrowmid-rangeviewingcorridor(computerdistance)toyourreadingprescriptionatthebottomofthelens.YoucanalwaysNindaplacetofocusonsomethingatanydistance.ThisiswhyIswitchedfromjustusingreaders.Inowwearglassesallthetime,butIamneverlookingforthemandIcanalwaysNindawaytofocusonsomethingatanydistance.

Programs

Please refer to the table at the end of this newsletter for an outline of TC FHT’s Groups/Workshops offered in Spring 2019. For some you need a referral and for others you simply need to contact the number provided. These are also posted on our website calendar (http://taddlecreekfht.ca/patients/event-calendar/).

As promised in my last column, here are the 2018 Quality Improvement Plan (QIP) results:

(Part2ofaseries)

Cont’donpage5

Measure Target/Outcome

Comments

% of patients, 65 and over, tapered and/or stopped benzodiazepines or Z-drugs

Target:21% Outcome: 67%

Pts who have tapered or stopped over fiscal 2017 & 2018

Retiring for fiscal 2019

% of pts, 18 and over, screened for poverty

Creating baseline

First year 2018. Continuing for fiscal 2019

% of pts who stated that when they see the doctor or nurse practitioner, they or someone else in the office (always/often) involve them as much as they want to be in decisions about their care and treatment

Target:96% Outcome: 96%

2018 Patient Survey Data.

Continuing for fiscal 2019.

% of pts able to see a doctor or nurse practitioner on the same day or next day, when needed

Target:83% Outcome: 77%

2018 Patient Survey Data.

Continuing for fiscal 2019.

% of pts with diabetes, aged 40 or over, with two or more glycated hemoglobin (HbA1C) tests within the past 12 months

Target:65% Outcome: 59%

2018 Patient Survey Data.

Continuing for fiscal 2019.

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WHAT’S HAPPENING AT TADDLE CREEK

Cont’d from page 4

Spring 2019The Taddler

We have some work to do and hope to see improvement with our change ideas planned for 2019. Our 2019 QIP, along with a narrative, is available on our website (http://taddlecreekfht.ca/about-us/quality-improvement-plan/).

The 2018-19 TC FHT Patient Care Survey results are in. The survey was sent to 13,594 patients (patients with an email in our electronic medical record) and 1728 patients completed it. A sincere thank you to those of you who completed the survey. Your comments provide insight into how we can better serve you and how we can improve your patient experience.

In addition to survey results reported in the QIP above (3 & 4), other quantitative results are as follows:

• 80% always or often were greeted warmly upon arrival • 82% always or often could contact the office by telephone easily • 84% always or often when calling office, with a non-urgent

medical concern, during regular office hours, got an answer on the same day

• 91% always or often can book an appointment within a reasonable time

• 92% always or often have a reasonable wait time when in the office

• 94% always or often when calling office, with an urgent medical concern, during regular office hours, got an answer on the same day

We are proud of these results but noted from comments that there are still areas for improvement.

Announcements

I am happy to announce, since my last column, that there have been no resignations (and thus, no new hires). We welcome the return of our dietitian, Julia Stanislavskaia. Julia returned from maternity leave in Dec 2018.

Cont’d from page 4 (Senior Eyecare)

Measure Target/Outcome

Comments

% of pts with medication reconciliation in the past year

Target:39% Outcome: 21%

Current performance is for the ‘Pts receiving MedRec within 14 days after discharge from hospital for mental health conditions when discharge summary received within 7 days.’

Continuing for fiscal 2019.

% of those hospital discharges (selected conditions) where timely (within 48 hours) notification was received, for which follow-up was done (by any mode, any clinician) within 7 days of discharge

Target:60% Outcome: 54%

TC FHT will be modifying this indicator for 2019 to be for any condition.

Areallprogressivelensesthesame?No.TheyallworkthesamebutthenewestalgorithmsandmanufacturingtechniquesgiveamuchwiderNieldofvision,asmoothertransitionbetweenfarandnear,andremarkableclarity.

Weallusecomputersnow,whatarethosecomputerlensesIhearof?Theyarecalledprogressivelenses.Theyaredesignedtogiveyouthewidestbandofvisionforworkingatthecomputer,readingyournewspapers/booksorperforminghandwork,butthereisacompromise.Computerlensesletyouseewellwithin7feet,buttheymustbeleftatyourdeskwhenyougogetacoffee.Thereislittletonodistance.Itisagreatnewproduct,butonlygreatfordeskorhandwork.AlsoaskaboutthenewBlueTechmaterial.Itprovidesgreatprotectionfromtheintensebluelightthatweareallputtingoureyesonwhenusingourcomputers,phones,iPadsandourNlatscreenTVs.Averycomfortableoption!

Isthereanythingelseweshouldconsider?Yes.Lookforeyeglassesthataredeep.Youwantthemostamountofreadingareapossible,andforthat,youneeddepth.

Considerapairofpolarizedglassesfordrivingorgoingoutontheboat.Theyarethebestsunglassesavailable.Ifyouenjoyjustbeingoutdoors,considerapairoftransitionlensesthatwilldarkenand/orpolarizeinthesun.Rememberthough,theydonotchangeinacar.ThecarwindowNiltersouttheUVlightthatisnecessarytomaketransitionsdarken.

Thereisalottoconsider.Startwithaneyeexamwithyouroptometrist!

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Ifyouand/oryourfamilyareplanningtotraveloutsideofthecountry,besuretocheckifyourvaccinationsareuptodate.Travellingtoanothercountrycanputyouandyourfamilyatriskofvaccine-preventablediseases,someofwhichhavealreadybeeneradicatedinNorthAmerica.Youshouldensurewithyourhealthcareprovider,atleast6weeksbeforeyourtraveldate,thatyourroutineimmunizationsareuptodate.Givingenoughtimetorevieweachperson’simmunizationhistorywillprovideyouwithsufNicienttimetogetanynecessaryvaccinesandbuildimmunity.Dependingonyourdestination,ageandtravelactivities,youmayneedadditionalvaccinesinordertobeprotectedfromspeciNicillnessesinthecountrytowhichyouaretravelling.Whetherthepurposeofyourtravelisforbusinessorleisure,thelastthingthatyouwanttohavehappenistogetsick.PleasenotethattravelvaccinesandtraveladvicearenotcoveredbyOHIP.

ThefollowingvaccinesarenotcoveredbyOHIP:• HepatitisA• HepatitisB• JapaneseEncephalitis• Typhoid• YellowFever

ThegovernmentofCanadahascreatedabooklettohelpCanadianstravellingoutsideofthecountry.Thebookletcontainsimportantinformationtokeepyouingoodhealth.Youcanaccessthebookletat:travel.gc.ca.

Withenoughknowledgeandpreparation,youcanprotectyourselffromunexpectedhealthhazardswhiletravelling.

The Taddler Spring 2019

WhattoKnowAboutTravelVaccinesBy:MonaBellaYacapin,RegisteredNurse

We are looking for people who would like to share their personal journey with diabetes. This could be about your difficulties and challenges or about successes and pleasant experiences living with diabetes. We welcome creativity so do not feel limited. We will accept anything from a poem to a story or any way you feel is appropriate for you to share. The purpose of this is to help other people living with diabetes to feel supported, encouraged and most importantly, not alone.

If you are interested, please e-mail us your story, up to 500 words. We will choose the top two pieces to be published in the diabetes newsletter and the Taddle Creek Family Health Team Newsletter (The Taddler). The winners will also receive a $75.00 grocery store gift card.

Please send all submissions to jzupan@tcfht.on.ca by Sept. 1, 2019.

Do you have a story about diabetes that can help or encourage others? We would like to hear from you.

One of the most powerful tools in managing diabetes is information. Although our diabetes team can provide medical information, your lived experience is equally as powerful.

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The Taddler Spring 2019

VitaminsThatCanBeHarmfulBy:JoannaPeddle,NursePractitioner

Vitaminsaresubstancesfoundinfoodandweneedthemfornormalmetabolism.Allvitamins,exceptVitaminD,needtobeeaten,astheycannotbemadebyourbody.Thesedays,youcanNindvitaminsaddedtomanyfoods,includingvitaminwaterandyourbreakfastcereal.Water-solublevitaminscangenerallybetoleratedathighdoses,withafewexceptions.Fat-solublevitamins(A,D,E,K)haveanincreasedriskoftoxicitybecausetheyarestoredinfatcells.

Mostofourdailyvitaminrequirementscanbemetwithahealthyandbalanceddiet,alongwithsomesunshineorVitaminDsupplements.Ifyouchoosetosupplementyourdiet,herearesomevitaminstokeepinmind,whichmaybeharmfultoyourhealth:

• HighlevelsofVitaminAcanincreasetheriskofheartdisease,bonefracturesandlungcancerinadultswithahistoryofsmokingorasbestosexposure.Also,inpregnancytoomuchVitaminAcancausebirthdefects.

• VitaminD,thesunshinevitamin,takenover4000unitsperday,maycauseelevatedlevelsofcalcium.Toomuchcalciuminyourbloodcanweakenyourbones,createkidneystones,andinterferewithhowyourheartandbrainwork.Pleaseconsultwww.osteoporosis.caforguidelinesonrecommendedVitaminDintake.

• VitaminCisabundantincitrusfruitsandmanyvegetables.Researchshowsthatsupplementsdonothelppreventcancer,heartdiseaseoreventhecommoncoldvirus.VitaminCcanslightlyeasethesymptomsanddurationofthecommoncold,makingithalfadayshorter.Theyshouldstillbetakenwithcaution,ashighlevelsofVitaminCsupplementsincreasetheriskofkidneystones,cancausenausea,diarrhea,bloatingandheartburn,andinterferewiththestooltestusedforcoloncancerscreening.

• VitaminEsupplementshavenotbeenfoundtobeeffectiveinpreventingheartdisease,cancer,dementiaorinfection.HighdosesofVitaminE,above400unitsperday,mayactuallyincreasetheriskofdying.Also,individualstakinganticoagulants,likeWarfarin,shouldnottakeVitaminEsupplementsduetotheirsynergisticeffects.

• VitaminB6takeninexcesscanresultinnumbnessandtinglingofhandsandfeet,rashes,sensitivitytolight,dizziness,andnausea

• Biotin(VitaminB7)hasnotbeenfoundtobeharmfulinhighdoses.However,takingthesupplementmayinterferewithbloodtestresultsforthyroidfunction,aswellasotherbloodtests.Makesureyoutell

yourprimarycareproviderifyouaretakingthesesupplements.

References:Hamishehkar,H.,Ranjdoost,F.,Asgharian,P.,Mahmoodpoor,A.andSanaie,S.(2016).Vitamins,AreTheySafe?AdvancedPharmaceuticalBulletin.Retrievedfrom:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241405/

FairNield,K.M.(2019).Vitaminsupplementationindiseaseprevention.UpToDate.Retrievedfrom:https://www.uptodate.com/contents/vitamin-supplementation-in-disease-prevention?search=vitamins&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

• Vitaminsarenotmiraclecures• Takinglargeamountscanbeharmfulbecauseweonlyneedsmallamounts• Eatingfruits,vegetablesandwholegrainswillsupplythebodywiththerightamountandbalanceofvitamins

• Vitaminsdonotreplaceahealthydiet,butifyourdietisinadequate,amultivitaminmaybehelpful

• Vitaminsareoftenrecommendedduringpregnancy,breastfeeding,ifalcoholintakeisaboverecommendedlevels,andintheelderly

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The Taddler Spring 2019

Measles:WhatYouNeedtoKnowBy:ShaunaSturgeon,NursePractitioner

Measlesisahighlycontagiousvirusthatspreadseasilythroughtheair.Inanunprotectedpopulation,9outof10peoplewillbecomeinfected.

Measlesistransmittedbytinydropletswhenaninfectedpersoncoughs,sneezesorbreathes.Theviruscansurviveintheairoronsurfacesforuptotwohours.AninfectedpersoniscontagiousSivedaysbeforeandfourdaysaftertheappearanceofameaslesrash,sotheycanspreadthevirusbeforetheyknowtheyaresick.

Initialsymptomsofmeaslesincludehighfever,malaiseanddecreasedappetite,followedbyconjunctivitis(pinkeye),runnynoseandcough.About2-4daysafterthefeverstarts,abumpyrashstartsonthefaceandneckandspreadstothewholebody.Onlighterskin,therashwillappearbrightred.

About30%ofpeopleinfectedwithmeasleswilldevelopcomplicationssuchasvomitinganddiarrhea,earinfectionorpneumonia.About1in1000peoplewithmeasleswilldevelopswellingofthebraincalledencephalitis,whichcanleadtodeath.Measlesviruscanalsocausesuppressionofthebody’simmunesystem,makingitmoredifNicultforthebodytoNightoffotherinfectionsforupto3yearsafterameaslesinfection.

Beforetheintroductionofthemeaslesvaccine,overtwomillionmeasles-relateddeathsoccurredannuallyworldwide,themajoritywerechildrenunder5yearsofage.MeaslesvaccinationhasbeenaroutinepracticeinCanadasince1970.Measlesvaccineisverysafeandserioussideeffectsareextremelyrare.

Canadausesa2-dosevaccinationschedule,whichoffers97%protectionagainstmeaslesvirus.Gettingfullyvaccinatedcanprotectyouagainstmeaslesandwillalsoprotectpeoplewhocannotreceivethevaccine,suchasinfantsunder6months,pregnantwomenandpeoplewhohaveaweakenedimmunesystem(e.g.patientsundergoingtreatmentforcancerorotherseriousillnesses).

Withoutadequatevaccination,weareallatrisk.InCanadain2011,onecaseofmeaslesinareturningtravellerledto678peoplebeinginfectedwithmeasles.TherehavebeentworecentmeaslescasesintheGTAinreturningtravellersinthelastmonthandthereareongoingoutbreaksofmeaslesinmanypartsofEuropeandtheUnitedStates.Thediseasecontinuestobeendemicinmanyareaswhereaccesstovaccinesislimited.

MeaslesvaccineisFREEandcanbeaccessedbymakinganappointmentwiththeRN,NPoryourphysician.Ifyouareunsureofyourvaccinationstatusorwouldliketoknowmore,pleasemakeanappointmentatyourearliestconvenience.

Cont’d on page 9

PeoplewhoshouldreceiveMMRvaccine:• Allchildrenonoraftertheir1stbirthdayandatage4-6years• Personsbornafter1970whohavenotyetreceivedanyvaccine• Personsbornafter1970whohavereceivedasingledoseofMMRvaccineoraboosterdoseofmeaslesonly

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The Taddler Spring 2019

We welcome reader contributions. Email vcharko@tcfht.on.ca if you are interested!We welcome reader contributions. Email vcharko@tcfht.on.ca if you are interested!

THETADDLERDISCLAIMER

The information presented in The Taddler is for educational purposes only and should not be used as a substitute for the professional advice, treatment or diagnosis from your health care provider. Contact your physician, nurse

practitioner or other qualified health care professional if you have any questions or concerns about your health.

ThepurposeoftheTCFHTNewsletter,“TheTaddler”istoprovide:

Educationonvariedhealth-relatedtopicsRegularcommunicationaboutwhatishappeningatTCFHTInformationonissuesthatimpactTCFHTanditspatients

AmeansforpatientstogetacquaintedwithTCFHTteammembersWehopeyouenjoyreadingit!

*TheTaddlerisnotforprivatemarketingpurposes

ApublicationofTaddleCreekFamilyHealthTeam

790BayStreet,Suite306TorontoONM5G1N8

416-260-1315

Editor:VictoriaCharko

EditorialTeam:SherryKennedy,VenusJarabaandDr.ChristinaBiancucci

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Cont’dfrompage8(Measles:WhatYouNeedtoKnow)

• Anypersonwhoisuncertainoftheirvaccinationstatus• Infantsaged6monthsorolderwhomaybetravellingtoanendemicareaoranareawherethereisacurrentmeaslesoutbreak*

• Preschoolerswhomaybeunderage4butwillbetravellingtoanendemicareaoranareawherethereisacurrentmeaslesoutbreak**

*IfaninfantreceivesadoseofMMRvaccinebeforetheirNirstbirthday,theyarestillrequiredtohavetwodosesonoraftertheirNirstbirthday.

**Seeyourhealthcareproviderformoreinformation

PeoplewhoshouldNOTreceiveMMRvaccine:• Pregnantwomen• Personsthataretakingmedicationsthatweakentheimmunesystemandcannotreceivelivevaccines• Personswhohavecertainhealthconditionsthatcauseaweakenedimmunesystemandwhohavebeenadvisednottoreceivelivevaccines

• Allergytoneomycinoranyvaccinecomponents

References:https://www.uptodate.com/contents/measles-epidemiology-and-transmissionsearch=measles&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3#H

https://www.who.int/news-room/fact-sheets/detail/measles

https://www.who.int/emergencies/ten-threats-to-global-health-in-201915294464

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The Taddler Spring 2019Taddle Creek Family Health Team

May 2019 – December 2019 – Groups/Workshops/Drop-In Offerings Groups/Clinics are open to TC FHT patients

For additional information, go to http://www.taddlecreekfht.ca/events-calendar Dates are subject to change

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The Taddler Spring 2019