Your guide to healthy living.
This is your chance to live well.
This is your chance to live well.
By Michael Sakarya [Get Well Clinic]
Diabetes mellitus is a term encompassing various disorders characterized by hyperglycemia, meaning increased blood glucose levels. It arises due to a combination of insulin resistance and dysfunction of the cells in the pancreas that secrete insulin1. In type 1 diabetes, the cells in the pancreas that secrete the hormone signal insulin are attacked by the body’s own immune system, causing a complete lack of insulin secretion. In type 2 diabetes, genetic and lifestyle factors can cause insulin resistance where the body’s cells do not respond to insulin as normal. As a result, there is reduced uptake of blood glucose by the body’s cells and increased glucose production by the liver. The pancreas compensates by excessively producing insulin, but in the long term, the pancreas begins to fail, and insulin secretion decreases. Hyperglycemia manifests in both type 1 and type 2 diabetes.
Farheen Khan, (Hons) B.Sc. (Biochemistry) [Get Well Clinic]
As we enter summer 2.0 of the COVID-19 pandemic (and hopefully the final summer as well), Canadians have been preparing to receive their second COVID-19 vaccine dose. To recap, most Canadians have already received their first dose of one of three COVID-19 vaccines: Pfizer-BioNTech (mRNA technology), Moderna (mRNA technology, or Oxford-AstraZeneca (adenoviral vector technology). Though there have been a lot of questions regarding the second dose, the most common ones have been regarding mixing vaccines. If you find yourself wondering whether it is okay to mix any of the available COVID-19 vaccines, please continue to read on as this article may answer some of your questions.
( Current upated information as of 25-Mar-2021 )
By Farheen Khan, (Hons)B.Sc. (Biochemistry) [Get Well Clinic]
It is now the month of March, and a few more vaccine candidates have marched into our COVID-19 vaccine toolkit. These include the newly approved Oxford-AstraZeneca and Janssen-Johnson & Johnson vaccines.
Both vaccines are viral vector vaccines.1 More specifically, these vaccines contain a weakened, live adenovirus - a virus that causes the common cold.2 To develop these vaccines, scientists first removed all disease-causing and replication-related genes from the adenovirus.1,3–5 As the adenovirus can now no longer replicate or cause disease, it is harmless to the human body.1,3–5
Farheen Khan, (Hons)B.Sc. (Biochemistry) [Get Well Clinic]
The year 2020 will forever be remembered as the year of COVID-19, social distancing, cancelled plans, and more. Luckily, it is coming to an end (finally) with promising results from Pfizer/BioNTech and Moderna regarding the availability of COVID-19 vaccines by early 2021. These vaccines are one type of many different vaccine systems being developed and produced for protection against COVID19.
Both vaccines are messenger RNA (mRNA) vaccines.1,2 Before going on to further explain how these vaccines work, I’d like to first assure that the mRNA engineered for the Pfizer and Moderna vaccines will not integrate into and remain in our DNA forever. Here’s why:
Newer HPV Vaccine prevents 90% of cervical cancers, anal cancers, and genital warts!
Gardasil-9 is better than original Gardasil.
Cancer is a scary word. We all know someone, a friend, family member, or co-worker who developed cancer. They go through difficult treatments like surgery, chemotherapy and radiation. Sometimes they die. We all fear getting cancer some day in our life. When you feel a little sensation in your body, do you often wonder if you might have cancer? Many people always end up going to family doctors and asking if they have cancer. It is a top reason why people request unnecessary imaging and tests, just to reassure themselves that they don't have cancer. We also always get asked questions about what kind of foods, or supplements to take to prevent getting cancer. Why wait until you have cancer to treat it, when you can prevent getting cancer in the first place?
Get Well Family Health Organization
We started Get Well Clinic with an idea that people should be able to see a family doctor when they need to in our community. We have been open to walk-ins since the beginning. However, we are transitioning to becoming a Family Health Organization. This means better care for our rostered family medicine patients. Please read more if you want to know how this might affect you and the importance of enrolling with a Get Well Clinic family doctor soon instead of remaining a walk-in only patient.
Please be advised that there is only one Dr. Kevin Lai who is a University of Toronto graduate, Family Medicine specialist working in Ontario, who used to work as emergency department doctor, and is currently also providing weight management programs and psychotherapy for mental health issues.
However, there are several medical professionals whom you may mistake him for...
A user's guide to getting the best health care the city has to offer, without blowing a gasket
Vincent Lam, Toronto Life
Get the low down on how to navigate the health system yourself with this great article published in Toronto Life.
Have you ever heard your family or friends from back home tell you this?
"Don't bother going to the family doctor, you should go see a specialist for your problem."
"Family doctors know a little bit about many things, but not alot about anything."
Shannon Youn, DCh
Varicose veins are enlarged and sometimes twisted veins found most commonly on the lower limb. At times, varicose veins along with reticular and spider veins (smaller, less prominent dilated veins) are more of a cosmetic concern, while other times, they may be signs of circulatory problems, specifically venous insufficiency. In other words, your veins are not functioning efficiently to work against gravity and bring the blood back to your heart. Rather, the blood pools and consequently dilates the veins in your lower body. See your health care professional when varicose veins are accompanied with aching, heavy, swollen, and/or painful legs, or skin discolourations.
Shannon Youn, DCh
A wart is a skin growth caused by a virus called the human papillomavirus (HPV). Plantar warts are ones that are specifically found on the sole of the foot. If found on a weight bearing area, a wart tends to grow inward under a thick layer of hardened skin/callus. There are generally three tell tale signs a lesion on your foot is a wart: 1. Disturbed normal skin lines 2. Black pinpoint dots which are clotted blood vessels 3. Pain with pinching of the lesion. Some warts will go away without treatment over time, while others may require a visit to a Foot Specialist.
Shannon Youn, DCh
Diabetes is a chronic metabolic disease characterized by elevated levels of glucose or sugar in the blood due a lack of insulin, insufficient levels of insulin, or increase in insulin resistance in the body. Insulin is required so that the body can absorb sugar from the blood and use it as an energy source; without it, the body will be left with high levels of sugar remaining the bloodstream. Consequently, chronically elevated blood sugar levels can lead to long term, sometimes debilitating complications, including blood vessel damage, neuropathy, and a compromised immune system.
Dr. Laura Lee Copeland Medical Psychotherapy Preliminary Forms
A. To be placed on the Wait List:
B. Forms to complete before your First Visit:
C. For handing in Therapy Homework, Create a Secure Email Account:
NOTE: Do NOT use your regular email to send us your forms. Please have your family doctor fax us your completed forms, or drop off the forms to Get Well Clinic in person.
"If you don't hear from us, it does NOT mean everything is OK. You must make a followup appointment for your results!"
You may find this odd that a clinic who values customer service would come right out and tell you not to expect us to call you for your test results. We want you to take responsibility and ownership of your own healthcare. We're not your parents who will nag you about seeing the doctor. If you have any results or further questions, please make an appointment with your doctor for followup and discuss your results. Please come back to discuss your important abnormal results, not-so-important abnormal results, your non-urgent normal results, and your abnormally normal results.
We basically ask our patients to expect that we will NOT call you for results. We do this on purpose in order to build a safety redundancy in to the system so that we will not miss important results. If you only relied on us for results, then it is a single point of failure. If you also were on the lookout for results, then both of us need to miss the results in order for an error to occur.
#1. Our clinic never received the results from the lab... so you never got called.
This happens more often that you think. You did the test, and went home. The lab missed a step and never processed or sent the results. Meanwhile, the doctor is plowing through reviewing hundred of test results daily for over a hundred patients a week, and has no way of knowing what test result to expect back for every single patient he/she saw. You may say: "But I asked the doctor to watch out for the test and call me when the results are in!" I'm reminded of a classic Ruffle's chip commercial: "But if I give one to you...I have to give one to EVERYBODY else!" If we do this favour for you, we have thousands of patients that will ask this same favour from us as well! Despite all our technology, we do not have a good system of tracking every single test for every patient. We like to use simple strategy: you.
If you come in to talk about your results that we did not know about since we did not receive it, this adds an extra layer of safety measure for us to actively pursue your test result from the lab.
#2. Our clinic received the results, but it was misfiled...so you never got called.
#3. The results are sitting in the doctor's inbox for review, but he/she is on vacation, or sick suddenly, or no longer works at the clinic...you you never got called.
#4. We received an abnormal result, and we actually did try to reach you, but could not reach you...so you think you never got called.
There can be many reasons why we can't reach you:
your phone number was wrong, and you didn't leave another contact number
your voicemail box is full and we can't leave any more messages
you don't have a voicemail answering machine, and you didn't pick up the call (maybe you were busy, or out of the cellular area)
we called you three times and no answer, so we moved on to calling the other hundred patients...
#5. You results are normal, and your doctor didn't want to bother you to come to the clinic (since you are just as busy as we are), wait an hour, only to hear everything is normal...so we don't call you.
We don't want to infuriate you. But here is catch, if you don't hear from us, does that always mean that everything in normal? (See above and the rest of this list) However, if you wanted to come to check on your results, then we were not the ones to drag you out to the clinic. We are happy to see you again!
#6. We don't get paid for discussing results over the phone with patients...so we don't call you tell you results over the phone.
Let's be honest, a quick phone call about results, isn't always just one thing. Once a doctor is on the phone with you, then that's a great opportunity to talk about a new problem, or more about an previous problem! Please pay your doctor well, and just make a simple visit to see him/her in person at the clinic. We would enjoy a friendly medically-related chat about your life, and get paid at the same time while doing it! You may say, "happy wife, happy life", and we say "happy doctor, happy healthcare".
#7. We run a slightly higher risk managing medical problems over the phone...so our doctors avoid being on the phone with you, unless it is an emergency.
Whether it is the non-medically trained front staff or even the doctor themselves on the phone with you, relaying medical information or attempting to diagnose and treat medical problems over the phone is fraught with uncertainty and prone for errors. Without the doctor actually physically able to see and touch you (assess you in person), many medical problems cannot safely be diagnosed and treated over the phone. We want to avoid medical errors here, so why would we want to encourage talking on the phone and opening up the possibility of miscommunication?
#8. When the doctor calls me...then it must be bad news!
Some people get anxiety if they get a call from a medical clinic. So what ends up happening, is that they can't sleep the whole night, and the whole week until they see the doctor. Only to find out that something simple was abnormal, like high cholesterol results (nothing you didn't know already).
#9. There are non-urgent abnormal results, that can wait to be discussed at your next scheduled followup visit...so we don't call you about an appointment you already know about because you made the appointment yourself.
Some results can wait to be discussed. Why come back twice when you can come back once? Although we like you coming back, we don't want to go overboard and infuriate you either.
We've also have had our front staff scolded by patients for reminding a patient about coming in for an appointment when they already made an appointment themselves. We value the mental health of our staff as well as our patients.
#10. Your results are normal, but the the problem is that you are still unwell, which means that we haven't found the problem yet...so we don't call you about seemingly "normal" results.
We would like you to followup after test results, because this gives the doctor a chance to see if the treatment advice or medications he/she suggested has been working or not. If it has not, then this triggers the doctor to investigate further, consider other diagnosis, or other treatment options (increasing dose or switching type of treatment). Often, some medical problems do not show all the symptoms if they are discovered too early, and it takes some time to have all the clues surface in order to narrow down a diagnosis from an undifferentiated list. We have no idea that you are still unwell just by reading a page of your "normal" results.
#11. Your results are normal, but the doctor hasn't finished treating you yet, so we already told you to come back for followup...so we don't call you for normal results because the point of coming back is not about the results, but to continue the treatment plan.
A ten minute doctor visit is often not enough time to address all your concerns, all of the doctors' concerns, and provide all the counselling and treatment plans for you. The first visit was to get you teed up for the second visit. Meanwhile, there are many other patients waiting to see the doctor.
#12. In your last visit, the doctor forgot to tell you to come back for results or followup OR you didn't hear the doctor asking you to come back for followup.
So we're telling you here, come back for results.
#13. We don't want you to expect us to call you for results.
I couldn't think of a thirteenth reason yet, but thirteen sounds ominous. Hopefully, we can all remember how important this is.
If we told you that we don't call, but we do happen to call you about a result, then why should you expect not to be called and come back for results? This conversation is starting to go around in circles. The message is "Don't expect us to call you about results! Come back for results on your own!"
Let's agree on working together for your health: You commit to coming back for your results (for all the reasons above), and we commit to calling you about important/urgent results.
A medical visit is not complete with one visit, but usually with a second followup visit (especially if the problem was serious enough to order tests).
Just because you know we may call you about an important/urgent result, don't be fooled and think you don't need to come back yourself and check up on us for your other results.
Besides, if your test results said you were having appendicitis or that you had a serious blood infection, wouldn't you want to be called and notified to go to the ER? : )
By Ava Kavianpour (Get Well Clinic)
Mental health is equally as important as physical health, and we must take care of both aspects of our lives. With the many options available, finding mental health support can sometimes be confusing. Psychologists, psychiatrists, general practitioner psychotherapists and registered psychotherapists are mental health professionals that are similar in what they cover, but there are also differences between them. Continue reading for a summary of each specialty and what they can offer you.
By Nadia Butt [Get Well Clinic]
Defining mental illness and mental health
Mental illness is when the brain is not working the way it should, and as a result, it affects how a person behaves, thinks and feels. Mental illness often disrupts a person’s ability to function in society and interact with others (American Psychiatric Association, 2018). There is a collection of different types of mental illnesses such as depression, anxiety, bipolar disorder, schizophrenia and post-traumatic stress disorder. Individuals with mental illness may experience sadness, extreme feelings of worry, anger and/or mood changes (Lobo & Agius, 2012). However, since mental illnesses are on a spectrum, the severity of symptoms vary between individuals (Lobo & Agius, 2012).
Figure 1. Mental Health Continuum Model (Every Moment Counts, n.d.)
By: Farheen Khan, Get Well Clinic
It is without a doubt that the COVID-19 pandemic has taken a tremendous toll on our daily lives. As we’ve continuously adapted to novel changes and restrictions, many of us have been faced with additional challenges. Below is a list of remote and in-person services that may help alleviate some of the stressors that you may be facing during these unprecedented times.
We know its tough. We're here to help.
If it works for us, it works for you as well.
Take care of yourself.
Psychological First Aid for Frontline Health Care Providers
(Thank you Melanie Joanisse, C. Psych for this helpful guide)