Frequently Asked Questions

Here’s a list of common health care questions that we are often asked. We hope that you will find them useful.

Diabetes

  • Why is my nurse insistent that I take good care of my feet?
    Foot care is an important part of diabetes care. Although diabetes can be controlled with insulin or medications, eventually the high blood glucose (sugar) levels can cause damage in your body. One of the problems is with the blood circulation and the nerves that send the sensation of pain; this is called peripheral neuropathy.Because you can’t feel your feet normally, you may get a cut or blister on your foot and not know it. The decreased circulation in your feet means that the blood flow isn’t strong enough to help your cut or blister heal properly. When this happens, the injury can become infected easily and before it is noticed, the infection may have progressed quite far.Good foot care also means watching for ingrown toenails and preventing athlete’s foot.If I take pills, does that mean I won’t have to take insulin shots?
    People who are diagnosed with type 2 diabetes are usually first treated with oral medications (pills). The medications work differently depending on the type. Some help your pancreas produce more insulin, some block the enzymes that digest the starches in the food you eat.People with diabetes can only take oral medications if they are still producing insulin. If the pancreas no longer produces any insulin, then insulin, through injections, is needed.Often, people with diabetes who gain a lot of weight or who have been taking oral medications for a long time will eventually have to start taking insulin. Some people take both insulin and oral medications.What’s the difference between juvenile diabetes & adult diabetes?
    Juvenile diabetes use to be the term used for diabetes that was discovered in children and required insulin to control it. It also used to be called insulin-dependent diabetes. Adult-onset diabetes is what adults were diagnosed with; it was later called non-insulin dependent diabetes. However, now the proper and more accurate terms to use are type 1 and type 2 diabetes.

    Type 1 is the type most commonly diagnosed in children and occurs when the pancreas does not make insulin. Its cause isn’t known. Type 2 diabetes is usually diagnosed later in life, although doctors are now starting to see it in younger and younger people. Although many people with type 2 diabetes don’t have any risk factors, many other do. It is often caused by lifestyle factors, such as obesity.

    What is gestational diabetes?
    Gestational diabetes is a type of diabetes that happens when a woman is pregnant. Often, gestational diabetes can be controlled by diet, but sometimes the woman must start taking insulin shots for the duration of the pregnancy.

    Gestational diabetes goes away after the baby is born. It is believed, however, that women who have had gestational diabetes are at a higher risk of developing type II diabetes later on in life.

    If you have any further questions about diabetes or any other subject matter, please don’t hesitate to contact us.

Home Care Nurses

What can a home care nurse do?
Home care nurses can do many things for you. When you call to arrange for a home care nurse, your needs are evaluated so you can be given the best type of care.

Some people need nurses to come into the home to do dressings or physical care. Others only need to have blood pressure monitored or medications to be prepared. Whatever care is needed that can be performed in a home environment by a nurse, can be done.

Home care nurses can also teach you how to do certain procedures yourself -or teach a family member. Then, the nurse can follow up to be sure the procedures are being done properly or to trouble shoot if there are any problems.

Evaluating your health status is a large part of a home care nurse’s role. The nurse (or nurses) keeps notes about your care and your progress. Through regular visits, they become familiar with your situation and can notice if you need more help or you can get by with less help. They may also be the first to notice if there is something wrong and call for medical help.

If you have any further questions about home care nurses or any other subject matter, please don’t hesitate to contact us.

Influenza, the Flu

Why is influenza (flu) so serious?
Influenza, or the flu as it’s often called, is a serious virus that can make people very ill and can cause death. Many people say they have the flu when they’re not feeling well and may be vomiting or have diarrhea. However, the true flu is much more than that.

Someone with the flu is very ill; they have chills, fever, muscle aches, and a bad cough. The cough is the dangerous part of influenza as many people end up developing pneumonia. This is one of the ways that the flu can be so deadly. Another danger to the flu is dehydration. If someone is too sick to take in fluids, dehydration could set in quickly.

Influenza vaccine, offered for free in Quebec to seniors and people with chronic illnesses, as well as some other groups, is your best prevention against getting the flu. It’s not perfect prevention, but it does decrease your risk.

Speak to your doctor about if you should have a flu shot during the vaccination period.

Pain Control

I don’t like to take too many pain medications so is it ok if I take only half of what the doctor prescribes?
Pain medication for chronic pain needs to be taken regularly for it to work properly. This means taking it on time every time. It also means taking the right doses. When a doctor prescribes a range, from one dose to another, you may take the lowest dose in the range that you feel helps you. However, if it isn’t relieving the pain completely, then the lowest dose is not helping you – the objective is to try and eliminate the pain if possible.

If you think your medication is too strong or too much, even at the lowest dose, it would be best to speak with your doctor before cutting any doses or the frequency.

I don’t want to become addicted to my pain pills. How can I keep that from happening?
Studies have shown that if you need the pain medication, the chances of addiction are very low. You can develop a tolerance to a medication, but this is different from addiction. A tolerance happens when you body become used to a certain dosage and you need to increase the dosage (with your doctor’s ok) for the medication to be effective again. The signs of tolerance are decreased effectiveness of the pain medication and/or shorter duration of pain relief.

Addiction, on the other hand, is not physical. It is a craving for a medication that you will do anything to get. It’s a need that must be met. If you fear you are becoming addicted, speak with your doctor about options.

What is an NSAID and why is it popular to give for pain?
NSAIDs, or nonsteroidal anti-inflammatory drugs, are medications like ibuprofen, Aspirin, and acetamenophen. These drugs work directly on the area that is painful by reducing the swelling. These are available over the counter, but there are also NSAIDs that are available by prescription.

NSAIDs are often the first choice analgesic (pain reliever) before doctors try stronger medications.

Some medications, such as some NSAIDs, can be hard on the stomach; this is one of the side effects. To prevent stomach irritation and/or nausea, medications with this side effect are usually taken with food to buffer the stomach.

Taking Medication

What does four times a day mean for medications – do I have to take them at exactly 6 hours apart?
When doctors write prescriptions for 4 times a day, they mean fairly evenly spaced apart, but it doesn’t have to be exactly 6 hours apart. There are many medications that must be taken every 6 hours. For these medications, the doctors will write, “every 6 hours” instead of 4 times a day. If you aren’t sure how often you should take your pills, speak with your pharmacist and he or she can help answer your questions.

My medications have to be taken 2 hours after a meal. Why? I like to eat many small meals a day so that becomes really impossible.
Many medications must be taken on an empty stomach for them to work properly. If there is food in your stomach, it will interfere with the absorption of the medications.

If you can’t take medications on an empty stomach because of your schedule or a medical issue, this should be mentioned to your doctor so a solution can be found or alternatives can be provided.

I have to take my medication with food. Does that mean a full meal or can it be with a snack?
Some medications must be taken with food to protect the stomach because they can cause irritation to the stomach, causing nausea or even irritation leading to ulcers. If it’s possible, you can take the medications with a meal, but if it isn’t convenient, a good snack will usually be enough to ensure there is something in your stomach to buffer the medications.

I take too many medications and can’t keep track. Some have to be taken before meals, some after, some every other day, some several times a day. I can’t keep it all straight.
People with multiple illnesses or even as people get older, they can end up having to take several types of medications, all with their own rules, so to speak.

If you find you are taking too many medications, speak to the doctor who is prescribing them. If you see more than one doctor, as is often the case with people who are followed by specialists, make sure your primary care doctor knows all the medications you are taking, as well as each specialist you see. Explain to them about the many medications and how it is difficult to keep up. Sometimes, medications can be changed or even combined.

At home, there are some tricks that may help you keep track of your pills.

First, pill organizers can be a wonderful help. You can either buy a larger dosette type that has many slots for each day of the week, according to time, or you can buy some of the week containers, with one slot for each day of the week. Some people buy several different colours of these: one for morning pills, one for lunch time, and so on. By using these organizers, you can put out your pills for a week and then if you can’t recall if you took a pill or not, you can check your container.

Some people use timers throughout the day to remind them when to take their pills. This may be a good solution if you take several throughout the day. It may take some experimenting to find a system that works well for you.

I can’t open the packages that my pills come in. The foil is too hard to break through and I end up having to use scissors or a knife. Why do the companies use that type of packaging?
It’s likely that the companies feel that this type of packaging is the most efficient to keep the medications safe and fresh, but you are right in that they can be difficult to open.

When getting your prescription filled, ask your pharmacist to take the pills out of the packaging and place them in a pill bottle. If he or she is willing to do that, it can make a big difference for you. If they can’t or won’t, perhaps you can ask someone to help you prepare your pills in advance.

Before putting pills in a bottle, however, ask the pharmacist if this is ok for your particular medication. Some medications cannot be exposed to light, for example, and must be kept in a dark container or they lose their potency.

I can’t swallow my pills but my pharmacist says I can’t cut them. What can I do?
There are many tricks to swallowing pills, anywhere from taking them with a spoon of applesauce or ice cream to crushing them if you are allowed to. Not everyone can swallow these pills though so that makes it really difficult for some people.

When you swallow your pills, do you throw your head back to try to encourage the pills to go down your throat? Most people do. The problem with this approach is that it lengthens your neck and tightens the muscles. Perhaps you should try the opposite. Some people have more success if they put the pills on the back of their tongue, take some liquid, and then bow their head forward to relax the neck muscles rather than tighten them.

If you still can’t swallow your pills, speak to your doctor about perhaps changing your prescription.