October 2020                                         View this email in your browser

Community Health Centre: Healthy People, Vibrant Communities

October 2020 Newsletter

Happy Thanksgiving
Flu season is soon upon us.  And while we laugh at our men when they get sick, it is actually no laughing matter.  Influenza or flu, is a virus that attacks the respiratory system. The flu virus is highly contagious: When an infected person coughs, sneezes or talks, respiratory droplets are generated and transmitted into the air, and can then can be inhaled by anyone nearby.  Unfortunately, COVID-19 has thrown a bit of a wrench into things.  The symptoms and transmission are much the same.  As we have seen and heard, a person who touches something with the virus on it and then touches his or her mouth, eyes or nose can become infected.
Flu outbreaks happen every year and vary in severity, depending in part on what type of virus is spreading. Influenza is a different virus, as it changes its proteins so that your body does not recognize it when you are subjected to it.  Therefore, your immune system does not recognize it as an enemy and go to battle with all of your good white blood cells.
Young children, people over age 65, pregnant women and people with certain medical conditions, such as cancer, asthma, COPD, diabetes or heart disease, face a higher risk of flu-related complications, including pneumonia, ear and sinus infections and bronchitis.  In Canada each year, 12,200 people are hospitalized and 3,500 die due to influenza and its complications.  Most people will recover with on 7-10 days.  Some people are at greater risk of complications, which include pneumonia, ear infections, dehydration and worsening of chronic medical conditions.
Coronavirus vs. flu: Similarities and differences:
It can be difficult to distinguish “flu” from other viral or bacterial causes of respiratory illness based n symptoms alone.  There are lab tests to diagnose flu, although it is usually not necessary for most people.

How are COVID-19 and the flu similar?

The viruses that cause COVID-19 and the flu spread in similar ways. They can both spread between people who are in close contact (within 6 feet, or 2 meters). The viruses spread through respiratory droplets or aerosols released through talking, sneezing or coughing. These droplets can land in the mouth or nose of someone nearby or be inhaled. These viruses can also spread if a person touches a surface with one of the viruses on it and then touches his or her mouth, nose or eyes.
COVID-19 and the flu have many signs and symptoms in common, including:
  • Fever
  • Cough
  • Shortness of breath or difficulty breathing
  • Tiredness
  • Sore throat
  • Muscle aches
  • Headache
  • Nausea or vomiting, but this is more common in children than in adults
  • The most common difference that one my experience with COVID-19 is Loss of taste or smell as well as one or more of the above symptoms.
The signs and symptoms of both diseases can range from no symptoms to mild or severe symptoms. Because COVID-19 and the flu have similar symptoms, it can be hard to diagnose which condition you have based on your symptoms alone. Testing may be done to see if you have COVID-19 or the flu. You can also have both diseases at the same time.
Both COVID-19 and the flu can lead to serious complications, such as pneumonia, acute respiratory distress syndrome, organ failure, heart attacks, heart or brain inflammation, stroke, and death.
Many people with the flu or mild symptoms of COVID-19 can recover at home with rest and fluids. But some people become seriously ill from the flu or COVID-19 and need to stay in the hospital.

How may COVID-19 affect this year's flu season?

Flu season in North America typically occurs between October and May. It's possible that the viruses that cause COVID-19 and the flu may spread in your community at the same time during the flu season. If this happens, people could become ill with one or both diseases at the same time. Testing can determine which virus you may have and help guide doctors to the appropriate treatment. People who become seriously ill from either disease may need to stay in the hospital at the same time, which could cause the hospitals to become full.

How can you avoid getting COVID-19 and the flu?

The good news is you can take the same steps to reduce your risk of infection from the viruses that cause COVID-19, the flu and other respiratory infections by following several standard precautions. In fact, some research has found that following these measures, such as social distancing and wearing a face mask, may have helped shorten the length of the flu season and lessened the number of people affected in the 2019-2020 flu season.
Standard precautions to reduce your risk of COVID-19, the flu and other respiratory infections include:
  • Avoiding large events and mass gatherings
  • Avoiding close contact (within 6 feet, or 2 meters) with anyone outside your household, especially if you have a higher risk of serious illness
  • Washing your hands often with soap and water for at least 20 seconds, or using an alcohol-based hand sanitizer that contains at least 60% alcohol
  • Wearing a cloth face mask when you're in public spaces, such as the grocery store, where it's difficult to avoid close contact with others
  • Covering your mouth and nose with your elbow or a tissue when you cough or sneeze
  • Avoiding touching your eyes, nose and mouth
  • Cleaning and disinfecting high-touch surfaces, such as doorknobs, light switches, electronics and counters, daily especially at work.
Taking these prevention measures can help you stay healthy and reduce your risk of becoming ill with COVID-19 or the flu.
  • Self-Isolate and get plenty of rest
  • Drink lots of fluids
  • Consider over the Counter medications that can help to relieve pain or fever.
  • Warm baths
  • Gargle sore throats
  • Avoid alcohol and Tobacco
  • Call your NP or  Doc FIRST for unrelenting fever, difficulty breathing,
  • Avoid the Emergency Department if possible
    • There are people compromised with cancer or other diseases, infants/Children that you may infect.
  • YOU CANNOT get the flu from the vaccine- it is NOT live virus.  If you feel unwell or sick after the flu vaccine, this is your body building antibodies against those flu strains that are in the vaccine.   Just like when small children get their immunizations starting at 2 months of age, side effects always include, fever, crankiness, feeling unwell for a couple of days, redness and swelling, muscle aches at the site of the injection.  This is not different with adults.
  • It takes 12-14 days post vaccination to be protected
  • It is possible that you MAY still get the virus, it may be a less serious illness or it could be a different strain than what was in the vaccine.
  • If 70% of the people in GREY BRUCE were immunized, chances of anyone getting the virus will be much less.  This is called “HERD IMMUNTY”.  Herd Immunity is a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, thereby providing a measure of protection for individuals who are not immune. In a population in which a large number of individuals are immune, chains of infection are likely to be disrupted, which stops or slows the spread of disease. The greater the proportion of individuals in a community who are immune, the smaller the probability that those who are not immune will come into contact with an infectious individual.
This year flu vaccine will be available at the Clinic end of October or Early November.  First people to get their flu shots should be high-risk patients.  The pharmacy may also be giving flu shots in your area.
We will be running flu clinics.   It will be by appointment only and you must come at your time, not early or not late.  You will be seen in a predetermined area and will not enter the clinic proper. 
Please wear a mask and wash your hands upon entering the clinic.
Patients not wearing a mask will not be seen in the clinic area.  If there is a medical reason why you cannot wear a mask please let reception know, a nurse will ask you to wait in your car, you can get your arm ready and she will some out to give you your injection.
You will be asked to wait 15 minutes before leaving.
If you are not a patient of the clinic you may be asked to sign a consent form.
You will not be seeing your primary care provider if you have only an appointment for the flu vaccine.  You will not be allowed in the clinic.  Please arrange a separate appointment for that.
Please watch for Flu Clinics advertised locally, IDA Pharmacy, Dundalk, Markdale.

October is Breast Cancer Awareness Month
The Stats
Breast cancer occurs when normal cells in the breast become abnormal and grow out of control.  The cancer can grow into a lump and eventually spread to other places in the body such as the bone, liver, lungs, or brain.  Breast Cancer most often diagnosed in women, but is also seen in men.
Breast cancer is the 3rd most common cancer in Canada and the most common in women.  Each year in Canada more than 22,000 women develop breast cancer and more that 5,000 die from the disease.  1 in 8-9 women is expected to develop breast cancer in her lifetime.   The risk goes up as women get holder.
Risk Factors
  • Age- can occur at any age, however, it increases with age
  • Family history
  • BRCA gene mutation
  • Reproductive status- menstruating at an early age (before age 12) having a first baby after age 30, or never having a baby and completing menopause after age 55.
  • Hormone Exposure ( ie. Estrogen- exposure over a long period of time and at high doses)
  • Alcohol- if you consume alcohol, stay within the recommended guidelines of one alcoholic drink per day.
  • Obesity- try to maintain or achieve a recommended body weight as discussed by your dietitian or provider.  Exercise is a great supplement to health and wellbeing.  Eat a healthy diet, reduce the amount of red meat, increase fruits and vegetable, watch portion sizes.  Eat three meals per day and healthy snacks.
  • Smoking – Nearly 17% of all deaths in Canada can be attributed to smoking. 
Fake News   True or False?
  • Underarm deodorants/antiperspirants causes breast cancer.
    • False
  • Underwire bras cause breast cancer.
    • False
  • Silicone breast implants increase your risk of breast cancer.
    • False
  • Monthly breast self-exams are necessary to find breast cancers.
    • False
  • Regular breast exams by your health care practitioner need to be done routinely.
    • False
Evidence clearly indicates that women between the ages of 50-74 should have a mammogram every two- three years or as recommended by the findings.  Women with dense breast tissue may be asked to come more frequently. 
The (dreaded) Mammogram
A mammogram is a low-dose x-ray that allows doctors called radiologists to look for changes in breast tissue.  It can often find or detect breast cancer early, when it’s small and even before a lump can be felt. This is when it’s easiest to treat.
screening mammogram is used to look for signs of breast cancer in women who don’t have any breast symptoms or problems. X-ray pictures of each breast are taken, typically from 2 different angles.  Mammograms can also be used to look at a woman’s breast if she has breast symptoms or if a change is seen on a screening mammogram. When used in this way, they are called diagnostic mammograms. They may include extra views (images) of the breast that aren’t part of screening mammograms. Sometimes diagnostic mammograms are used to screen women who were treated for breast cancer in the past.
A mammogram uses a machine designed to look only at breast tissue. The machine takes x-rays at lower doses than usual x-rays. Because these x-rays don’t go through tissue easily, the machine has 2 plates that compress or flatten the breast to spread the tissue apart. This gives a better picture and allows less radiation to be used.  It should not be painful, but can be uncomfortable.
Mammograms expose the breasts to small amounts of radiation. But the benefits of mammography outweigh any possible harm from the radiation exposure. Modern machines use low radiation doses to get breast x-rays that are high in image quality.   We are exposed to background radiation daily.  The dose of radiation used for a screening mammogram of both breasts is about the same amount of radiation a woman would get from her natural surroundings over about 7 weeks.
Other Investigations
Ultrasound may be requested after your mammogram or during it for an ultrasound to target an uncertain area that is seen on a Mammogram.  This is neither unusual or harmful, although it may cause you some anxiety.  It just means that something has been picked up on the mammogram that requires a different type of image.  This helps to rule in or rule out a query about a possible lesion that may require further investigation with a biopsy.
MRI-Magnetic Resonance Imaging of the breast is a painless test that produces very clear images of breast tissue. MRI uses a large magnet, radio waves, and a computer to produce detailed images of breast tissue. It does not use X-rays (radiation).
MRI is used to provide more detail after a person has been diagnosed with breast cancer. A MRI exam helps measure the extent of the cancer, look for other cancer or abnormal tissue in the breast, and monitor for breast cancer after treatment.
The Canadian Cancer Society recommends that women with a high risk of breast cancer be screened with MRI and an annual mammogram to detect breast cancer. However, MRI is not recommended as a screening tool for women at average risk because it can miss some of the cancers found by a mammogram and because it can result in many “false positive” findings. In other words, the high sensitivity of the MRI can lead to many unnecessary tests, biopsies, and anxiety for average-risk patients for what turns out to be a non-cancerous lesion.
Thermography, also called thermal imaging, uses a special camera to measure the temperature of the skin on the breast’s surface. It is non-invasive test that involves no radiation.
Thermography is based on two ideas:
  • Because cancer cells are growing and multiplying very fast, blood flow and metabolism are higher in a cancer tumor.
  • As blood flow and metabolism increase, skin temperature goes up.
Thermography has been available for several decades, but there is no evidence to show that it’s a good screening tool to detect breast cancer early, when the cancer is most treatable.  This is not recommended by most practitioners.
Booking a Mammogram
  • Self- Refer to Ontario Breast Screening Program
    • The closest for Grey Bruce residents  is Grey Bruce Health Services – Owen Sound  519-376-8637
      • Wear a two piece outfit
      • No deodorant or body powder  :-O
  • You practitioner will do a requisition for urgent referrals and this can be in Orangeville, Owen Sound, Barrie etc.
High Risk Women will discuss with their family provider about the best course of action taking into consideration all of the risks and the facts and applying the best evidence.
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