Acne 101

What is Acne?

The medical term for it is Acne Vulgaris. Vulgaris seems like a bad word but it really just means common and it is exactly that. It affects 80-90% of the population (by age 25 only 10% of the population is affected). It is a disease that can scar for life and could have been prevented.

What causes Acne?

Acne is caused by occlusion (clogging) of skin pores, which leads to overgrowth of bacteria, pus, inflammation and pain. Untreated acne can leave scars and persistent redness of the skin.

Acne Myths?

Acne is NOT caused by foods and does not reflect poor hygiene (in fact, aggressive soaps and scrubbing may worsen acne). The black heads are NOT dirt they are melanin and oxidized lipids. SO cleaning vigorously or picking can actually make the acne worse.

Treatment of Acne

There are many different treatments to try. The goal of treatment is quite simple:

1. To reduce plugging 

2. Minimize inflammation

There are over 140 different treatments and over 250 combinations! SO what does the research show to be the most effective treatments?

Benzoyl peroxide: this is a first-line treatment for mild and moderate acne due to its effectiveness and mild side-effects (primarily an irritant dermatitis). It works against the “P. acnes” bacterium, helps prevent formation of comedones, and has anti-inflammatory properties.

Antibiotics: commonly used antibiotics, either applied topically or taken orally it is to reduce bacteria and fight inflammation. They include: erythromycin, clindamycin, and tetracyclines such as doxycycline. We do worry about over using antibiotics so it is good to take a break from them every few months to see if you still need to take them.

Hormones: In females, acne can be improved with the use of any combined oral contraceptive. This decreases hormones that cause plugging.

Topical Retinoids: these are medications that possess anti-inflammatory properties and work by normalizing the follicle cell life cycle. This class includes tretinoin, adapalene, and tazarotene. Like isotretinoin, they are related to vitamin A, but are administered topically and generally have much milder side effects.

Oral Retinoids: Isotretinoin is very effective for severe acne as well as moderate acne refractory to other treatments. Improvement is typically seen after one to two months of use. After a single course, about 80% of people report an improvement with more than 50% reporting complete remission. About 20% of people require a second course. Isoretinoin is a homerun for acne treatment.

You must use birth control as this drug can cause birth defects and in no way can a pregnant female take this drug.

**Remember it takes about 6 – 8 weeks to see if treatment is working. When we are treating acne it for the next round of acne. The success rate is not 100% according to studies it is about 40-70%. You can increase the success rate when you find something that works for you. You may have to experiment to see what works best.

Bring Acne up with your doctor, there is nothing to be embarrassed about. Cheers to a healthy emotional life through your healthy skin!

Love My Life and Your Life,

Peter Eppinga M.D.

 

The 3 ABC’s of Diabetes

A stands for “A1C” which is a test that looks at your control of blood sugar over the last 3 months.

B stands for “blood pressure”. High blood pressure puts you at risk for heart attack, stroke, and kidney disease.

C stands for “cholesterol” Cholesterol is a waxy substance found in the blood. High cholesterol is another factor that increases your risk of heart attacks, strokes, and other serious problems.

The second set of ABC’s

A stands for “activity” – increasing your activity, walking, biking, swimming, running, or doing whatever you love to do.

B stands for reducing your “belly” and weight. We know with diabetes weight around the tummy is especially important even a few percentage lost can make a really big difference.

C stands for “change”. Your belief and ability to change can have a big impact on diabetes also creating new social contacts with people who want to change.

The third set of ABC’s

A stands for “appointment”. Schedule a regular visit with your clinic every 3 to 4 months so you can review how you are doing over time. We need to measure you so we can tweak your medications or lifestyle choices to improve your chances of staying healthy.

B stands for “BMI”. Body mass index is a measure for human body shape based on an individual’s mass and height. The target range for diabetics is 18.5 – 24.9.

C stands for “control” – you are in control of looking after your health and taking your medication and knowing what they are used for. We are here to help you but ultimately it is up to you to keep yourself healthy.

What should my ABC levels be? — The levels you should aim for will depend on how severe your diabetes is, how old you are, and what other health problems you have. Ask your doctor or nurse what your target levels should be.

In summary from above many people with diabetes aim for:

A1C levels below 7 percent

Activity – aerobic activity (30minutes) most days of the week and resistance training three times per week

Appointment – Schedule a regular visit every 3-4 months.

Blood Pressure below 130/80, (or lower in some cases, your doctor may help you set a different goal).

Belly –waist circumference, Male <94cm and Female <80cm

BMI – targeted to be 18.5 – 24.9

Cholesterol – LDL = level below 2.6 mmol/L (LDL is one type of cholesterol, often called the “bad cholesterol” or “lousy cholesterol”)

Change and Control – you can change and you are in control. We are here to help you along the way to better health.

How can I control my ABC’s? — You and your doctor will work together to create a plan to keep your ABC’s under control. Remember to write down all the numbers so you can keep track of where you are and where you are going.

Take care of your body. It’s the only place you have to live.  ~Jim Rohn

Love my life and your life,

Peter Eppinga M.D.

 

 

 

 

 

 

 

 

Wanting to Quit Smoking?

For many quitting smoking has been a rollercoaster ride. Many attempts have been made with no success. You are not alone. Only 1 in 10 smokers are successful on each attempt. Why?

Nicotine is the SOLE reason for continued tobacco usage. Nicotine is safe in usual 1-4mg doses, BUT TOBACCO IS THE SOLE CAUSE OF DISEASE.

The benefits that some people think they get from smoking is actually the benefits of nicotine which include: mental alertness, stimulation of your muscles, and assisting in a feeling of relaxation. Nicotine itself is a safe substance.

SO HOW CAN YOU QUIT?

Using safe pure nicotine substitution.

1. Gum 2mg nicotine ($30/105 pieces)

2. Lozenges ($22/24)

3. Inhaler ($45/42 cartridges)

The above techniques allow for flexible dosing when you have a craving.

4. Patch (Provides 7-14mg of nicotine and allows for a baseline level of nicotine)

5. & 6. I won’t talk to much about the pills but they are available. One may use Zyban (Buproprian) or Champix (Verenicline) (may be a little more effective and newer but has some side effects that you can discuss with your doctor).

Combination therapy has shown to increase success rates by 3-4 times.

What doesn’t work: acupuncture, laser therapy, and hypnosis. When compared to a placebo the rates of stopping smoking are not better.

5% of people quit cold turkey for 6-12 months, but most relapse in about 8 days. 2/3 to 3/4 of people quit smoking on their own, this is good but is always good to talk to your doctor or health care provider about this. We are here to help you with the process.  

The Disgusting facts that you already know about so I will not spend too much time writing about it: Tobacco contains 10 billion carbon particles/ml, 4500 chemicals, 500 are gaseous and 50 are carcinogenic, sexual dysfunction in later years, poor healing of injuries, 7 year life span loss in the “golden retirement years”, increased risk of heart attacks, increased risk of stroke, and increased risk for many cancers.

STAY MOTIVATED: YOU CAN DO IT. WE CAN HELP. YOU ONLY HAVE ONE BODY TO LIVE IN, TAKE THE BEST POSSIBLE CARE OF IT.

If you have tried quitting and were not successful try again. The Japanese have a proverb that says success is falling down 7 times and getting up 8 times.

Love my life and your life,

Peter Eppinga M.D.

How To Take an Accurate Blood Pressure Reading

Did you know that approximately 4.6 million Canadians aged 20 years and older (19% of the population) have high blood pressure? That is why it is so important that we get our blood pressure checked and do our best to make it accurate.

The first part of accuracy is to choose the appropriate blood pressure cuff size. Cuffs that are too short or too narrow may give a falsely high reading. Using a regular sized cuff on a large arm may lead to a false diagnoses of hypertension. This means that heavy or very muscular people with thick arms need a larger bladder, while children need a smaller bladder.

* Ask your doctor to make sure they are using the appropriate cuff for your arm.

– The width of the inflatable bladder should be about 40% of the upper arm circumference (about 12-24 cm in the average adult).
– The length of the inflatable bladder should be about 80% of upper arm circumference (almost long enough to encircle the arm).

Here are some things that you should do before taking your blood pressure:

-You should not smoke, drink caffeinated beverages, or exercise 30 minutes before your blood pressure is measured.

-The room should be quite and comfortably warm

-Your arm when taking the blood pressure should be at mid chest level, or your elbow at the level of your heart

-Remove excess clothing that might interfere with the BP cuff or constrict blood flow in the arm.

-Your legs should not be dangling or crossed over. It’s better if you rest for 5 minutes in that position before the measurement.

-Try not to talk during the measurement.

– When the doctor is deflating the cuff. It is recommended that the pressure should fall at 2 – 3 mmHg per second, anything faster may likely result in an inaccurate measurement. This means when the doctor is letting the pressure come out of the cuff that it should take at least 10 seconds.

-If you need to check the pressure again for accuracy wait about five minutes between readings. Typically, blood pressure is higher in the mornings and lower in the evenings.

-If the blood pressure reading is a concern, masked or white coat hypertension is suspected, a 24- hour blood pressure study may be required to assess your overall blood pressure profile.

Below is a table for blood pressure measurements (Canadian Guidelines):

Category (Systolic / Diastolic)
Normal            (120-129 / 80-84)
High – Normal (130-139 / 85-89)
High blood pressure (measured in a doctor’s office) (140 / 90)
High blood pressure (measured at home with home monitoring device) (135 / 85)
High blood pressure for people with diabetes (140 / 90)

* One high reading does not necessarily mean you have high blood pressure. If you have one high reading, you should have it measured at least two more times on separate days to check whether it is consistently high.

To summarize the table above:

Normal blood pressure is between 120/80 mm Hg and 129/84 mm Hg.

Blood pressure that is consistently more than 140/90 mm Hg when measured in the doctor’s office or 135/85 mmHg when measured at home is considered high. If you have diabetes, 140/90 mm Hg is high.

* If your blood pressure is between 130/85 mm Hg and 139/89 mm Hg, you have “high-normal” blood pressure, which is more likely to develop into high blood pressure.

Because hypertension is a “silent disease” many people are not worried about it. However hypertension can cause much harm to the body if untreated, some of the harms it can cause include the following: stroke, vascular dementia, hypertensive retinopathy, left ventricular dysfunction, angina, heart attack, heart failure, chronic kidney disease and intermittent claudication.

The good news is that you can try lifestyle changes to make it better. One of the best treatments is to loose weight, you can also try a DASH diet (dietary strategies against hypertension – talk to your doctor about this). It is also important to have low sodium intake, increase your physical activity (discuss with your doctor), use alcohol in moderation, stress management and please (pretty please) stop smoking.

If the lifestyle management is not working to control your blood pressure (follow up should be in about 3 – 6 months) you may have to talk with you doctor about trying some medications to get your blood pressure under control.

“Take care of your body. It’s the only place you have to live”.

Love my life and your life,
Peter Eppinga M.D.

Order Your Brain 3 Pounds of Fat Equals Your Life and Destiny

I am so excited to announce the release of my book available in June 2013 it is titled:

YOUR BRAIN – Three Pounds of Fat Equals Your Life and Destiny

All of your thoughts, beliefs, opinions, theories or dogmas are in your mind, which is contained in YOUR BRAIN. In other words whatever you impress in your mind will become expressed in your physical life. Your brain has the ability to change your life and this book will teach you how to look after your brain and maximize its potential.

You can now Pre order your book and we will send you a copy in June when they are available. You can purchase by clicking the buy now button under the book. 

I recently graduated from medical school and during my medical training I became deeply fascinated with the brain. I loved everything about it and how it works. We know little about it and it is responsible for our life. Your mind is housed in your brain, and it is your mind that will determine who you are.

In this book, I give many interesting facts and insights to your brain. There are several ways in which we need to take care of it, including proper sleep and exercise, in order to reap all its benefits and for it to function optimally. This 3 pound piece of fat truly does contain your destiny and you need to learn about it and look after it. Just like maintaining a car, you have to understand how it works and look after the engine, the same is for your brain and mind. As you look after it properly you will get the best results for your life and reap all of its benefits.

I wrote this book with the intention to help you find your destiny in God. There is a reason as to why you are here. God sees your life from the end. From the moment of conception to the end, he knows your life. God never starts anything that is not already complete, including YOU. My desire and hope is to make God’s vision for your life clearer to you. There are many tools in this book to help you see this vision and complete your destiny.

I am sure when you are done reading this book your life will not be the same. A wise doctor once told me, “There are two things that will change your life, the people you meet and the books you read.” This is a book that will change your life and will draw you closer to the Creator of the Universe. The electronic version for kindles and iPads will be available in mid June.

Love My Life and My BRAIN!

Peter Eppinga M.D.

 

Stay Away From the “White Stuff”…..SUGAR

We consume a lot of refined sugar in the form of high fructose corn syrup and table SUGAR. According to the new Statscan report, which used data from the 2004 Canadian Community Health Survey, one in every five calories that Canadians consume comes from SUGAR. Canadians consume an average of about 110 grams of sugar per day (the equivalent of about 26 teaspoons). About a third of that intake is derived from normal sugars that come from vegetables and fruit.

Calculating that out, the report showed us that 35% of the sugar we consume is coming from the “White Stuff” we should stay away from…namely that includes sweets and soft drinks. This means the average Canadian consumes about 38.5 grams (10 teaspoons) from the bad “White Stuff” per day!

We have come from consuming a little bit of SUGAR in our diets to now having a large portion of our daily diet complimented with SUGAR.

SUGAR is one of the causes of the Obesity Pandemic in North America. About 31% of Canadians (and about 30% of Americans) are obese and the number is growing and has been growing for the past 20 years in addition to this we are now dealing with the childhood obesity problem.

Our holidays are associated with SUGAR. Halloween (sweets), Easter (chocolates), and Christmas (candy canes) have the culture of SUGAR built around them. Even at birthday parties the birthday cake is covered in SUGAR and the drinks are full of it as well.

Science tells us if our body has too much SUGAR it will react negatively to it (especially high fructose corn syrup). It can lead to obesity, which we know that obesity leads to certain cancers, cardiovascular disease and type 2 diabetes. The good news is you can eliminate it from your diet.

How to avoid the SUGAR problem:

1. Try not to buy it – the more sugary treats that are close to you….you will eat it. Don’t buy SUGARY soft drinks (pop), the sugar or pop will always win if it is in your house.

2. Take small steps to slowly wean it from your life. Find creative ways to eliminate refined SUGAR from your diet.

3. Have good support from your friends. Share your goals with them and the people in your home. Tell them, “If you see me eating SUGAR….remind me I want to stop it”.

4. Reward yourself with all of your efforts. Enjoy your life and fun!

5. Eat more fruits, vegetables, decrease SUGAR intake and exercise and you will loose weight. Talk with your Doctor or medical health professional about your goals and ask them for their help.

I have many things I tell myself in the morning and one quote that has changed my life is,

“I eat food to fuel my body and NOT to satisfy my appetite, I only have one body and I need to look after it”.

Cheers to eliminating refined SUGAR from your diet. “Love My Life” and my one and only body 🙂

What is the greatest medicine? What makes the biggest difference to your health?

~ People with knee arthritis were on this medicine for one hour, three times/week and this reduced their rates of pain and disability by 47%.

~ This treatment decreased progression to Dementia and Alzheimer’s by 50% in older patients.

~ Patients with high risk of Diabetes had a 58% decrease in the chances of getting frank diabetes on this medicine.

~ Post-menopausal women were treated 4 hours/week and had a 41% reduction in the risk of hip fractures.

~ This treatment decreased anxiety by 48% in a big meta analysis.

~ Patients suffering from depression were on this treatment and 30% were relieved with a low dose of the treatment and this increased to 47% as the treatment was increased.

~ Following 100,000 Harvard Alumni for over 12 years this treatment gave a 23% lower risk of death than those who did not get the treatment.

~ This medicine is the number one treatment of fatigue and most importantly this therapy increases ones quality of life.

SO WHAT IS THE TREATMENT? NOT A SUPER PILL, OR ANY SUPERINVENTION.

THE TREATMENT WAS SIMPLE EXERCISE. Yup you heard me right….Exercise….and with exercise there is no side effects but health benefits.

Dr. Steven Blair conducted a study called the Aerobic Centre longitudinal Study. Where he followed 50,000 men and women. A part of the study was looking for the strongest predictor of death…what do you think he found….did you think smoking was the strongest predictor of death? What about high blood pressure? Both of these were not the answer he found the strongest predictor of death is Low Fitness.

“THE BEST THING YOU CAN DO FOR YOUR HEALTH IS BEING ACTIVE FOR A ½ HOUR A DAY”

The studies above looked mainly at walking as the form of exercise. By spending ½ hour or 1 hour being active every day will be a positive benefit to your health.

Another study to note is the nurse’s health study which followed women who were not active and then followed them as they increased their activity to one hour/week and found that they reduced heart disease rates by almost a half!

Your style and approach to exercise is what matters:

~ Remember to talk to your doctor before you start any exercise program.

~ You can meet with friends to play sport or go for a walk

~ Your commute to work can be a walk to work…you save money on parking and your body receives the health benefits from it.

~ Walking the dog is great…one study found dog walkers meet the exercise requirements more often.

~ You can play in a Basketball tournament! By the way the Haida’s won the All Native Tournament this year. Way to Masset Masters and Skidegate Saints! 2013 Champs!

There is no “pill” better than exercise. Hippocrates said, “Walking is man’s best medicine” and I couldn’t agree anymore.

(It is also good for your Brain…..but that will be a later post) 🙂

Peter Eppinga M.D. “Love my Life” especially when exercising!

 

 

Aboriginal Teen Suicide Prevention

Love my Life t-shirt is to remember all those who have taken their life by suicide. The Haida design is of an eagle and a raven inside of a heart. Allan Weir is the Haida artist who did the magnificent design. Allan and I unfortunately have had our own cousins take their life in Haida Gwaii and this shirt is to remember them.

The purpose of this shirt is to reach out to the youth specifically the Aboriginal youth to prevent suicide. The websites provided on the shirt allow youth to read about mental health issues themselves. Mincheck.ca allows youth to fill out a questionnaire that will tell them more about how they feel and if it is necessary to contact a mental health professional in their local community or call the number provided on the website. Please check out www.mindcheck.ca for more information on filling out the questionnaire.

Remember suicide is 100% preventable and depression is a common complaint that I have seen in the emergency room and family practice setting. There is hope out there and different treatments available. A great elder once told me, Honour your life and Esteem others better then yourself. I wanted to leave the same message with you to Honour your Life and get help if you need it.

You have a purpose for your life and you are not an accident. You are an original. When the Creator made you He threw away the mold so that there would only be one of you in this world. The Creator has great things planned for your life! Never let anyone’s opinion of you determine what you will do with your life. Be proud of who you are. If you’re Aboriginal be even more proud of who you are and know that you are intelligent and capable of doing anything with your life!

“Look up hold your head high……be proud of who you are!” I put this on the bottom of the shirt and made the letters upside down so the person who is wearing the shirt will be able to read it as reminder to be proud of who they are. They will have what is called a positive affirmation about themselves. I have seen many youth looking down and not making eye contact with me when I shake their hand. I just wanted to remind them and you to look up and be proud of where you come from. You are going to do great things for your community.

Stay blessed! Love my Life!

Peter Eppinga M.D.

How to Have Better Communication With Your Doctor

Have you ever left a doctors appointment feelings your questions were not answered or you were unsure about what to do next?……don’t worry you are not alone.

Today I want to talk about how to speak up for your self when you are at the doctor’s office or the hospital and how to improve communication with your health care team.

When your talking to doctors or nurses tell them how you feel. Don’t be shy to ask questions or correct a doctor or nurse if they misunderstood what you said. The more information you can share with your doctor the better able they will be to help you.

Here are 5 tips for effective communication with your doctor:

  1. Write a list and take a pen. Arrive with your top 2 or 3 questions and take notes.  This will help you track of the conversation and remember what was said.
  2. Bring information, outside test results, and a current list of medications. Do not assume that your doctor has all the medical information at hand.
  3. Bring another set of ears. If you think you may have trouble remembering important information it will be good to have a relative or a trusted friend in the appointment. They can listen, ask questions and take notes for you.
  4. If you do not understand something ask again. Don’t be afraid to ask the doctor to repeat something or explain it in a different way.
  5. Ask for an interpreter if you need one. If English is not your primary language don’t be afraid to ask to have an interpreter present if needed. Call ahead to be sure the interpreter will be available at the time of your visit.

Good communication is a two-way stream. It is your body and it is your life.  It is up to you to speak up for yourself and make sure you get the treatment and information you need to stay healthy. Cheers to living a healthy life.

Young Adult and Teen Mental Health

Something’s not quite right…..

You’ve noticed that you’ve been feeling or acting differently. Maybe you’re feeling a bit more moody, anxious or stressed than usual. Maybe your finding it difficult to accomplish tasks as easily as you used to or your drinking is getting out of hand. Maybe things just don’t feel quite right, and you don’t know why.

It could just be a tough time you’re going through….maybe it’s something more. Checking it out at mindcheck.ca right away can help make all the difference.

mindcheck.ca offers quizzes to help you better understand what’s going on with you and provides support such as education, self-help tools, website links, a chat link, and assistance in connecting to local professional resources. Fraser Health and BC Mental Health and Addiction Services’ mindcheck.ca website and is focused on early intervention and prevention for teens and young adults.

Acting early will help you feel better faster, and stop the problem from getting worse.

If you do find out that your dealing with depression, anxiety,  or substance misuse, you’re not alone. One in five B.C. youth and young adults experience these types of issues and if you act early, you can stop them from interfering with your life at home, school, work, and with your friends. Help is there.

I just visited  www.mindcheck.ca   and thought it was a fantastic resource. I highly recommend checking this site out! This goes out to all my Haida Peeps!