Tuesday, 22 July 2014

Vitamins 101

I've gotten many questions asking me to give some advice or information about nutrition, along with other health inquiries. While I am not your family doctor , I am studying to become a nurse and have a few months left (I am so excited!). I am not in any position to give you direct medical advice, but I am willing to share what I know and have studied in order to help you! As such, this post will be dedicated to discussing some vitamins, their functions, and interesting information on them. If you have any other topics about health or nutrition (including mental health, eating disorders, medications, food, exercise, etc), feel free to comment and let me know. Again, I want to stress that I am NOT giving medical advice here - it is simply my way of relaying my knowledge thus far to those who request it, or to help you understand difficult concepts that perhaps were not well explained to you by other healthcare members, etc. Before we get started, let me warn you that this post will be LONG. I suggest that you read it in two parts: fat vs water-soluble vitamins. As long as this post is, however, it is a great summary of what you need to know about vitamins!

So, let's talk about our vitamins! First, let us separate the vitamins by what they are soluble in. It is easier to remember which are fat-soluble, as there are only four: vitamins A, D, E, and K. That means that everything else - the B vitamins and vitamin C, are water-soluble. This means that the fat-soluble vits (vitamins) need fat to be absorbed into the body. Thus, a deficiency of fat may result in deficiencies in these vits. Now that we know which are fat vs water soluble, we can learn a bit more about the vitamins and what they do in the body, as well as some notable pieces of information.


FAT SOLUBLE

1) Vitamin A: this is needed for vision (yes, your mom was right about carrots and vision!). Deficiencies can result in night-blindness, which, when detected early, can be restored with sufficient vit A intake. However, too much vitamin A is associated with many problems, such as birth defects in pregnant women.

2) Vitamin D: yes, what you heard about bone health and vit D is right. Vit D helps the body absorb calcium, which we know is needed for bone health. Our skin can convert a compound into vit D when exposed to sun, but this isn't enough for our needs. This is because we use sunscreen and do not get enough sun exposure. As such, we need enough vit D in our diet, which is also limited in foods (fish, fortified diary products, etc). Over the age of 50, it is recommended that all adults take a supplement of vit D. Remember to always talk to your doctor before taking any medications or supplements!

3) Vitamin K: This is mainly needed for blood clotting, although it also has a role in maintain strong bones. A deficiency is uncommon, but can occur if the diet doesn't have enough fat in it. Newborns don't have enough vit K at birth (some if made by bacteria in our gut), so we give them an injection within 6 hours of their birth. If you are taking blood thinners, you will likely need to ensure that you do not consume foods high in vit K, which can interfere with the medications.

4) Vitamin E: this is an antioxidant. This means that it helps to decrease or neutralize the toxins that enter our body, which can be from food, metabolic processes, smoke, etc. It is remade by vitamin C.

WATER SOLUBLE
Before I start, let me warn you that there are 12 B vitamins. Most of these function as cozymees, which meant that they are needed for certain processes in our bodies to function normally. For eample, to metabolize foods at the cellular level, our enzymes and proteins need these vitamins to work properly. I will not go into detail about all of these B vitamins, as most of them function in similar ways. I will simply focus on the main ones you should be aware of: folate (vit B 9), and vit B 12, as well as vitamin C.

1) Vit B 9 or FOLATE: this is VERY important for pregnant women because it is needed for DNA synthesis and also for closing the neural tube. The neural tube is part of the brain: it needs to close early in the first trimester (around week 6). If it does not close or does so partially, this results in a neural tube defect (NTD), including spina bifida or ancephaly (a baby without a brain). If born, the baby will have many difficulties and health challenges. Because most women don't even know they are pregnant in the first trimester, folate intake BEFORE pregnancy is essential. Generally, it is recommended that any female who is thinking about pregnancy begin to take folate supplements a year or more before pregnancy, and continue to do so during pregnancy. Note that males, while they do not get pregnant, also need folate bvecause of its role in DNA synthesis. In addition, a defiency of folate in men or women results in a type of anemia in which red blood cells are large (macrocytic). The red blood cells do not divide, so they remain big, which means that there are less of them in the body, resulting in anemia (often called megaloblastic anemia).

2) Vitamin B 12: this is VERY important as well! Vit B 12 is needed for the synthesis of the myelin sheath, which is a coating on our nerves. Without it, changes begin to occur, including tingling in the body and memory loss.  Also, vit B 12 is needed to remake more folate, so a deficiency of vit B 12 can actually result in a deficiency of vit B 9 (folate) as well. Vit B 12 needs enough stomach acid (pepsin and HCl) as well as intrinsic factor (a compound made in the stomach and released by cells in the stomach). As we age,  our stomachs make less of both these, which puts the elderly at an increased risk for vit B 12 deficiency. The recommendation is for all adults over 50 years old to take a vit B 12 supplement. Vegetarians or vegans may also need to take a supplement, as vit B 12 is mainly found in meats.

3) Vitamin C: this is an antioxidant, like vit E. In addition, it is needed for collagen, a protein that holds our skin together. Without enough vit C, we can get symptoms of scurvy, which include loosening of teeth from the gums, open cuts and poor wound healing, etc. Have you heard that vit C can prevent colds? This is a common myth. While it hasn't been found to prevent colds, studies have shown that taking vit C BEFORE a cold may help to shorten the duration of a cold. Also, as vit C is acidic, it enhances (helps) iron absorption. This is why you may have been told to take iron with vit C or with a cup of orange juice.

I hope that was informational! I realize that it is a lot to take in at once, so if it feels like too much, read it in two parts: fat vs water-soluble vitamins. What I love about this topic is that it shows how amazing our bodies are - look at how much goes on inside the body! It also helps us realize why sufficient and healthy diets are important. Without a good, healthy diet, we cannot get all the vitamins and minerals we need to be well. A healthy diet is truly the best way to prevent illness, be healthy and strong, and maintaining a high quality of life. I never thought that I would ever say this...but food is really, really important....and good. Poor food intake and insufficient quantities can result in many problems. Aside from being delicious, look at how food provides us with what we need to be healthy!


Monday, 14 July 2014

Published again! 3 Phrases to Keep You Going

Yet again, blessing upon blessing, I am honoured that my work has been published on Fr. Anthony's site. This time, the topic is on three phrases always said by the late Pope Shenouda III, may he rest in peace. Even if you are not Coptic Orthodox, I strongly encourage you to read this post on these three phrases. I guarantee that you will feel at peace and will draw upon these sentences in times of trouble or distress. http://franthony.com/the-three-phrases-of-pope-shenouda/#disqus_thread

What are the three phrases? Simple: “’this too will end soon”, “God is here”, and “all is for the good”. We all have times when we want to give up. We all have moments when we are frustrated, angry, sad, and tired. And although it is at these times when we least feel like calming down, this is when we need to take a moment to breathe. And when you do, think of these 3 sentences. They have always brought me comfort and peace when in despair. If you can meditate and think of these phrases, you will see how much truth is in them. You will see that this challenge and obstacle will pass; there cannot be a rainbow if there is no rain. The sun comes out after the darkness.
So, please read my post and if you desire, leave me a comment on Fr. Anthony's site and here. Thank you once again to all my readers, supporters, family, and friends. Taking a look back to my blog...it was two years ago when I was just starting up this site up. I was beginning my journey of recovery. And now...wow. I have this blog, I've done interviews, and now, I have my own book. God is good. For all of you who are suffering, tired, or feel like you are fighting a heart-breaking and endless journey - do not give up. Every challenge you face makes you stronger and teaches you a lesson. If it were not for my journey with ED thus far, I would bot have had all these amazing opportunities to use my experiences to help others. So, whenever you feel like giving up....remember: “’this too will end soon”, “God is here”, and “all is for the good”.



Monday, 7 July 2014

The 'Dr. Oz' Controversy

Before I start this post, let me put a disclaimer: I am not shaming Dr. Oz as a person or professional. I am simply retaking the facts and weighing in (haha - weighing in! Did you catch that pun there?) on an issue that must be discussed.

You may be familiar with Dr. Oz. We seemed not to know this doctor until he appeared on the Oprah show one day. Since then, he has become quite famous. From books to a show to online, everyone speaks about Dr. Oz. His show speaks about new 'miracle weight loss' tips and solutions. He promotes certain diets or herbs or pills that apparently are going to revolutionize the way we can control our weight. And there is no end to those who idolize him. The common love for him goes something like this: 'Dr. Oz says something, and the world responds. He can say nothing wrong. If Dr. Oz says something, it must be true. I must go out and buy this miracle pill because Dr. Oz said that it works'.


So can you imagine what happened when the world is told that Dr. Oz was challenged just two weeks ago. It was found that some of his statements and claims were false; they are not based of scientific evidence. He then admitted that 'there is no magical pill that will help you lose weight without diet and exercise'. In the end, it seems that Dr. Oz's claims about weight loss miracles are simply not true or accurate. They are misleading. (See
http://www.ctvnews.ca/health/dr-oz-effect-celebrity-doctor-scolded-for-pushing-miracle-weight-loss-aids-1.1873171) for details. And sadly, his position as a doctor, one also loved by Oprah, makes this even more tragic. People believed in him. People believed that as a 'doctor', whatever he said was correct. People thought that since he appeared on Oprah, he must be right. Media claims about Dr. Oz's wisdom filled society with the idea that whatever Dr. Oz said was right. And now, we are told that this is false. Society is now (finally) hearing the truth: Dr. Oz is not always right. Not very grunt he says must be true.


I've personally never been a fan of Dr. Oz. For one thing, I know that a pill or food alone cannot help control weight. In all my nursing studies, I'll tell you the basic notion: weight control comes from eating a balanced diet and exercising. Secondly, Dr. Oz's 'advice' never comes with scientific articles that have proven to me what he is saying. I refuse to accept his claims without studying the evidence behind them. Third, just because he is a 'doctor' doesn't mean that he is always right. I'm a nursing student, soon to be a nurse. If I said that you can grow wings by eating purple broccoli, would you believe me?

Perhaps the hype around Dr. Oz come from the desire of society to refuse to accept responsibility for our health. We don't want to be told that eating a variety and balance of foods in moderation is the best option. We don't want to hear that exercise is needed. Society wants to hear that there is a miracle for being healthy. We want the easy way out, so to speak. It's a lot easier to buy a pill and hope that it will speed up my metabolism than it is to actually our in the effort of eating well and controlling my stews. But what society needs to know is that there IS NO MIRACLE. THE MIRACLE IA BALANCE: balance in eating all things in moderation, sleeping and exercising, and controlling stress and risk factors. We also need to begin to realize that we can't believe everything we read or hear. We need to learn to search for the evidence and to see that simply being someone in authority and prestige, such as Dr. Oz, doesn't make someone the wisest person alive.

Will everyone stop listening to Dr. Oz now? Sadly, I don't think so. People who love him will refuse to believe that his claims are fake and wrong. Or people will soon forget about this when he comes on TV the next episode to talk about some other miracle solution. What needs to change is society. We need to become smarter receivers of information. We need to stop consuming information without stopping to see if it is credible. We need to start taking charge of our health and seeing that our bodies are not experiments. Our bodies need care. That means a balanced diet, physical activity, and rest. No miracle pill can give your body this. Once we learn to stop taking advice from sources that aren't reliable, we can begin to take steps that will truly promote our health. And once we stop paying attention to false source of information that claim they have found 'miracle solutions and magical life savers to the weight/body size/(whatever problem the world faces), we can ensure that these sources do not continue to fool people. Please, be aware of what you listen to and what advice you take. Do not simply listen to advice because someone is in a position of authority or because everyone else is doing it. Be smart and informed.

And just to lighten things up a bit, here is a comic that both brings this message across...and makes me laugh each time I read it.


Tuesday, 1 July 2014

Iron!


I don't think it is incorrect to assume that you have heard that you need enough iron, or else you will develop anemia. Iron is necessary for health, not only to prevent anemia from occurring. What foods contain iron? When are supplements needed? What IS anemia?

Let's start with talking about iron itself. Iron is a micronutrient that is needed for many bodily processes. The most well-known and studied function of iron is its association with hemoglobin and myoglobin: these are proteins that are needed for blood. But, did you know that iron is also needed for an enzyme that detoxifies the body? Or that iron also has a role in immune functions? Probably not - neither did I at first. This is because iron's main function is that of hemoglobin synthesis.


Hemoglobin, made of iron, delivers oxygen to cells and body tissues. So, what happens when we don't have enough iron (Fe)? Less hemoglobin, meaning less oxygen to cells and tissues. This is problematic because we know that our cells need oxygen and blood to survive. A lack of iron may result in iron-deficiency anemia (IDA). Signs and symptoms may include pallor or a pale skin colour (especially on the face), feeling cold, weakness, fatigue, rapid heart rate (palpitations), and irritability.
Male adults need about 8 mg of iron a day, although this increases during pregnancy. Females also need more because of the loss of blood through mensuration, which puts their recommended iron intake at around 17 mg a day. After menopause, female iron needs drop to 8 mg, the same as men. Vegetarians may not take enough iron in the diet and may need supplements. However, it is important to remember that iron can be found in many foods. What is VERY important to know is that iron absorption is inhibited by many factors or nutrients, including calcium, fibre, and tea. However, iron absorption is INCREASED if consumed with acidic foods such as vitamin C or orange juice, as well as red meat (ex. beef). This means that while beef contains iron, it also enhances iron absorption. The picture contains some food sources of iron.
So, the question many people have is...should i take an iron supplement? Again, I am not in the place to give anyone medical advice. But what I CAN say is that if you have any concerns about your iron intake, it is a good idea to keep track of it in a journal. Also, if your family has a history of anemia, it may be a good idea to bring this to your medical team's attention. If you have symptoms of anemia such as tiredness, low blood pressure, weakness, paleness, etc., also be sure to bring this to your doctor's attention. Finally, if you do take iron supplements, remember not to take it with any diary products. Also, taking it with vitamin C will enhance absorption. I hope this post taught you something about iron!

Tuesday, 24 June 2014

Care of a patient with ED

I was inpatient once for my eating disorder...and...well, let's just say that it wasn't my favourite experience. Why? Was the problem in me? Was it the staff there? Or both? How do nurses and doctors care for patients with ED?

There is a lot of evidence that is now focussing the relationship we have with patients with ED. When I say 'we', I mean healthcare providers. I am lucky because I got to see this from both ends: from being a patient, and now, as the nurse. I can tell you that one thing that I hated about inpatient (IP) was being treated like a baby or child. The staff made me feel like I was...inferior because I had an ED. I felt that despite being 18, I was not treated as such. In addition, I felt that no one there cared about me. Sure, the staff did their jobs. But in the end of the day. there is definitely room for improvement. What is interesting is that this advice can even go beyond how to treat someone with ED - it all comes down to understanding how we, as society, should treat anyone in general...especially those who are ill and need compassion and support.

As a nurse, I am aware of how my attitude and mannerisms can affect patients. If I am angry, this can make the patient feel sad or uncomfortable. If I am happy, I can do my best to comfort the patient. Helping patients with ED is not any different. Sure, nurses and doctors are simply 'doing their job', and I am not expecting every healthcare professional to love their patients. But I AM expecting that you treat them with respect and dignity. That, during your time at work, you for your best o help patients and to advocate for them.

I can see how doing this can be hard. Caring for a patient with ED means that you need to be careful with what you say and do. You need to take careful assessments of their body systems to recognize complications and to keep them safe. You need to understand that sometimes, the patient will not be able to understand how ill she or he is, despite being so thin and frail. As a nurse, I see this all the time with patients with ED. But because of my experiences as a patient. I also realize that this is not their fault. Patients CANNOT see that they are ill. They are sick, but they don't FEEL it. At the same time, patients may be smart, funny, or appear to be healthy. This is why caring for ED patients is so hard - you need to be mindful that looks can be deceiving, and that intellect is different from illness. ('Caring for the hospitalized patient with an eating disorder' (2003) by Gimby and Wolfe is a pretty good article about how to assess a patient with ED).

What I particularly want to point out is that as nurses, we need to be mindful that patients with ED need a lot of care. They don't just need to be fed, weighed, and monitored for exercise or self-harm. They need to feel cared for, and they need to learn how to care for themselves. They need to understand that you are doing your best to keep them healthy, even if they do not want this now. You need to tell them that despite their discomfort now, they will get better and recovery is possible. You know how hard they are working, and you realize that eating and gaining weight is the hardest thing that they will ever do in their lives. But you also know that this is worth it, and that they are strong enough to overcome this. You know that this is not their fault; that recovery is on its way and that it will take time. Mistakes happen, and they are human. Even with relapses or mistakes, you know that they can muster up the strength and devotion to continue on their way towards recovery. You know that they are more than their eating disorder - that the ED does not define them, nor does it say anything about their character, personality, manners, beliefs, etc.

Again, this is easier said than done. I was a patient with ED before, and I know how stubborn and firm I was. But again, I know that this wasn't my fault. I was ill, and I needed my nurses and doctors to understand this. instead of blaming me, I needed support and motivation. Instead of making me feel stupid for being sick, I needed someone to tell me that I was being strong. instead of treating me like nothing more than an eating disorder, I needed someone to make me feel that I was human and I had a life outside of this illness. The main point, in the end of the day, is to remember that all patients, with any illness, are not at fault for their disease. And regardless of what they are ill with, or how this came to be, they deserve to be treated with respect, love, care, and dignity. No blame, no shame.

Monday, 16 June 2014

Bone Health

You have probably heard many different things about bones and how to keep them strong. Your parents likely told you to drink your milk, and your physician may have instructed you to take calcium, or vitamin D supplements. We all hear that bones need calcium and vit D to be strong...but why? Are supplements better? Is milk the only cure? How much do we need? (Please note: I am not in any position to give individual medical advice because I am not aware of your personal health and needs. Please contact your medical team for definitive advice that will be tailored to you! This blog is not a substitute for medical attention).

First, let me give you some background information on bones. Structurally, they are made of calcium and phosphorus, with some magnesium. Two hormones control calcium levels in the body: PTH from the parathyroid glands, and calcitonin from the thyroid gland. This is not necessary to know, but I will include it here so that if you are interested, you can look for more information. Now, you must understand that calcium is important for other processes in the body as well, such as muscle contraction, hormone release, and more. Thus, our bodies need to ensure that blood calcium, levels are not too high nor too low - they must be just right. When the calcium levels get too low, PTH is released. PTH acts on the bone to release calcium from bones, thus making more calcium available in the blood. This is important because we just learned that our bodies need calcium, levels to stay just right for normal processes. BUT PTH breaks down the bone to release this calcium into the blood. So, if you don't have enough calcium, PTH will break down the bone to ensure calcium levels are stable.

This is largely why we need to ensure that we are eating enough calcium, in our diets. If we don't, PTH causes the bone to break down, thus weakening our bones and depriving them from the calcium that makes them sturdy and strong. How much calcium do we need? People over the age of 18 generally need around 1000 mg a day, while women over 50 and males over 70 need 1200 mg a day. Children typically need 1300 mg a day. The picture has some sources of calcium and how much they contain.

When women reach menopause, changes in hormones occur - namely, estrogen and progesterone drop. This causes many changes, but for the sake of this post, we will focus on what it does to the bones. Estrogen and progesterone maintain bone health in females. So, when they drop at menopause. women are at greater risk for osteoporosis. By the way, osteoporosis is when the bones are no longer as strong as they should be, characterized by decreased bone mass density. This puts them at greater risk for fractures as well. This is why females really need to ensure they consume enough calcium!

Supplements are often needed because the modern day diet doesn't contain enough calcium. There are SO many different calcium supplements out there, so please speak to your physician and/or pharmacist before taking one. You should ensure that you need the supplement, as too much calcium is not desirable either. Also, calcium pills should generally be taken two to four hours within other medications because they can impair the absorption of other medications.

Equally important is vit D, which is needed in the intestines for calcium, to be absorbed. This is why you will hear that vit D and calcium, are needed together. We need about 600 IU of vit D a day, which is VERY hard to get from the diet alone. Vit D is not very plentiful in foods except for some fish and fortified dairy products or orange juice. Vit D supplements can also be taken, and they are usually very small pills (which is nice, b3cause calcium pills are usually big!). Again, talk to your medical team before taking any supplements.

I hope that clarified some myths or questions some of you had about bones and calcium! As usual, I am open to researching or providing any information about health or mental health, etc that you are curious about, so let me know. Being a nursing student has made me that much more interested in these topics, so please ensure that you are informed!  In the end of the day, ensure you are getting enough calcium for your needs, as this is extremely important for bone health and will prevent future complications such as osteoporosis, falls, fractures, and more. Remember, a healthy life begins with a healthy mind and a healthy body!

Monday, 9 June 2014

What does 'healthy' mean?

What does it mean to be healthy? To different people, health means many things. The most widely accepted or popular definition of health is that of the World Health Organization, which states that health is spiritual, mental, emotional, and physical - and not simply the absence of disease. 

I like that definition, mainly because it sums up what I have learned to see health as. When I was sick, I didn't really care what health was. Was I underweight? Yes. But I felt good, didn't i? I was still religious. I was getting good grades. So, technically, I thought I was okay. Looking back now, I see that I wasn't. Health is more than just physical, but being physically healthy is important too.

Unfortunately, society today has somewhat changed our perceptions of health. Sometimes, we don't even know what 'health' is - and why it's important. Take a look at commercials for diets or any product. Do they advertise health as important for happiness and success? No. Diet products show that losing weight is important so that you can look good. Yes, some of them say that this will help you feel good. But they miss the point that feeling good doesn't come simply from being at a certain weight. Or, consider the example of a commercial for a dating website. Emotional health is important, right? So wouldn't a relationship be important too? Yes! But is this the only thing about health? No. Again, society doesn't give us a compete picture of health. And if we aren't careful and alert, we won't be aware of what health really is.

Being healthy is important because it helps us maintain an optimal quality of life. Being healthy helps us love life fully. We can then set goals and strive to achieve them, always persevering and feeling successful. We can eat and drink in moderation and feel strong physically. We need a good education so that we can work, feel accomplished, and bring something important to the world. We need healthy relationships so that we can communicate and live peacefully with others. We need to feel at peace and to feel safe so that we can complete our daily tasks and be proud of ourselves, feeling safe and confident. Therefore, all aspects of health are important. We can't be healthy physically and expect that this alone means we are 'fine', because perhaps emotionally we are struggling. We can't be healthy mentally and expect that we will be alright, as we may in fact be struggling physically and therefore suffer. What's the 'take home' point? Health encompasses many aspects of our lives - and one isn't more important than the other.

But society will try to tell you what it wants you to believe - that one aspect alone implies a state of health. Be aware and alert, and take time to define what health means to you. When you know how you define 'health', you will be able to determine what aspects of health you have in your life, and what remains. And remember, life isn't perfect. It's nearly impossible to be 'healthy' in the compete sense, because challenges always appear. The difference - and what's important to recall - is that you have the power to change your life. You may not be able to control what happens to you, but you CAN change how you respond to it and how you let experiences impact you. Take each moment and each experience as am opportunity to learn and grow. When you do this, you can start to see that although being fully 'healthy' may be difficult, having an awareness of health will allow you to pick yourself up after every struggle and remind yourself that you alone have the power to control how life's obstacles influence you. Will you let your troubles make you or break you?