“Even though people are staying close to home, physical distancing can lead to an increase in high-risk behaviours, which in turn cause the types of injuries we often end up treating here,” says Dr. Marc Jeschke, medical director of the Ross Tilley Burn Centre at Sunnybrook.

The good news is that often, a little common sense can go a long way. Below are some tips from our Ross Tilley Burn Centre (RTBC) team:

Be careful when burning brush and debris

It’s understandable that many people want to make use of their time at home to get a head start with spring maintenance around their properties. Those who live on larger properties outside of the city, however, should think twice before burning large piles of brush and debris.

“Do not pour gasoline or another igniter fluid onto a fire that’s already burning, like a bonfire. The fire can come right back up into the container you’re holding, which will then explode,” he says. The person holding the container may also react by throwing it, inadvertently spraying other people nearby with burning fuel.

There is also the risk of a sudden shift in the direction of the wind, or the potential for unknown substances to be added to barrel fires. Have a safety plan in place, which includes having a container of water nearby or a garden hose on standby before starting the fire, and make sure someone else who knows what you’re doing (and where).

“With fires, you should always remember safety, and know where the closest water supply is,” says Dr. Jeschke.

Try not to use alcohol as a coping mechanism

Tolerating isolation is difficult for many people, particularly as the pandemic drags on, but Dr. Jeschke warns against drinking more alcohol as a coping mechanism.

“People are staying at home and drinking and smoking more, putting themselves at risk,” says Dr. Jeschke.

He says many of the injuries they see in the RTBC are the result of poor judgment. Simple activities like smoking and cooking can become deadly if a person falls asleep. Dropping a lit cigarette onto the carpet or leaving a stove unattended can ignite a fire very quickly.

If you do decide to consume alcohol, enjoy responsibly.

Take care of your mental health

The past year has brought huge changes to our daily routines, significantly impacting the mental health of many people. Anne Hayward, RTBC’s social worker, says it’s important to remember that physical distancing does not equal emotional or psychological distancing.

“For many people, physical distancing increases feelings of isolation, anxiety and depression, especially in at-risk populations. This, in turn, can lead to an increase in substance misuse and self-harm,” says Hayward.

“It’s more important now than ever to keep engaged, which can include staying in contact with people by phone, text, e-mail and using virtual technology.”

Hayward also recommends limiting the amount of time spent reading, watching and listening to the news, and only using reliable sources when you do.

“There’s a balance between being informed, but not overwhelmed,” she says.

If you are feeling anxious or overwhelmed, one strategy Hayward recommends is Expressions of Gratitude.

“By asking yourself what you are grateful for, it shifts the focus away from some of the negativity and worry and helps you to focus on something positive. This could include something simple like an act of kindness, spending time with people you love, or realizing what’s important,” she says.

Take care when cooking

With stay-at-home orders in place once again, more people are preparing and cooking meals at home. Keep some simple safety tips in mind, such as not wearing loose, flowing clothing while cooking.

“With loose clothing, you turn around quickly or get too close, and the fire ignites the clothes. You then have a major injury for no reason whatsoever,” says Dr. Jeschke.

Make sure your smoke alarms are working, stay in the kitchen at all times when you’re cooking, move anything that can catch fire away from your stovetop, and keep kids away from areas where hot foods or liquids are being prepared, like stoves and microwaves.

If you do suffer a burn:

If it’s a significant burn, call 911. While waiting for help to arrive, don’t put butter, vinegar, oil or lemons on the burn.

“The best initial treatment for all burns is cool running water. Don’t soak the injured area, just let the water run over it,” says Dr. Jeschke.

Help is available

Hayward says there are many reasons for people to feel anxious or overwhelmed right now.

“People may be struggling with financial, housing, food and job insecurity concerns, new or pre-existing mental health issues. They may also have immune-compromised or senior loved ones who are at risk, or loved ones who are living in other cities, provinces or countries that they can’t get to right now,” she says.

Others may be self-isolating in abusive or volatile living situations, which can lead to scalding, contact or chemical injuries, she adds.

Help is available through a variety of organizations, including 211 Ontario, Kids Help Phone and Connex Ontario, among others. A complete listing of crisis support hotlines is available at ontario.ca/coronavirus. If you are experiencing an emergency crisis situation, please contact 911 immediately or present to your nearest emergency department. 

If you’re a former RTBC patient and feel as though you need support during this challenging time, Dr. Jeschke encourages you to get in touch with the burn centre.

“Please reach out. You are not alone, and we will assess how we can best help you,” he says.

Note: this article was originally published in April 2020 and has since been updated.

The post Staying safe during COVID-19 lockdown: tips from our burn centre appeared first on Your Health Matters.

Here’s some reasons why you should be up front about whether or not you smoke – even if it’s just a cigarette here or there:

1. Smoking puts you at risk for certain illness, blood pressure issues and more. Knowing you smoke, your physician can keep a closer eye on those things and catch any problems early. Hiding your smoking status from your care team means they may not know you are at higher risk for certain illnesses. Learn more about how smoking affects your body.
2. Smoking can affect your healing time when it comes to surgery. If you have surgery coming up, your doctor may provide specific instructions to you if you smoke. Smoking can slow down the healing process because of the reduced amount of oxygen getting to the surgery site. (Read more on the benefits of quitting smoking before surgery.)
3. Your doctor can connect you with quitting resources when you are ready. There are medications and nicotine replacement products available that can make quitting easier. Your doctor, if they know you smoke and you are looking to quit, can point you in the right direction.

It’s never too late to quit. You can find more resources from Sunnybrook’s Smoking Cessation team at sunnybrook.ca/quitsmoking

The post Why you should tell your doctor if you smoke appeared first on Your Health Matters.

People are starting to be more aware of the impact second-hand smoke has on non-smokers and children. That’s why the Smoke Free Ontario Act states that you can’t smoke in your car if there’s a child in it.

The effects of third-hand smoke – that’s the build-up of a cigarette’s contaminants on a surface – are still being studied. Here are answers to some of the frequently asked questions I get about third-hand smoke.

If you or a loved one is thinking of quitting smoking, check sunnybrook.ca/quitsmoking for more info.

What is third-hand smoke?

When someone smokes, nicotine and other tobacco compounds accumulate on surfaces such as clothes, furniture, walls, and vehicles and can stay there several months after smoking has stopped, even after surfaces are washed. These residues are called third-hand smoke and contain toxic compounds, which have shown harmful effects on cells and animals in laboratory studies.

Smoke also clings to hair, fur, drapes, walls, bedding, carpets, dust, vehicles and other surfaces long after smoking has stopped. The residue builds up on surfaces over time. Third-hand smoke can’t be eliminated by airing out rooms, opening windows, using fans or air conditioners, or confining smoking to only certain areas of a home.

Is third-hand smoke bad for my health (or my kids or my pet)?

If you are in a home where someone has smoked, or in a car where someone smokes (even days later) you will likely smell smoke. That’s because compounds from the smoke sticks to surfaces. This residue is thought to react with common indoor pollutants to create a toxic mix including cancer-causing compounds, posing a potential health hazard to nonsmokers — especially children.

Studies suggest that exposure to third-hand smoke can have an impact on non-smoking adults and children when they inhale, swallow or touch objects that contain third-hand smoke.

Babies crawl on the floor and put things in their mouths (no matter how much we chase them and try to stop them!) This means they take in more dust than adults and in turn more third-hand smoke.

Pets lick third-hand smoke from their fur when they groom themselves. Same when birds pick through their feathers. This grooming adds to their cancer risk, especially for cats.

​Exposure to third-hand smoke has been linked to liver, lung and skin problems.

What’s something I can do as a non-smoker to reduce my contact with third-hand smoke?

Researchers are still studying all possible dangers but the only way to protect non-smokers is to create a smoke-free environment.

• Ask others not to smoke in your home or car.
• Remove all ashtrays, lighters, matches and smoking paraphernalia from inside your home. Clean out your car’s ashtray and remove it or fill it with something else like candies or coins.
• Ask caregivers and babysitters not to smoke in your home and car.
• It can be difficult or uncomfortable to ask people visiting your home to smoke outside. You might want to tell them before they arrive that you have a smoke-free home. Most people are used to smoke-free environments. Give them a comfortable place to smoke outside and thank them for helping out.

What’s something I can do as a smoker to be conscious of third-hand smoke risks to my friends and family?

• Wash your hands, brush your teeth or use mouthwash and change your clothes after having a cigarette.
• Don’t smoke in your home or car or around family, friends or others especially when children are present.
• Realize that if you’re not smoking in your home or car that
  • The air will be fresher, cleaner and will smell better.
  • You will be able to breathe easier.
  • The chance of fire in your home will be lower.
  • Your children will be less likely to smoke.
  • Pets will be healthier.
  • The resale value of your home and car may be greater.
  • Your food will taste and smell better.
• Make a list of the reasons for your family to reduce smoke in your home and car.
• Set a date that you are going to reduce smoke in your home and car.
• Remove all ashtrays, lighters, matches and smoking paraphernalia from inside your home.
• Clean out your car’s ashtray and remove it or fill it with something else like candies or coins.
• If you cannot go outside to smoke, the best place to smoke is in the bathroom with window open.
• The worst place to smoke in your home is in the basement
• Don’t smoke outside near windows, doors or vents.

Resources:

• Cancer.ca
• Sunnybrook.ca/QuitSmoking

The post What is third-hand smoke? appeared first on Your Health Matters.

But quitting smoking – or supporting a loved one who is trying – is not quite that simple.

Lisa Di Prospero, Sunnybrook radiation therapist and member of the Smoking Cessation committee, knows that all too well. Her husband started socially smoking in high school and has considered himself a “smoker” for 17 years now.

“He has tried many times to quit,” Lisa says. “He is on his 10^th attempt as we speak, and he is doing great.”

It’s tough to find a balance between nagging, worrying and supporting a loved one before or during a quit attempt, Lisa says.

“I tell my husband I am speaking as his wife that doesn’t want anything to happen to him and as a radiation therapist as well,” she says. “I have seen way too many cases of cancers that are classic textbook of someone who smokes. And I don’t want to lose him that way.”

It’s important to understand that many smokers would like to quit but the addiction to nicotine is so strong that they are afraid to try, says Bonnie Bristow, smoking cessation committee member and radiation therapist.

Based on some frequently asked questions, Bonnie has some important tips for supporting a loved one before or during a quit attempt.

My loved one smokes. She seems kind of interesting in quitting but then when I bring it up, she says I’m nagging. What do I do? 

Start by asking if it’s OK to discuss their smoking with them. If the answer is yes:

• Tell them you are genuinely concerned about them – maybe there has been a recent health issue and you want to be together with them for a long time
• Ask them what they think about the situation – smoking or their illness
• Ask: is there something that would motivate you to become more committed to quitting?
• Tell them that you are there for them whenever they are ready to make a healthy lifestyle change
• Find out if there is something they are afraid of losing if they are not smoking – friends or social circle?

Listen for change talk – your loved one may not be ready to quit now but might be in the contemplative stage. If they are talking about quitting, help them to set a date and prepare to support them.

Quitting smoking can be a long process and everyone is different how they approach it. Remember, ultimately it is their decision, and they have to quit because they want to — they can’t quit for anyone but themselves.

Are there strategies for helping a loved one quit that I could try without just saying “Quit smoking!”?

• Create a smoke-free environment (Lisa and her family have set the house and garage as smoke-free zones)
• Help them avoid triggers.
• Consider this: Is there something you can give up to show that you understand how difficult to?
• Help them replace smoking with a healthy alternative.

How can I lead my loved one in the right direction without pushing them away?

• Be respectful of when and how they decide to quit
• Get them to see whether their friends in their smoking circle might quit with them – ask the friends and family to be supportive
• Reward their accomplishments in a positive way, no matter how small if they are going in the right direction.
• Don’t be judgmental.

It is important that you don’t harass your loved one – it won’t help and may cause resentment, Bonnie says.

“Let your loved one know you will support them regardless of what happens,” Bonnie says. “Go on this unknown adventure with them to have a happier and healthier lifestyle together.”

Resources:

• Sunnybrook.ca/quitsmoking
• Canadian Cancer Society
• Ontario Lung Association
• Smokers Helpline
• Speak with friends, family, staff at public health units, healthcare professionals in the hospital.

The post How to support a loved one who smokes (and may or may not want to quit) appeared first on Your Health Matters.

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Keep older adults safe from burns

Is there an older adult living with you? They are at higher risk for burn injuries. Keep them safe with these tips:

Wear short sleeves or tight-fitting clothes when cooking. Loose clothing can catch fire. Don’t cook or be close to flames when feeling ill.

Don’t smoke or have open flames near medical oxygen. Keep all candles, lighters, cigarettes etc. away from medical oxygen.

Test the water before bathing or showering. Older adults’ skin becomes thinner with aging, making them at higher risk for burn injuries. Install anti-scald devices in the bathroom.

Make accommodations for disabilities. Install smoke alarms and alert devices (strobe lights or bed/pillow shakers) for those who are deaf or hard of hearing. Ensure anyone with a disability is included in your fire escape planning.

Remember, older adults are at a higher risk for burn injuries for many reasons, including slower reaction times and reduced mobility, balance, vision and hearing.

Learn more at ameriburn.org or health.sunnybrook.ca

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Leslie Gibson, occupational therapist and member of Sunnybrook’s Smoking Cessation Committee, answers some common questions about e-cigarettes.

What is an e-cigarette?

An e-cigarette is an electronic device that has a fluid-filled cartridge and a battery. When you puff on the e-cigarette, a sensor goes off and the fluid is heated, which produces a vapour that is inhaled like a cigarette and then exhaled.

There are lots of types and so they can look different.

Are e-cigarettes legal?

In 2009, a Health Canada Advisory discouraged the use of e-cigarettes as they may pose health risks and haven’t been fully evaluated for safety and quality. In addition, Health Canada said e-cigarettes cannot be marketed as having any health benefits.

In May 2016, Bill 45 was passed in Ontario, which outlines where you cannot use e-cigarettes. E-cigarettes are now viewed like regular cigarettes — you can’t use them anywhere you can’t smoke cigarettes. So, you cannot use e-cigarettes in buildings, on patios, at baseball diamonds, parks, or anywhere on hospital property.

In May 2018, legislation was passed to allow the sale of vape products containing nicotine in Canada.

Vaping is covered by the Smoke Free Ontario Act. People over age 19 can buy these products in Canada and the Smoke-Free Ontario Act has rules about where you can use them.

What are your concerns about e-cigarettes?

My concerns are the common concerns among health-professionals.

E-cigarettes have been sort of glamorized as smoking’s cool cousin. And the flavours seem to appeal to teens. This goes against all the gains made with the tobacco industry in not marketing to teens and the province’s move toward having a “smoke free” environment.

E-cigarettes have not been around long enough for researchers to study the long-term effects. Do we know exactly what is in the pods? What are you breathing in? Who made it? Who made the battery device and how – is that safe?

So what’s the bottom line?

While e-cigarettes may be less harmful than regular cigarettes, more research needs to be done to even properly compare the use of e-cigarettes to regular cigarettes. The bottom line is: Don’t reach to either.

What about using e-cigarettes as a way to quit smoking regular cigarettes?

More research needs to be done to see if e-cigarettes are an effective way to help people quit smoking. If you are trying to quit, there are things you can do that have been proven through research as helpful. Use nicotine replacement therapies. These have been studied. (Things like nicotine gum, lozenges or the patch, vaporizers or inhalers)

If you want to quit smoking, speak to your health-care team, or check out some online resources at Sunnybrook.ca/quitsmoking

The post Are e-cigarettes safe? appeared first on Your Health Matters.

A hookah is a waterpipe that is used to smoke flavoured tobacoo or non-tobacco products. This year, the province’s Smoke-Free Ontario Act extended to ban hookah smoking in licenced bars and restaurants.

I’ve heard before that smoking hookah is fine for your health and not at all like smoking cigarettes.

To set the record straight and find out how hookah smoking can affect our health, I spoke to Bonnie Bristow, a Sunnybrook radiation therapist and leader on the Smoking Cessation Team.

“Hookah smoke is just as dangerous as cigarette smoke,” Bonnie said. “In a one-hour hookah session, the user is exposed to 100 to 200 times the volume of smoke inhaled from a single cigarette.”

This smoke contains cancer-causing substances just like cigarette smoke, she said. And hookah smoke contains higher levels of arsenic, lead, and nickel than a single cigarette and 72 times more tar. “A one-hour hookah session can expose the smoker to the same amount of tar and nicotine as one pack of cigarettes.”

Hookah uses flavoured tobacco that contains nicotine, which is the addictive substance. Even herbal-based shisha, which doesn’t include tobacco, produces second-hand smoke that is still harmful.

Hookah smoking has been significantly associated with low birth weight, periodontal disease, significant drop in oxygen consumption cancer, respiratory illness and cardiac disease.

A common misconception, Bonnie said, is that the water in the pipe filters the tobacco and makes it safe to smoke.

“It was invented in the 16th century in India by a physician who thought smoke would be filtered through the water and not be harmful,” she explained. “Today we now know that the water cools the smoke but does not filter out the toxins. Water-filtered smoke can damage the heart and lungs. Hookah use is related to a higher level of benzene, a chemical that has been linked to leukemia.”

There is more social acceptance surrounding the hookah, particularly in some parts of the world where teens and even children sometimes smoke at home with their parents, Bonnie said. However, most countries in the Middle East have now banned indoor hookah smoking.

While more than 80 per cent of the people who smokes cigarettes say would like to quit, less than 30 per cent of those who smoke hookah would like to quit. Bonnie said the belief that hookah is safe and not addictive might lead to that number.

“But the nicotine contained is more than in a cigarette causing higher and faster dependence,” she said.

For those who’d like to quit, counselling and motivational interviewing to increase the desire to quit can be helpful.

“Nicotine replacement therapy and other smoking cessation medications can be helpful,” she said. “There are ongoing trials to determine the best method for this. Also, removing yourself from the triggers such as social settings with hookahs in them can help too.”

“People need to realize the false advertising of the safety of hookah compared with cigarette smoking,” Bonnie said. “Both are bad for you.”

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It’s well researched and documented that smoking cigarettes can have a bad impact on your health.

Bonnie Bristow, radiation therapist, says smoking can have much more of an affect on the body and its functions than people may realize.

“Patients and their families are sometimes surprised to hear about the ways cigarettes can affect their bodies,” she said.

Here are some of the more surprising facts:

Smoking hurts your eyes.

Smoking cigarettes doubles the risk of changes in the lens of your eye, resulting in cataracts, Bonnie says. It triples the risk of age-related macular degeneration, which is the leading cause of blindness over 65 years old. And it also increases the risk of glaucoma, another leading risk of blindness.

Smoking slows down healing.

“Oxygen is the basis for wound healing and it all begins at the cellular level,” Bonnie says. “Smoking deprives the body of the much-needed oxygen required to repair and build cells.” If you have a surgery coming up, it’s a great time to consider quitting smoking.

Smoking affects your Zzzzzzzs.

Nicotine is a stimulant. That means, while many people think it calms them down, it actually temporarily increases energy, your heart rate and breathing, and your blood pressure. Cigarette smokers can easily develop insomnia (the inability to fall or stay asleep) if they smoke close to bedtime.

“Smokers often feel more restless in the morning after having difficulty falling asleep,” Bonnie says. “The nicotine changes your natural circadian rhythm and increases your risk of sleep apnea.” Sleep apnea is a disorder where your breathing pauses and starts when you are asleep.

Smoking affects your senses, your skin and more.

Smoking dulls the sense of taste and smell. It also is one of the main causes of premature aging of the face because of the biochemical changes in the body that speed the aging process. If you smoke, you may be more susceptible to seasonal flus and colds and you have an increased risk of diabetes.

Smoking harms other peoples’ bodies: your spouse, kids and friends.

Bonnie reminds us that exposure to second-hand smoke causes more frequent and serious asthma attacks, respiratory infections and ear infections in kids. Rates of tooth decay are doubled in kids exposed to second hand smoke. Adults in contact with second-hand smoke have an increased risk of heart disease, stroke and lung cancer.

If you need help to quit smoking, check out sunnybrook.ca/quitsmoking for more resources or talk to your family doctor who can point you in the right direction. Here are some tips from a Sunnybrook social worker.

The post Surprising ways smoking affects your body (and your family’s bodies too) appeared first on Your Health Matters.

They are right. But why? To answer that question, Dr. Chris Idestrup, Anesthesia Site Chief at Sunnybrook’s Holland Orthopaedic and Arthritic Centre, directed me to StopSmokingforSaferSurgery.ca, a site maintained by Ontario’s Anesthesiologists. This site has some great info and five reasons about why it might be a good idea to quit smoking before going in for surgery.

Your lungs.

Smoking damages your lungs and that can put you at a higher risk of breathing issues from the anesthetic you need for surgery.

Being smoke-free for even just a few weeks before your surgery can help your lungs heal.

Your heart.

According to StopSmokingforSaferSurgery.ca, the carbon monoxide in cigarette smoke reduces the amount of oxygen that your blood can carry to your heart. Nicotine makes your heart beat faster. Together, that puts you at a higher risk of a heart attack.

Your recovery.

If you smoke after surgery, this can slow down your healing and increase your chance of getting an infection. This is because of the reduced oxygen getting to your surgery site, slowing the normal healing process. Staying smoke-free after surgery can help your healing.

Your success at quitting for the long-term.

Changing your routine can help you quit smoking – so preparing for and undergoing surgery is a good time to switch things up. Plus, hospitals are smoke-free zones, so even a short stay in the hospital will limit your actual ability to light up. And, hospitals are full of people who can give you the necessary resources and support for quitting. Tell your doctor or another health-care provider that you have recently quit smoking or if you are in the process of quitting; they can help.

The rest of your life.

If you stay smoke-free, it’ll reduce your risk of returning to the hospital, both due to infection from this surgery and for further health issues.

From the Heart and Stroke Foundation:

• Within one year of quitting smoking, your added risk of coronary heart disease is cut in half than that of a smoker.
• Within five years, your risk of having a stroke will be nearly the same as a non-smoker.
• Within 10 years, the risk of dying from lung cancer is cut in half.
• Within 15 years, your risk of coronary heart disease will be similar to that of a non-smoker.

Check out StopSmokingforSaferSurgery.ca and Ontario Anesthesiologist’s site for more information.

The Smoker’s Helpline has quitting support and info.

Or check out quick tips on quitting from a Sunnybrook social worker.

The post Got surgery coming up? Quit smoking now. appeared first on Your Health Matters.

1. Quit smoking.

If you smoke, make a plan to quit. (And if you don’t smoke, don’t start. Within months, quitting smoking reduces your risk of a heart attack, improves breathing and helps circulation. After a year of quitting, your risk of heart disease and smoking-related heart attack is cut in half. Start by making a quit plan. Need help? Check out sunnybrook.ca/quitsmoking or talk to your health-care provider.

2. Cut down on sugar.

The World Health Organization (WHO) suggests we try to keep our sugar intake to less than 6 teaspoons a day (not including naturally occurring sugars, like in fruits). Eating too much sugar has been linked to cardiovascular disease and other health issues. Do you put two sugars in your tea? Try cutting back to one. (Even better, none!) Keep an eye out for hidden sugars. Cereals, yogurts, salad dressings and sauces can often have a wild amount of added sugar. Choose these items with less sugar (or use less dressing when tossing your greens!)

3. Add an extra veggie to each lunch.

Cut up some celery sticks to eat with your sandwich, or add broccoli to your pizza. Sneaking an extra vegetable in at lunchtime can help you reach Canada’s Food Guide recommended servings of vegetables/fruits (7-8 for adult women, 8-10 for men). Eating the recommended amount of vegetables can help reduce your risk of many chronic diseases.

4. Try a meatless Monday (or at least one meatless meal per week)

Have one vegetarian meal each week that includes legumes like beans, chickpeas or lentils. Legumes are packed with protein and fibre, and are lower in saturated fats than most meats. Eating more legumes can help manage diabetes and improve cholesterol levels. Need inspiration? Try this three-bean chili. 

5. Add three 10-minute chunks of activity to each day.

We know you’ve heard this one: adding daily activity to your lifestyle has many health benefits. But remember, daily activity doesn’t mean you have to spend hours at the gym. Try to add three 10-minute chunks of medium activity. Park farther away from the doors and briskly walk, get off the bus a stop early, have a walking meeting or take the stairs). Check out Canada’s Physical Activity Guidelines for more ideas.

 6. Take electronics out of the bedroom.

To improve your sleep quality, make your bedroom a no-phone zone. Leave phones, TVs, tablets or other things with bright screens out in the living room. Actually, studies show that avoiding these devices one hour before bedtime can improve your sleep quality, leaving you better able to make healthy choices the next day.

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