Charleswood community correspondent
Recent articles of Lisa Lagasse
Fortunately, in my career I have only come across a few patients diagnosed with amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, after the famous New York Yankees baseball player who died in 1941.
However, the impact of ALS has hit closer to home for me after having an uncle diagnosed with it. Much remains medically unknown about this disease, but it is estimated that five to 10 per cent of patients get ALS due to heredity. It is a progressive nervous system disease that affects the nerve cells in the brain and spinal cord, resulting in loss of muscle control. Eventually, it affects mobility, speech, nutritional intakes and breathing. Unfortunately, it remains incurable but there are some promising treatments under study.
Symptoms of ALS include difficulty with walking and the basic activities of daily living, such as dressing brushing teeth, etc. These eventually lead to tripping and falls, muscle weakness, slurred speech, dysphagia (difficulty swallowing), muscle cramping, and cognitive and behavioral changes. ALS causes nerve cells (motor neurons) to die, and the brain and spinal cord cannot send messages to muscles. The complexity of the nervous system makes treating and managing ALS very difficult. ALS is most common in those 40 to 60 years of age and affects men more than women. A multidisciplinary, team-based approach is required to manage ALS. This includes not only MDs but also dietitians, speech language pathologists, occupational therapist, physiotherapists, and social workers.
In terms of nutrition, it is important to focus on combating malnutrition, dehydration, reducing the risks of aspiration pneumonia (food going into the lungs) and choking. Texture-modified diets are often required, along with nutritional supplementation. Many patients will go for swallowing tests such as a video fluoroscopy to see what type of diet texture is required. As the disease progresses, many will be unable to swallow, and an enteral feed may be considered. Also known as a tube feed, this is where a tube is inserted into the stomach or small intestine and a nutritional formula is delivered via a pump feeding system. Medications can also be delivered via the feeding tube. A registered dietitian will calculate the amount of formula required based on height, weight, lab data, calorie, protein, and hydration needs, etc. Enteral feeds can be flexible with both intermittent and continuous feeding times based on the individual’s preferences and routines.
May is Mental Health Awareness month and at no time has this been more significant with Canadians being profoundly affected by the restraints of COVID-19 over the past two years.
Lockdown restrictions combined with fear have had a detrimental effect for many, with statistics proving increased substance abuse and suicides. Unfortunately, many Canadians suffer with some form of mental illness, with mood and anxiety disorders being the most common, encompassing depression, bipolar disorders and substance abuse.
Does nutrition play a role in mental health? The short answer is yes.
Research links show that poor nutritional choices can increase risk factors for anxiety and depression disorders. Overeating, comfort eating and under-eating not only affect mental health but also physical and overall medical health as well.
Irritable bowel syndrome (IBS) is a chronic gastrointestinal condition that can cause bloating, abdominal pain, diarrhea, constipation and cramping.
It can be exacerbated by stress, illness, and dietary habits or specific foods and beverages. IBS can be hard to diagnose because there are a lot of other diseases that have similar symptoms such as celiac disease, Crohn’s disease, and ulcerative colitis.
If you are experiencing ongoing gastrointestinal upset, it is important to talk to your medical professional. Keep a journal of what you are eating and what your symptoms are so that it is easier to narrow in on what the problem may actually be.
Even some vitamin and mineral deficiencies such as vitamin B12 or a lactose intolerance can cause similar issues. When specific foods cause discomfort, it would be best to leave them out for a while and reintroduce in small quantities at a later date.
There has been a lot of media scrutiny of long-term care facilities that have been in COVID-19 outbreaks. Some of it has been positive but a lot has shone a negative light on the shortcomings within some personal care homes.
I am a registered dietitian working in two large for-profit facilities, and the pandemic has been especially hard, especially at Extendicare Oakview Place.
Oakview Place’s COVID-19 outbreak began in November. Initially, only one or two residents tested positive but it spread rapidly. Thankfully, the outbreak was contained to the north side of the building.
The quick action and team efforts of all staff made a world of difference in ensuring that all residents received proper care, nourishment, support and protection. The regional director put out daily communications to family members and staff to keep everyone abreast of what was going on. Daily cleaning schedules were ramped up, all staff had access to personal protective equipment including N95 masks and strict screening criteria were (and always had been) implemented. Residents were immediately isolated to their rooms once they tested positive and units were closed.
The gluten-free diet has become popular but, unfortunately, this has been for all the wrong reasons.
Gluten-free diet restrictions should only be used with a confirmed diagnosis of celiac disease or dermatitis herpetiformis. Blood tests and an intestinal biopsy are used to diagnose celiac disease, which is an auto-immune disorder.
It is also important to note that if you suspect that if you believe you have celiac disease, you should not start a gluten-free diet before diagnosis, as this will skew your results. The signs and symptoms of celiac disease are broad and varied and certainly not limited to gastrointestinal discomfort. They can include anemia, weakness, weight loss, skin issues, bone and joint pain, infertility, migraines, depression, fluid retention and canker sores.
A gluten-free diet is the only treatment for celiac disease and dermatitis herpetiformis. Too often, people self -diagnose themselves and start a gluten-free diet when celiac disease may not be the issue at all. Gluten-free diets are also being used for weight loss purposes, which is not advised.
With summer starting to wind down and the school season around the corner, fall will soon be upon us.
Fall has always been one of my favourite seasons. The bugs are gone, we still have some nice weather and of course, those fall colours are beautiful. I remember one year visiting one of my aunts in Quebec over the Thanksgiving holiday and the yellow, orange and red landscape was breathtaking.
The one thing that I am not too crazy about is the amount of yard work required at this time of year. We have an exceptionally large yard in Charleswood with plenty of oak trees that shed their many leaves that do not typically breakdown anytime soon.
By the end of October, we can have close to 100 bags collected and I always think there must be a better way to do this besides cutting down the trees. If there is, I have not found it yet. We do find that a leaf blower makes a significant difference to at least collecting the leaves in one spot and then raking and bagging them.