Fentanyl is a strong medicine made from opioids (chemicals used to treat sudden and ongoing pain). It’s up to 100 times stronger than other opioids like morphine, heroin, or oxycodone.

Drug dealers often sell fentanyl as fake oxycodone. Buyers may think they’re getting oxycodone, but they’re getting another opioid drug that has fentanyl and other substances in it. On the street, these drugs have nicknames like:

beans

green apples

apples

shady eighties

eighties

fake oxy

greenies

Why do people take fentanyl?

People take fentanyl to help with pain (e.g., from cancer) that other medicine has not been able to help with. Others may use it to get high or to help with sleep.

How is fentanyl different from oxycodone and other opioids?

Fentanyl is much stronger than oxycodone and many other opioids. When fentanyl is taken by mouth or by intravenous (IV) injection, it has a stronger effect than most other opioids.

How can I be sure that I’m buying real fentanyl?

The only way to be sure your fentanyl is real is to get it prescribed by a doctor. You can take it safely by following your doctor’s directions and taking the recommended dose. However, drugs bought on the street are never safe.

Can using fentanyl kill me?

Yes, it can poison you if you take too much. Early signs of fentanyl poisoning may include:

sleepiness

trouble breathing (it may sound like snoring)

slow, shallow breathing

cold, clammy skin

unresponsiveness to pain or a person’s voice

The most dangerous side effect of fentanyl is it can cause you to stop breathing.

Is fentanyl addictive?

Yes, fentanyl can be addictive. If you use opioids a lot, you may find that you develop a tolerance and need more and more to feel the same effects. You can become mentally and physically dependent on fentanyl.

People addicted to fentanyl may have withdrawal symptoms when they quit, including:

cravings

sweating

runny nose and yawning

restless sleep or trouble sleeping

weakness

nausea or vomiting

stomach cramps

diarrhea

muscle spasms or bone pain

chills or goose bumps

feelings of irritation

Mild withdrawal symptoms usually start between 12 to 30 hours after the last time you took fentanyl. While the worst symptoms pass within a few days, it can take months to feel normal. Opioid withdrawal can be very uncomfortable, so it’s best to stop using them under supervised care.

If I have the antidote (naloxone), is fentanyl safe to use?

Fentanyl is safe when it’s prescribed by a doctor and taken as directed. Fentanyl patches or lozenges release the medicine slowly. You can poison yourself if you change the medicine to get a stronger or faster effect. Fentanyl that’s made illegally has an unknown amount of fentanyl and may contain other substances like cocaine, heroin, and xylazine (a drug given to animals to help with pain), which put users at higher risk of being poisoned.

Naloxone can reverse symptoms of fentanyl and other opioid poisoning. However, it doesn’t work every time and the effects of the naloxone may not last as long as the opioid.

What should I do if I see someone who is poisoned from fentanyl?

Call 911 as soon as possible if the person becomes unconscious, stops breathing, has chest pain, or has a seizure. Start CPR right away if the person stops breathing or has no pulse. Take any remaining pills from the person’s mouth or patches from his or her skin so the person doesn’t absorb any more fentanyl. If you have naloxone, give it to the person as soon as possible.

What if I have taken fentanyl and I think I have fentanyl poisoning?

Call 911 right away if you think you may have fentanyl poisoning. Don’t take any more pills. If you’re wearing patches, take them off so you don’t absorb any more fentanyl.

I’m concerned about my, or someone else’s, misuse of fentanyl. What can         I do?

If you’re concerned about your own, or someone else’s, misuse of fentanyl, or would simply like more information on drug use, contact the Addiction & Mental Health 24 Hour Helpline at 1-866-332-2322.

The Poison and Drug Information Service (PADIS) is a free, confidential, 24/7 service for all Albertans. Staff are specially trained in the assessment and management of exposures to drugs and toxins like fentanyl, and are available by calling 1-800-332-1414.

For 24/7 nurse advice and general health information call health Link at 811.

Current as of: June 2, 2017

Author: Poison and Drug Information Service (PADIS)

Source: www. myhealth.alberta.ca

Translated with permission from Alberta Health Services and is not intended to replace the advice of care you get from your provider or other healthcare professional.  Always consult your health professional for medical diagnosis and treatment.

Anxiety can cause physical and emotional symptoms. A specific situation or fear can cause some or all of these symptoms for a short time. When the situation passes, the symptoms usually go away.

Physical symptoms of anxiety include:

• Trembling, twitching, or shaking.
• Feeling of fullness in the throat or chest.
• Breathlessness or rapid heartbeat.
• Light-headedness or dizziness.
• Sweating or cold, clammy hands.
• Feeling jumpy.
• Muscle tension, aches, or soreness (myalgias).
• Extreme tiredness.
• Sleep problems, such as the inability to fall asleep or stay asleep, early waking, or restlessness (not feeling rested when you wake up).

Anxiety affects the part of the brain that helps control how you communicate. This makes it harder to express yourself creatively or function effectively in relationships.

Emotional symptoms of anxiety include:

• Restlessness, irritability, or feeling on edge or keyed up.
• Worrying too much.
• Fearing that something bad is going to happen; feeling doomed.
• Inability to concentrate; feeling like your mind goes blank.

Anxiety disorders

Anxiety disorders occur when people have both physical and emotional symptoms. Anxiety disorders interfere with how a person gets along with others and affect daily activities. Women are twice as likely as men to have problems with anxiety disorders. Examples of anxiety disorders include panic attacks, phobias, and generalized anxiety disorder.

Often the cause of anxiety disorders is not known. Many people with an anxiety disorder say they have felt nervous and anxious all their lives. This problem can occur at any age. Children who have at least one parent with the diagnosis of depression are more than twice as likely to have an anxiety disorder than other children.

Anxiety disorders often occur with other problems, such as:

• Mental health problems, such as depression.
• Substance use problems.
• A physical problem, such as heart or lung disease. A complete medical examination may be needed before an anxiety disorder can be diagnosed.

Panic attacks

A panic attack is a sudden feeling of extreme anxiety or intense fear without a clear cause or when there is no danger. Panic attacks are common. They sometimes occur in otherwise healthy people. Panic attacks usually last only a few minutes, but an attack may last longer. And for some people, the anxiety can get worse quickly during the attack.

Symptoms include feelings of dying or losing control of yourself, rapid breathing (hyperventilation), numbness or tingling of the hands or lips, and a racing heart. You may feel dizzy, sweaty, or shaky. Other symptoms include trouble breathing, chest pain or tightness, and an irregular heartbeat. These symptoms come on suddenly and without warning.

Sometimes symptoms of a panic attack are so intense that the person fears he or she is having a heart attack. Many of the symptoms of a panic attack can occur with other illnesses, such as hyperthyroidism, coronary artery disease, or chronic obstructive pulmonary disease (COPD). A complete medical examination may be needed before an anxiety disorder can be diagnosed.

People who have repeated unexpected panic attacks and worry about the attacks are said to have a panic disorder.

Phobias

Phobias are extreme and irrational fears that interfere with daily life. People with phobias have fears that are out of proportion to real danger, and they are not able to control them.

Phobias are common and are sometimes present with other conditions, such as panic disorder or Tourette’s disorder. Most people deal with phobias by avoiding the situation or object that causes them to feel panic (avoidance behaviour).

A phobic disorder occurs when the avoidance behaviour becomes so extreme that it interferes with your ability to participate in your daily activities. There are three main types of phobic disorders:

• Fear of being alone or in public places where help might not be available or escape is impossible (agoraphobia)
• Fear of situations where the individual might be exposed to criticism by others (social phobia)
• Fear of specific things (specific phobia)

Phobias can be treated to help reduce feelings of fear and anxiety.

Check your symptoms to decide if and when you should see a doctor.

For 24/7 nurse advice and general health information call health Link at 811.

Source: www. myhealth.alberta.ca

Current as of: March 20, 2017

Translated with permission from Healthwise Inc.^© and is not intended to replace the advice of care you get from your provider or other healthcare professional.  Always consult your health professional for medical diagnosis and treatment.

• Thirty per cent of all cancer deaths are caused by tobacco use.
• Nicotine is the chemical in tobacco which causes addiction. It is highly addictive.
• While it can be difficult to quit, there are nearly 1 million former smokers in Alberta.
• Second and third hand smoke is harmful to those around you.

Why Quit?

• Your health will improve.
• Your clothes and living areas will no longer smell of smoke.
• You’ll feel better.
• Your teeth and fingers will no longer be stained yellow.
• You’ll be less likely to develop diseases associated with tobacco use.
• You will save money.
• You will be a role model for family members, children, friends and co-workers
• You’ll breathe more easily and your food will taste better.
• You will become part of the majority of Canadians who do not use tobacco
• Your sense of smell will return to normal.

How can I quit?

One way to help reduce your use of tobacco is to practice the 4 D’s:

Delay

Delay using tobacco. The strong urge to use tobacco only lasts about three minutes.

Drink

Drink lots of water instead of alcohol or drinks with caffeine.

Deep Breathe

A deep breath relieves some of the urge to use tobacco and fills the lungs with oxygen.

It will make you feel better.

Do

Do something else to take your mind off the urge to use tobacco.

There are also medications that can help you reduce or quit.

Nicotine replacement therapy (NRT) provides the body with nicotine to reduce withdrawal symptoms (anxiety, irritability, headaches, and difficulty concentrating) and your urge to use tobacco. It can double your chance of quitting.

Prescription medications do not contain nicotine. They work in various ways, depending on the medication, as an aid to quit using tobacco. They have been shown to significantly improve your chances of quitting.

Talk to a doctor or pharmacist if you are interested in using any NRT or prescription medication to find out which ones are right for you.

For additional support call the AlbertaQuits helpline at 1-866-710-QUIT (7848). Services are available in languages other than English.

Going without tobacco is hard. We can help.

www.albertaquits.ca

Tobacco smoke is put into three categories:

1. First-hand smoke, which is inhaled by the smoker.
2. Second-hand smoke, which is the smoke either exhaled by a smoker or released from the end of a burning cigarette.
3. Third-hand smoke, which is the tobacco smoke residue and gases that are left after a cigarette has been smoked.

Second-Hand Smoke

Second-hand smoke is both sidestream smoke (the smoke that comes from the burning end of a cigarette) and mainstream smoke (the smoke exhaled by the smoker).

Sidestream smoke makes up about 85% of second-hand smoke. It’s made up of different chemicals than exhaled mainstream smoke because it burns at lower temperature, and the burn is not as clean or complete.

Being exposed to second-hand smoke affects an adult’s heart and blood vessels right away. Adult non smokers who live with smokers are at about 25% more risk of developing heart disease.

Second-hand smoke causes lung cancer even in non-smokers. In Canada, more than 300 non-smokers die each year from lung cancer related to second-hand smoke.

Babies, Children, and Second-Hand Smoke

Because their bodies are developing, babies and young children are especially at risk to the toxins in second-hand smoke. Being exposed to second-hand smoke may cause:

• a low birth weight, which increases the chance of developing heart disease and type 2 diabetes when they grow up
• a higher risk of SIDS (sudden infant death syndrome)
• serious lower respiratory infections, like bronchitis and pneumonia
• respiratory symptoms, including coughing, mucous, wheezing, and being short of breath
• more ear infections than in a child who isn’t exposed to second-hand smoke (they are also more likely to have tubes put in their ears to drain the fluid caused by having a lot of ear infections)

Children who already have asthma have more attacks and the attacks are more serious.

Traces of cancer-causing and other toxins are found in the blood, urine, saliva, and breastmilk of non smokers, even after little exposure to second-hand smoke.

Opening windows in buildings or vehicles doesn’t protect you from the effects of second-hand smoke. Opening windows may get rid of the smell; however, it doesn’t get rid of the cancer-causing toxins in the air. Only 100% smoke-free environments protect you from second-hand smoke.

Third-Hand Smoke

Third-hand smoke is made up of the residue and gases of tobacco smoke. It:

• includes the gases that go back into the air
• stays on surfaces and in dust after the tobacco has been smoked
• builds up on surfaces, furniture, clothing, drapes, and carpets
• reacts with other elements in the environment to make more pollution

When tobacco is burning, it releases nicotine in the form of a vapour. This vapour attaches to surfaces like walls, floors, carpeting, drapes, and furniture. Nicotine reacts with nitrous acid (one source of which is burning tobacco) and forms cancer causing tobacco-specific nitrosamines (TSNAs). The nicotine can last for months on indoor surfaces. This means that these TSNAs are always being created. TSNAs are then inhaled, absorbed, or ingested. Anyone who smokes in any enclosed space (like a car or home) is exposing non-smokers to TSNAs.

Children are more sensitive to being exposed to third-hand smoke because they breathe near, crawl on, play on, touch, and even taste (because they often put their hands in their mouths) surfaces contaminated with tobacco residue.

Experts on third-hand smoke recommend 100% smoke-free homes and vehicles. They also suggest that replacing furniture, carpets, drapes, etc., can greatly reduce exposure to third-hand smoke residue.

Policies to Protect People from Exposure to Second-hand and Third-hand Smoke

Through Alberta’s Tobacco Reduction Act (TRA), all public and work places in the province are smoke free. The act also prohibits smoking on patios with food service and within 5 metres of a doorway, window, or air intake of a public place or workplace (including enclosed parking garages and work vehicles).

The following will protect children and others from exposure to second-hand and third-hand smoke:

• keep your home and vehicles smoke-free
• support legislation to make all hotels and motels smoke-free
• support policies for smoke-free multi-unit dwellings

For 24/7 nurse advice and general health information call health Link at 811.

Author: Tobacco Reduction Program, Alberta Health Service

Current as of: July 1, 2015

Ttranslated with permission from Healthwise Inc. ^© and is not intended to replace the advice of care you get from your doctor or other healthcare professional.  Always consult your health professional for medical diagnosis and treatment.

Over-the-counter (OTC) medicines are drugs you can buy without a doctor’s prescription. This doesn’t mean that OTC medicines are harmless. Like prescription medicines, OTCs can be very dangerous for children if not taken the right way.

Be sure to read the package instructions on these medicines carefully. Talk to your doctor or pharmacist before giving OTC medicines to young children.

Here are some safety tips for parents and other caregivers:

• Don’t give children medicines intended only for adults.
• Always follow the directions on the label. This label tells you how to give the medicine safely and in the right amount. It lists warnings, tells you how often to give the medicine, and helps you know if the medicine is safe for your child.
• Check the “Active Ingredients” listed on the label. This is what makes the medicine work. If you use two medicines with the same or similar active ingredients, your child could get too much.
• Talk to your doctor or pharmacist before giving your child more than one OTC medicine at the same time. Also, find out what natural health products, foods, or drinks shouldn’t be mixed with your child’s medicine.
• Talk to your doctor before you give fever medicine to a baby who is 6 months of age or younger. This is to make sure a young baby’s fever is not a sign of a serious illness. The exception is if your baby has just had an immunization.
• Don’t give aspirin to anyone younger than 20 unless your doctor tells you to. Aspirin increases the risk of Reye syndrome, a serious illness.
• Don’t take medicine in front of children, since kids will often copy what you do. And never call medicine “candy” to get your kids to take it.
• Be extra careful with liquid medicines. Infants usually need a different dose than the dose that children need. And some liquid forms are stronger (more concentrated) than others. Always read the label so that you give the right dose.
• Don’t give chewable medicines to children younger than age 3 years. Wait until your child has molars.
• Don’t use teething gels on your child. The Canadian Dental Association (CDA) does not recommend using teething gels you put on a baby’s gums. Gels can make a baby’s throat numb. This may cause trouble swallowing. Some teething gels contain the medicine benzocaine, which can harm your child.

Giving the right amount

• Always follow directions about your child’s age and weight when you are giving a dose.
• When giving medicine, use the tool that comes with the medicine, such as a dropper or a dosing cup. Don’t use spoons instead of the tool. Spoons can be different sizes. If the medicine doesn’t come with a tool to give doses, ask your pharmacist for one.
• Never increase a dose because your child seems sicker than before.
• Talk to your child’s doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Storing medicines safely

• Store medicines where children can’t see or reach them. Many OTC medicines are colourful, taste good, and can be chewed. Kids may think that these medicines are candy.
• Use medicines with a childproof cap. Lock the cap after each use by closing it tightly.
• Don’t buy or use medicine from a package that has cuts, tears, a broken seal, or other problems. Check the medicine at home to make sure the colour and smell are normal.
• Check your medicine supply at least once a year. Ask your pharmacist how to get rid of medicines that are past their expiration dates.
• Always store medicines in a cool, dry place or as it says on the label.
• Keep all medicines in their original containers. This way you avoid giving the wrong medicine by mistake.

Using cough and cold medicines

Studies show that over-the-counter cough and cold medicines don’t work very well. Some of these medicines can cause problems if used too much. These medicines don’t cure the cold or cough. And they don’t help your child get better faster.

Use these medicines exactly as your doctor says, and keep them out of children’s reach.

Be careful with cough and cold medicines. Don’t give them to children younger than 6, because they don’t work for children that age and can even be harmful. For children 6 and older, always follow all the instructions carefully. Make sure you know how much medicine to give and how long to use it. And use the dosing device if one is included.

• Don’t give antihistamines, such as diphenhydramine (Benadryl, for example), to your child unless you’ve checked with your doctor first. Antihistamines are sometimes used in cold medicines, so check for them on the label.
• Try other home treatments besides medicines. A humidifier may soothe swollen air passages or help a cough. Honey or lemon juice in hot water or tea may help a dry cough. Do not give honey to a child younger than 1 year.
• Don’t give your child too much acetaminophen or ibuprofen. If you are giving your child fever or pain medicine (such as acetaminophen or ibuprofen), don’t give your child a cold or flu medicine that contains the same ingredient. Your child could get too much medicine.

For 24/7 nurse advice and general health information call health Link at 811.

Current as of: August 9, 2016

Source: myhealth.alberta.ca

Ttranslated with permission from Healthwise Inc. ^© and is not intended to replace the advice of care you get from your doctor or other healthcare professional.  Always consult your health professional for medical diagnosis and treatment.

Shingles is a painful skin rash. It is caused by the varicella zoster virus. Shingles usually appears in a band, a strip, or a small area on one side of the face or body. It is also called herpes zoster.

Shingles is most common in older adults and people who have weak immune systems because of stress, injury, certain medicines, or other reasons. Most people who get shingles will get better and will not get it again. But it is possible to get shingles more than once.

What causes shingles?

Shingles occurs when the virus that causes chickenpox starts up again in your body. After you get better from chickenpox, the virus “sleeps” (is dormant) in your nerve roots. In some people, it stays dormant forever. In others, the virus “wakes up” when disease, stress, or aging weakens the immune system. Some medicines may trigger the virus to wake up and cause a shingles rash. It is not clear why this happens. But after the virus becomes active again, it can only cause shingles, not chickenpox.

You can’t catch shingles from someone else who has shingles. But there is a small chance that a person with a shingles rash can spread the virus to another person who hasn’t had chickenpox and who hasn’t gotten the chickenpox vaccine.

What are the symptoms?

Shingles symptoms happen in stages. At first you may have a headache or be sensitive to light. You may also feel like you have the flu but not have a fever.

Later, you may feel itching, tingling, or pain in a certain area. That’s where a band, strip, or small area of rash may occur a few days later. The rash turns into clusters of blisters. The blisters fill with fluid and then crust over. It takes 2 to 4 weeks for the blisters to heal, and they may leave scars. Some people only get a mild rash. And some do not get a rash at all.

It’s possible that you could also feel dizzy or weak. Or you could have pain or a rash on your face, changes in your vision, changes in how well you can think, or a rash that spreads. A rash or blisters on your face, especially near an eye or on the tip of your nose, can be a warning of eye problems.

Call your doctor now if you think you may have shingles. It’s best to get early treatment. Medicine can help your symptoms get better sooner. And if you have shingles near your eye or nose, see your doctor right away. Shingles that gets into the eye can cause permanent eye damage.

How is shingles treated?

Shingles is treated with medicines. These medicines include antiviral medicines and medicines for pain.

See your doctor right away if you think you may have shingles. Starting antiviral medicine right away can help your rash heal faster and be less painful. And you may need prescription pain medicine if your case of shingles is very painful.

Good home care also can help you feel better faster. Take care of any skin sores, and keep them clean. Take your medicines as directed. If you are bothered by pain, tell your doctor. Other treatments may help with intense pain.

Who gets shingles?

Anyone who has had chickenpox can get shingles. You have a greater chance of getting shingles if you are older than 50 or if you have a weak immune system.

There is a shingles vaccine for adults. It lowers your chances of getting shingles and prevents long-term pain that can occur after shingles. And if you do get shingles, having the vaccine makes it more likely that you will have less pain and your rash will clear up more quickly.

Shingles Vaccine Availability in Alberta

Zostavax^® is the vaccine to prevent shingles (herpes zoster). Anyone 50 and older can now get immunized.

The vaccine is not given as part of the routine Alberta immunization schedule. You have to pay for the vaccine as it’s not covered by Alberta Health Care. Check with your insurance company about your coverage.

Talk to your doctor before you get the shingles vaccine. You may not be able to get it if you take some medicines or have an illness that affects your immune system.

You can get immunized for shingles at special AHS immunization clinics in Edmonton or Calgary (the Sheldon Chumir clinic in Calgary and the Immunization Business Unit clinic in Edmonton). You need to call first to make an appointment but you don’t need a doctor’s prescription for these clinics.

Some doctors’ offices provide shingles immunization. Talk to your doctor to see if they can give you the vaccine.

If you have a doctor’s prescription, you may also be able to get the immunization at some pharmacies. You need a doctor’s prescription to make sure you’re medically okay to get this live vaccine. Call your pharmacy to ask if they provide this immunization service because it’s not available at all pharmacies.

For 24/7 nurse advice and general health information call health Link at 811.

Author: Immunization Program, Alberta Health Services

Current as of: December 3, 2015

Translated with permission from Healthwise Inc. ^© and is not intended to replace the advice of care you get from your doctor or other healthcare professional.  Always consult your health professional for medical diagnosis and treatment.

You need to be able to learn to use the hand brakes and your hands need to be strong enough to squeeze the brakes.

The 4 wheeled walker usually has a seat, pouch or basket and brakes you operate
by hand (see diagram 1). They also fold down for storage or travel.

Choosing a 4 Wheeled Walker

Speak with a healthcare provider about the type of walker that is best for you.

Look for:

• a walker frame and seat that can safely support your weight
• a way to adjust the height of the handles and a seat wide enough for comfort
• the ability to sit with your feet touching the ground
  • a walker that will fit through the doorways in your home

If you use a portable oxygen tank, check that:

• the tank fits in the basket on the 4 wheeled walker (wire baskets are best because they are stronger)
  • you can take the oxygen tank in and out of the basket by yourself

Check whether there is an internal or external braking system.  Internal brakes may add weight to the walker, but there is less chance of breaking a cable when you transport the walker. Internal brakes are recommended if you travel by plane or bus.

How to Make Your Walker the Right Height for You

1. Put on the shoes you will be wearing when you use your walker.
2. Put your walker in front of you and stand close to it.
3. Stand up straight and relax your shoulders.
4. Hang your arms at your sides and check that the hand grips are at your wrist
   (see diagram 2). Adjust the height of the walker as needed.
5. You can adjust your walker height by:

• Loosening the knobs on the outside of the hand grips to raise or
  lower the height. Tighten the knobs once you find the correct height OR
• If your walker has bolts under the knobs, remove them and then move the
  hand grips to the correct height. Put the bolts back on and screw the knobs to the bolts.

1. When you place both hands on the hand grips, your elbows should be slightly bent.
2. Stand upright, with your feet between the back wheels of the walker and the
   walker a little bit around you.
3. Put both hands on the handles
4. Get your balance.
5. Carefully squeeze the brake handles to unlock the brakes.
6. Walk close to your walker.
7. To slow your walker on a slope, squeeze or pull up on the brakes (see diagram 3).
8. Talk to a healthcare provider if your walker tends to speed ahead of you when the ground is level.

Walking

Walk with your back as straight as possible.  Look forward and not at your feet.

Turning

1. Hold onto the hand grips.
2. Slowly move your walker as you step and turn in a large curve.
3. Keep your feet between the wheels and take small steps when turning so you do not twist your leg.
4. Get close to the chair. Walk backwards using your walker until you can feel the chair touch the back of your legs.
5. Lock the brakes.
6. Reach back and put both hands on the armrests or seat of the chair.
7. Lower yourself gently onto the chair (see diagram 4).
8. Move yourself back in the chair as needed.

Sitting on a chair or bed

Standing

1. To get out of the chair, put your walker in front of you.
2. Make sure the brakes are locked.
3. Move yourself closer to the edge of the chair.
4. Push down on the armrests or seat of the chair and lean slightly forward. Push yourself up.
5. Put your hands on the handgrips.
6. Get your balance before you move.

Note: Make sure the chair is stable and not too low.

Sitting on the Seat of a 4 Wheeled Walker

1. If you can, put your walker against a fixed object like a wall.
2. Lock the brakes.
3. Turn around so your walker is behind you.
4. Reach behind for the handgrips.
5. Sit down slowly.

Standing Up from the Seat

1. Check that the brakes are locked.
2. Push down on the handgrips and lean slightly forward.  Push yourself up.
3. Get your balance.
4. Turn around slowly so you are facing your walker. Use the handgrips for support.

Safety Tips

• Check the brakes, knobs, and screws regularly.
• Do not move your walker when you’re sitting in it.
• Do not unlock the brakes of your walker when you are sitting on it.
• Do not lean or pull on your walker when getting up or sitting down. This could
  make the walker tip over.
• Always wear non-skid, supportive shoes. Avoid open-heeled sandals, clogs, or slippers.
• Remove loose mats and rugs, electric cords, and cables to prevent tripping.
• Watch for wet or uneven surfaces. Take small steps if you must walk on wet, icy or uneven surfaces. Pay special attention on ramps or slopes.
• Do not use the 4 wheeled walker on stairs or escalators.

This content may be updated without notice.

Last Revised: July 7, 2017

Author: Allied Health (Physiotherapy), Alberta Health Services

This material is for information purposes only. It should not be used in place of medical advice, instruction and/or treatment.  If you have questions, talk with your doctor or appropriate healthcare provider.

There are many reasons older people fall. They may lose their footing when stepping off a street curb. Or they may fall after getting dizzy from taking medicines. Some falls may be related to the effects of aging, such as muscle weakness or delayed reflexes. Or falls may be related to the results of a stroke.

Experts agree that some falls in older adults can be prevented. But since each person’s risks are a bit different, talk to your doctor about which of the tips below might help you.

Take care of yourself

• Keep your bones strong. Talk to your doctor to be sure you are getting enough vitamin D and calcium.
• Have your vision and hearing checked each year or anytime you notice a change. If you have trouble seeing and hearing, you might not be able to avoid objects that make you lose your balance.
• Call your doctor if you have calluses or corns on your feet that need to be removed or if you have sores that are not healing. If you wear loose-fitting shoes because of foot problems, you can lose your balance and fall.
• If you tend to feel light-headed when you stand up quickly, take the time to get up slowly from your bed or chair. When you wake up, it may help to sit up first and count slowly to 10 before you try to stand up. And after you stand up, stay still for a few seconds before you move.
• If you are very weak or dizzy, don’t try to walk around. Instead, see your doctor as soon as possible.
• Call your doctor if you are dizzy and lose your balance. You may have a health problem that needs treatment, such as a blood pressure or inner ear problem. Or you may be having a side effect from a medicine that you take.
• Be sure you are drinking enough water, especially if the weather is hot.
• If you live alone, think about wearing an alert device that will bring help in case you fall and can’t get up. Or carry a cordless or cell phone with you from room to room. Then you can quickly call for help if you need it.
• Set up a plan to make contact once a day with a family member or friend. Have one person who knows where you are.
• Learn how to get up from a fall. Try this when you have someone with you. If you can get up alone, practice this often enough to feel comfortable. If you can’t get up by yourself, see a physiotherapist for help.
• Learn to do a few exercises for strength and balance. Practicing these each day can help you stay active and independent.
• Wear low-heeled shoes that fit well and give your feet good support. Use footwear with non-skid soles. Repair or replace worn heels and soles.
• If you use a walker or cane, make sure it is fitted to you. If you use a cane, replace the rubber tip when it becomes worn.
• If you have pets, keep them in one place at night. Train your pets not to jump or get underfoot. Think about buying a collar with a bell for your pet so you will know when your pet is nearby.
• Know the side effects of the medicines that you take. Ask your doctor if the medicines you take can affect your balance. For instance, sleeping pills and some medicines for anxiety can affect your balance.
• If you take two or more medicines, talk to your doctor about how they work together. Sometimes combinations of medicines can cause dizziness or sleepiness. Either of these can lead to a fall.
• Remove or fix things you could trip over, such as raised doorway thresholds, throw rugs, or loose carpet.
• Keep paths clear of electrical cords and clutter.
• Use non-skid floor wax, and wipe up spills right away.
• Keep your house well lit. Use night-lights (or keep the overhead light on at night) in hallways and bathrooms.
• Put sturdy handrails on stairways. Make sure you have a light at the top and bottom of the stairs.
• Store things on lower shelves so you don’t have to climb or reach high.
• Keep a phone and a flashlight by your bed. Check the flashlight batteries often to make sure they still work.
• For a complete list of hazards to look for and fix at home, see the checklist for preventing falls.
• Install grab handles and non-skid mats in the tub and shower.
• Use a shower chair or bath bench. You can also try using a hand-held shower head.
• Get into a tub or shower by putting the weaker leg in first. Get out of a tub or shower with your strong side first.
• When you go outdoors, keep your hands free by using a cross-body shoulder bag, a fanny pack, or a backpack.
• If you wear bifocal or trifocal glasses, you may have problems as you step off curbs or climb stairs. See about getting glasses with a single prescription that you can wear when you walk.
• Find out about 24-hour drugstores and grocery stores near you that can take orders over the telephone and make deliveries to your home. Use these services, especially when the weather is bad.
• If you live in an area that gets snow and ice in the winter, have a family member or friend sprinkle salt or sand on slippery steps and sidewalks.

Take extra care if you live alone

Learn ways to keep your balance

Learn about your medicines

Make your home safer

Stay safe while bathing

Prevent outdoor falls

For 24/7 nurse advice and general health information call health Link at 811.

Source: www. myhealth.alberta.ca

Current as of: August 4, 2016

Translated with permission from Healthwise Inc. ^© and is not intended to replace the advice of care you get from your doctor or other healthcare professional.  Always consult your health professional for medical diagnosis and treatment.

Read the following information to help you decide whether you might have depression. It does not take the place of a doctor’s diagnosis.

Depression causes you to feel sad or hopeless much of the time. It’s different from normal feelings of sadness, grief, or low energy. Depression is a medical problem that needs treatment. If you think you may be depressed, see your doctor for diagnosis and treatment right away. Untreated depression may get worse.

You may have major depression if you have at least 5 of the symptoms listed below for 2 weeks or longer and 1 of the symptoms is either sadness or loss of interest. You may:

1. Feel sad, hopeless, or empty. Others might have noticed that you appear sad or tearful.
2. Lose interest in or not get pleasure from most daily activities.
3. Lose or gain weight because of changes in how hungry you feel.
4. Sleep too much or not enough.
5. Feel restless and not able to sit still, or sit quietly and feel that moving takes great effort.
6. Feel tired all the time.
7. Feel unworthy or guilty for no reason. You may worry that people don’t like you.
8. Find it hard to focus, remember things, or make decisions.

A serious symptom of depression is thinking about death and suicide. If you or someone you care about talks about suicide or feeling hopeless, get help right away.

Learn the warning signs of suicide, which include talking a lot about death, giving things away, or using a lot of alcohol, drugs, or both. If you see these signs in yourself or a loved one, get help.

If you have fewer symptoms, you may still be depressed and need treatment. No matter how many symptoms you have, it’s important to see your doctor. The sooner you get treatment, the better your chance for a quick and full recovery.

There are several types of depression that may have different symptoms and patterns. These include:

• Seasonal affective disorder (SAD). People who have seasonal affective disorder are depressed only at a certain time each year, usually in the fall and winter months.
• Premenstrual dysphoric disorder (PMDD). Women who have regular and severe emotional and physical premenstrual symptoms that interfere with daily life may have PMDD. This is similar to premenstrual syndrome (PMS) but has symptoms that are more severe.
• Postpartum depression. Women who become depressed after the birth of a child may have postpartum depression.
• Dysthymic disorder (chronic mild depression) occurs when a person has only 2 to 4 symptoms of depression for a period of at least 2 years.
• Double depression. This occurs when a person with dysthymia also has an episode of major depression.
• Adjustment disorder with depression. Sometimes a stressful situation can cause temporary symptoms of depression that improve after the crisis is resolved.

If you think you have depression after reviewing this list, print the list and circle those symptoms that you have. Take the list to your doctor.

If your depression is related to a health problem, such as hypothyroidism, treating the disease usually cures the depression. Substance use problems also may cause depression that is cured when the substance use is stopped. Substance abuse also can be a sign of depression.

If you have just lost someone you care about, you may have symptoms similar to those of depression. Feelings of sadness, sorrow, and grief are normal. And most people start to feel better over several months. But if you feel very sad or depressed, your symptoms don’t go away, or you think about killing or hurting yourself, see your doctor. You may need treatment.

For 24/7 nurse advice and general health information call health Link at 811.

Current as of: February 13, 2017

Source: myhealth.alberta.ca

Ttranslated with permission from Healthwise Inc. ^© and is not intended to replace the advice of care you get from your provider or other healthcare professional.  Always consult your health professional for medical diagnosis and treatment.

• Plan ahead for lunch.  Make extra portions of casseroles, stews, soups, or chili at supper.  Keep leftovers in the fridge to use for lunches within 3-4 days.  You can also freeze leftovers in single servings to use later.
• Get children involved!  Have them help with planning, shopping, and packing.  Children are more likely to eat their lunch when they help plan and prepare it.
• Make lunches in the evening for the next day so they are ready to go in the morning.
• Wash and peel enough vegetables for several days.  Store in a closed container in the fridge.
• Slice leftover fish, poultry, or meat and use in sandwiches, wraps, or salads.
• Keep sandwiches interesting.  Try whole grain breads, buns, small bagels, pitas, tortillas, or crackers, and a variety of fillings.
• Cut up sandwiches for young children.  Make triangles, strips, circles, or other fun shapes.
• Sandwiches can be made ahead of time and frozen to make preparing lunches faster.  Add the vegetables to the sandwich when you take it out of the freezer to pack it.

Pack it up healthy

Pack a variety of foods from at least 3 of the 4 food groups from Canada’s Food Guide: Vegetables and Fruit, Grain Products, Milk and Alternatives, and Meat and Alternatives.  Include a reusable water bottle to refill throughout the day.

Vegetables and Fruit

Choose vegetables and fruit with no added sugar, salt, or fat:

• Tomato, cucumber, grated carrots, or lettuce in a sandwich
• Homemade vegetable soup or salad
• Carrot or celery sticks, cucumber slices, snap peas, cherry tomatoes, cauliflower, or broccoli “trees”
• Fresh, frozen, or dried fruit
• Canned fruit cups or apple sauce

Grain Products

Choose whole grains that are lower in fat, sugar, and salt most often:

• Breads, bagels, buns
• Floor or corn tortillas
• Chapatti, naan, pita
• Cereal bars
• Rice cakes
• Rice barley, quinoa
• Noodles
• Homemade muffins
• Crackers, breadsticks
• Dry cereal
• Plain popcorn

Milk and Alternatives

Select lower fat milk products:

• Skim, 1% or 2% milk, or fortified soy beverage
• Plain yogurt – add fruit or use a dip for vegetables
• Cheese slices or cubes
• Soup made with milk

Meat and Alternatives

Select lean meats and alternatives with little or no added fat or salt:

• Meat, fish, chicken, turkey, or egg fillings in a sandwich
• Chicken legs, boiled eggs, tofu
• Chili, stew, meatballs, lentil soup, baked beans
• Bean dips and spreads, such as hummus
• Nuts and nut butters (if allowed), seeds

Menu ideas

• Tortilla rolled with turkey, shredded carrot and spinach, a banana, and milk
• Pita wedges, hummus and fresh vegetables, yogurt, an orange, and water
• Rice with vegetables and tofu, yogurt, and water
• Oatmeal muffin, cheese, carrot sticks, apple, and water
• Pasta salad with vegetables and cheese, blueberries, and water
• Chili with pita chips, fruit cup, and milk
• Salad with tuna, crackers, a pear, and water

Packing lunches

• Store lunch supplies together in the same cupboard or drawer for faster lunch preparation.
• Use an insulated container for hot or cold foods
  • For hot foods (chili, soup, or stew), pour hot water into the insulated container for a few minutes to heat.  Empty.  Add very hot food and close tightly.
  • For cold foods (drinks, cold soups, or yogurt), chill the insulated container with cold water or keep in the fridge overnight with the lid off.  Empty if needed. Add cold food and close tightly.
• Frozen containers of milk or water help chill sandwiches and will thaw in time to drink at lunch.  A freezer pack can also keep items cold in the lunch bag.  Keep lunches in the fridge if possible.
• Food that will be reheated in a microwave should be kept cold until lunch.  Use only microwave-safe containers for reheating.

Food allergies

Does your child bring lunch to school, a childcare centre, or sports facility?  Before you pack lunch, check the facility’s food allergy guidelines.

Tasty recipes

Go to the website and apps below:

Inspiring Healthy Eating recipes found on www.healthyeatingstartshere.ca

Cookspiration website and phone app for healthy and tasty recipes.  www.cookspiration.com

For 24/7 nurse advice and general health information call health Link at 811.

Source:           Nutrition Services, Alberta Health Services

Current as of: February 2016

Translated with permission from Alberta Health Services and is not intended to replace the advice of care you get from your provider or other healthcare professional.  Always consult your health professional for medical diagnosis and treatment.