Latest / Morning Medical with Dr. Chow / Outdoor Time & Mental Health, Cold Water Immersion, Refugee Health Workers in Nova Scotia

Transcript

Outdoor Time & Mental Health, Cold Water Immersion, Refugee Health Workers in Nova Scotia · Morning Medical with Dr. Chow

• 0:00
  Welcome to Morning Medical with Dr.
• 0:01
  Chow, where we bring you the latest updates in the world of health and medicine.
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  I am your host, Dr.
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  Chi-Ming Chow, and today we have some fascinating stories to discuss.
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  Let's dive right in!
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  Our first story today is about the impact of spending time outdoors on mental health.
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  According to a recent study from the University of Utah, just being outside for at least ten
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  minutes a day can significantly improve mental health.
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  Researchers found that outdoor exposure can reduce stress and enhance mood.
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  Professor of Social Work, Joanna Bettmann Schaefer, emphasized that it does not matter
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  what you are doing outside; simply being in a natural environment for a minimum of ten
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  minutes is beneficial.
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  She said, "In order to get the benefits of nature exposure, you just have to be in a
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  natural area for a minimum of ten minutes."
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  Interestingly, the study pointed out that the location does not have to be a remote
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  wilderness.
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  Whether you are in a city park or on a hiking trail, the benefits are the same.
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  Schaefer mentioned, "You can find a street that has more trees than buildings.
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  More greenery around you.
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  It can be a garden…
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  Anything that is more green than it is built."
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  The data shows that despite having different mental illnesses, individuals can still
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  experience the same positive effects on their mental health by spending time outdoors.
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  This is a crucial finding, as it suggests that nature exposure can be a universally accessible
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  tool for mental health improvement.
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  So, whether you are feeling stressed, anxious, or just in need of a mood boost, consider
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  stepping outside for a few minutes.
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  It might be just what you need to feel better.
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  Remember, nature is a powerful healer, and sometimes, the simplest solutions are the most
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  effective.
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  Taking too many prescription pills can lead to a host of side effects and potential problems.
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  The practice of deprescribing, or reducing or stopping medications that are no longer
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  necessary for a patient’s health, could relieve these side effects and improve overall health.
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  Swallowing a handful of pills is a daily ritual for many people, from young adults coping with
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  anxiety to older adults managing chronic conditions.
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  In the United States, 13 percent of people take five or more prescription drugs.
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  For those aged 65 and older, that number jumps to 42 percent.
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  However, taking multiple medications can lead to potential problems.
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  One pill can cause a side effect, leading to another pill and another side effect in what
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  experts call a 'prescribing cascade.' Some drugs can cause harm if taken for years, while
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  others may stop working or interact badly with new medications.
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  A drug that was tolerated well initially can cause side effects later, leading to cognitive
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  decline and injuries from falls.
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  Dr.
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  Elizabeth Bayliss, a researcher at Kaiser Permanente's Institute for Health Research in
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  Aurora, Colorado, studies deprescribing.
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  She notes that 'our metabolism changes as we get older.
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  Everyone's ability to metabolize the medications they have been taking for a long
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  time may change.'
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  Medication overload, as it is called by the non-profit Lown Institute, is a situation
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  predicted to cause 4.6 million hospital visits this decade.
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  If your daily pill routine is getting out of hand, it might be time to ask for a medication
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  review.
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  Start with a professional you trust, like a doctor or pharmacist, said Lisa McCarthy, a
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  pharmacist and deprescribing expert at the University of Toronto.
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  Pharmacists can help you review your medications and write up recommendations to
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  share with your doctors.
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  If you're asking your doctor, do not wait until the end of a 15-minute visit.
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  Instead, make a dedicated appointment and tell them when booking that you want to talk about
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  your medicines, McCarthy advised.
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  Your doctor may not have the full picture of what you are taking if other prescribers are
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  involved, and some doctors hesitate to manage drugs prescribed by others.
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  That is when a pharmacist can help by reviewing everything and writing up suggestions you can
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  share with your doctors, said pharmacist Bradley Phillips of the University of Florida
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  College of Pharmacy.
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  'We are considered the medication experts,' Phillips said.
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  Swelling, incontinence, restlessness, and insomnia are all side effects caused by common
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  medications that sometimes get treated with new drugs.
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  McCarthy wants people to ask their doctors a simple question: Could this symptom be related
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  to one of my medications?
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  'If we could teach the public to ask that question it would be very powerful,' McCarthy
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  said.
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  For a follow-up question, she suggested inquiring whether the problematic medicine is
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  still needed.
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  Barbara Farrell, a pharmacist at an outpatient geriatric center in Ottawa, has seen dramatic
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  changes in many people she helps.
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  Some have emerged from drug-induced dementia after their medications were reduced.
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  A seventy-seven-year-old woman was able to leave her wheelchair and walk with a cane after
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  cutting her daily pills from thirty-two to seventeen.
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  She had arrived sedated and unable to communicate, and a few months later, she was
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  back to her hobby of knitting.
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  Weaning off medication takes time.
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  Some medications can be stopped abruptly, but others require a slow taper to prevent
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  uncomfortable withdrawal symptoms or even life-threatening seizures.
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  Tapering to progressively lower doses is particularly important with drugs for
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  depression, insomnia, and anxiety.
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  Therapist Molly Bernardi of Spokane, Washington, began tapering down her doses after
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  two decades on various pills for these conditions.
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  The forty-five-year-old suspected the pills were causing her worsening problems with
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  digestion, balance, memory, stiff muscles, and flickering dots across her field of vision.
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  When scans ruled out other illnesses, she gradually stopped each of four medications.
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  'It has been by far the hardest thing I have ever done,' Bernardi said.
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  One of the final drugs she stopped was the toughest: a benzodiazepine, a class of
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  sedatives that can be harmful if taken long-term.
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  Over the course of three months, she used a kitchen knife and a nail file to cut her
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  one-milligram daily pill into ever-smaller pieces.
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  She listened to her body, found support groups on Facebook, and used breathwork and prayer to
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  get through withdrawal symptoms.
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  'Now when I have a good day, a good hour, a good moment, it is peace and presence like I
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  have never known since before I was medicated,' Bernardi said.
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  'I am just experiencing a little bit of great.
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  And a little bit of great is so great that it keeps me going.'
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  Even in the best-connected health-care systems, information about prescriptions is not always
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  shared among doctors.
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  And they will not know about your over-the-counter drugs, vitamins, or nightly
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  CBD gummy.
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  The only person who knows everything you take is you, McCarthy said.
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  So keep a current list of what you take, why it was prescribed, and when you started taking it.
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  McCarthy said a medication list is a 'tremendously powerful' tool.
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  McCarthy and her colleagues have created workshop materials designed to help people
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  reduce or stop medications safely.
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  If you are feeling overwhelmed by the number of pills you are taking, consider looking into
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  deprescribing.
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  It might just be the answer to improving your overall health and well-being.
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  You may have seen people jumping into frigid seas or stylish ice baths, claiming these dunks
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  are good for heart health, muscle recovery, stress, and more.
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  This practice is known as cold water immersion, a type of cryotherapy or cold therapy, which
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  can be applied for medical or therapeutic purposes in various ways.
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  It can be done via ice, water, or air, including cryosurgery for lesions, ice packs
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  for swelling, or through ice baths for various purposes including exercise recovery or stress
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  reduction.
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  There is a long history of people immersing themselves in cold water for the purported
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  health benefits, tracing all the way back to ancient Greece—thus, a larger body of research
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  on this type of cold therapy.
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  In modern times, some people wonder if cold showers, a more accessible form of this trend,
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  could also do the trick.
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  Taking cold showers may have benefits for your mental and cardiovascular health, experts say.
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  Dr.
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  Corey Simon, an associate professor in the department of orthopedic surgery at Duke
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  University and senior fellow at the Duke Aging Center, mentioned that 'The research is very,
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  very thin as it pertains to cold showers itself.' There are at least 100 studies, some
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  of which are decades old or have methodological issues, and most also have low numbers of
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  participants, who are usually healthy younger adults, Simon said.
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  But experts have ideas for why cold showers might work, based on what scientific and
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  anecdotal evidence there is, he added.
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  Simon thinks most of the benefits of cold showers come from the psychological process of
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  adapting to and overcoming a stressor—in this case, the chilly water.
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  'Folks do not just go from zero to sixty in cold showers,' he said.
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  'They have to work up to them usually, so there is the element of your body being able to
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  control being in a stressful environment.'
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  This theory tracks with the results of some studies on cold showers.
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  Participants who took showers with a water temperature of about fifty degrees Fahrenheit
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  to fifty-seven point two degrees Fahrenheit—ten degrees Celsius to fourteen degrees Celsius—for
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  up to a minute daily for two weeks reported lower stress levels than the control group,
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  according to an October 2022 study published in the journal Current Psychology.
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  The benefits were stronger when participants took their showers after doing a few rounds of
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  a breathing technique that involved deep breathing, exhalation, and breath holding.
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  Simon takes a cold shower once or twice per week, which he said has helped him become more
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  mentally present in general since the practice forces him to process the 'suffering.' Cold
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  showers may also improve mood and energy or mental alertness, which Dr.
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  Rachelle Reed, an exercise physiologist in Athens, Georgia, has experienced, she said.
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  'You sort of feel a little bit elated, and that is thought to be due at least in part to that
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  increase in the neurotransmitters epinephrine, norepinephrine, and dopamine.'
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  These psychological benefits may also be a primary reason why some people feel cold
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  showers reduce their pain, for which psychological distress is a main predictor,
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  Simon said.
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  During immersive cold therapy, the temperature shock can briefly stress the cardiovascular
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  system, spiking blood pressure, heart rate, and breathing rate, experts said.
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  But this hyperactivity can lead to improved blood flow since the body needs to work to
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  return to its normal state and warm up, Reed said.
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  Cold showers could theoretically produce the same effect to some extent.
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  That said, people who have cardiovascular issues, circulatory problems, sensation
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  issues—such as Raynaud’s disease or neuropathy—or diabetes should not try cold
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  showers without speaking to a doctor first, experts said.
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  The same goes for those who are pregnant, have recently had surgery, or are under the
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  influence of alcohol or drugs, Reed said.
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  People have died from trying cold therapy, Simon said, so this disclaimer is serious and
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  should not be ignored.
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  Cold showers may also help support the immune system.
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  In a May 2014 study, the authors tested whether the immune systems of a small group of Dutch
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  men could be improved by practicing meditation, deep breathing, and cold showers for ten days.
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  When the authors administered a bacterial infection via injection, the study participants
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  who had used the wellness techniques had fewer symptoms.
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  Those participants also produced more anti-inflammatory chemicals and less
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  inflammatory proteins in response to the infection.
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  But Simon is not sure this result is wholly positive, since recent research has started to
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  suggest decreasing the inflammatory response to temporary illness might prolong or prevent
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  recovery, he said.
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  Chronic inflammation, not acute inflammation, is the bigger problem, Simon said.
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  The Dutch study also does not reflect the individual effectiveness of the three
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  techniques: meditation, deep breathing, and cold showers.
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  However, a September 2016 study based in the Netherlands found people who spent thirty to
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  ninety seconds taking a cold shower experienced a twenty-nine percent reduction in the amount
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  of time absent from work due to sickness.
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  There have also been anecdotal reports of getting sick less often while taking cold
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  showers.
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  Cold showers could be beneficial in regard to fitness as a way to alleviate muscle
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  soreness—but not right after a resistance training workout, Reed said.
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  'The latest evidence suggests that you would not want to disrupt the inflammation process
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  that comes after lifting,' Reed said, which causes 'the muscles to get stronger and larger
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  and more efficient over time.' Reed recommended using cold therapy only on days off from
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  lifting.
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  Additionally, cold showers may temporarily increase metabolism but have not been linked to
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  weight loss.
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  If you want to try taking cold showers and have been cleared by your doctor, start small,
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  experts said.
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  Studies tend to employ cold showers in the range of fifty degrees Fahrenheit to sixty
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  degrees Fahrenheit—ten degrees Celsius to fifteen point five degrees Celsius—but a
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  thermometer is not required, said Simon, who does not use a thermometer and still
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  experiences benefits—though he acknowledges this is anecdotal.
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  Quickly going from hot to cold could be too shocking, so ease from lukewarm water into
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  cold, Simon suggested.
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  Fifteen to thirty seconds of cold exposure is good to begin with, Reed said.
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  After that, try adding fifteen seconds or so every few weeks.
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  As you build your tolerance level, box breathing can help you feel calm in the shower;
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  resist holding your breath for too long, she added.
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  That involves inhaling for four counts, holding for four counts, exhaling for four counts, and
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  holding for four counts.
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  Pay attention to your body’s feedback and any cues that you should remove yourself from the
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  cold, Reed said.
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  Simon and Reed cannot definitively say taking cold showers are a surefire way to improve
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  overall health, but they do think that in a stressful world, the practice can be a good
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  addition to a baseline level of health already supported by the basics: diet, hydration,
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  physical activity, and sleep.
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  Our final story today focuses on the inspiring journey of refugee health-care workers who have
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  recently settled in Nova Scotia, Canada.
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  These workers, recruited from one of the world's largest refugee camps in Kenya, are now
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  contributing significantly to the local health-care system.
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  Abdifatah Sabriye and Patricia Omar Kamssor, two of the health-care workers, arrived in Nova
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  Scotia nine months ago.
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  They were part of a federal program aimed at bridging the gap between skilled displaced
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  individuals and labor shortages in Canada.
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  Now, they are working as continuing care assistants at the Mahone Bay Nursing Home on
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  Nova Scotia's South Shore.
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  In an interview at the nursing home, Kamssor expressed her affection for the residents,
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  saying, "I really love them.
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  Any time I go home, I do miss them." Sabriye, who has already picked up the local Maritime
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  term of endearment, echoed this sentiment while assisting a resident, saying, "Honey, I want
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  you to roll towards me." He added, "In our culture, if someone's elder, they are like our
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  parents, so I'm always treating them like my parents."
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  Both Sabriye and Kamssor had spent over a decade living in the Kakuma refugee camp in
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  northern Kenya before coming to Canada.
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  Sabriye had been there for 14 years and Kamssor for 11 years.
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  Despite the challenges they faced, such as the harsh winter and the lack of African food or
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  halal meat in their small town, they have found the community to be welcoming and have enjoyed
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  their work.
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  The Economic Mobility Pathways Pilot (EMPP) is the federal program that facilitated their
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  move.
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  Launched in April 2018, the program allows refugees to become permanent residents as soon
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  as they land in Canada.
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  This means they are not tied to a specific province or workplace, giving them the freedom
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  to move within the country.
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  Doug Stephens, chief human resources officer for MacLeod Cares, the company that owns Mahone
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  Bay Nursing Home, highlighted that traditional recruitment efforts were not as successful as
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  the EMPP in attracting workers, especially after the COVID-19 pandemic.
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  Stephens said, "It's made it a lot easier for us to transition to a new home, expand our
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  workforce and have enough staff to run the facility." The federal government has set
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  ambitious targets for the program, hoping to resettle 2,000 people over the next few years.
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  Kamssor and Sabriye have faced some challenges, such as finding permanent housing and adapting
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  to the Canadian winter, but they remain optimistic.
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  The company provided temporary housing, but they are now searching for affordable permanent
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  housing within walking distance, as they do not have cars and there is no public transit.
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  Both Kamssor and Sabriye have expressed their gratitude for the opportunities Canada has
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  provided.
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  Kamssor, who worked as a supervisor in a pharmacy and provided care in a clinic inside
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  the refugee camp, said, "As long as it is concerning human life and taking care of them,
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  I'm just OK with it, and it's not boring at all." Both are planning to continue their
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  education and hope to become nurses.
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  They are also learning to drive, have joined soccer teams, and hope to eventually be
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  reunited with their families left behind.
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  Sabriye said, "I know a lot of friends there.
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  They're skilled but they don't have anything." They are encouraging more companies to consider
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  recruiting from refugee camps.
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  These stories of resilience and dedication serve as a reminder of the immense potential
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  and strong skills that refugee health-care workers bring to their new communities.
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  Their contributions are invaluable, and their journeys are truly inspiring.
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  That wraps up today's episode of Morning Medical with Dr.
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  Chow.
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  Thank you for joining us as we explored these compelling stories.
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  Remember to take a few minutes to step outside today, consider the benefits of deprescribing,
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  and if you are brave enough, maybe even try a cold shower.
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  We'll be back tomorrow with more updates and insights from the world of health and medicine.
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  Have a great day!