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November 2017
Boys Don't Cry: Understanding Men and Depression
   November is Men’s Health Awareness Month, when folks are reminded of, and can openly discuss men’s health issues. Mental health issues, including depression, are often unrecognized and, unfortunately, seldom discussed with men.
     The phrases "take it like a man," "man up," and "be a man" imply staying quiet, pulling one’s self up by the bootstraps, and moving forward. Unfortunately, the message of staying quiet is dangerous when it applies to mental health.
     According to various surveys, there are half as many reported cases of depression in men compared to women; however, this rate is likely under-reported. In 2014, the Centre for Suicide Prevention reported that there were 3728 completed suicides in Canada, and 2781 of these suicides were male.
     Moreover, far fewer men seek treatment or support for depression, including health care providers, friends or family, when compared to women.
     A few of the barriers to help-seeking behaviours in men include: stigma related to depression and help-seeking (i.e., "If I have depression, it means that there is something really wrong with me", "If I seek out help, it means that I am weak"), beliefs regarding gender-roles ("A real man would solve this on his own"), and a lack of priority and awareness related to mental health issues. And, instead of talking about stress or trying to seek help for their depression, men are at greater risk to mask their stress and deal with depression through avoidance and withdrawal, or through harmful behaviours and actions, such as violence, drinking, drugs, gambling, reckless activities and, as highlighted earlier, suicide (Centre for Suicide Prevention, 2014).
     As identified in his book, I Don’t Want To Talk About It; author Terence Real identifies that biological, psychological, and social factors all play a part in men’s depressive symptomology, as do lifestyle choices, relationships, and coping skills (Real, 1997).
     Stressful life events or anything that makes one feel helpless, profoundly sad, or overwhelmed by stress can also trigger depression in men, including:
  1. Overwhelming stress at work, school, or home
  2. Marital or relationship problems
  3. Not reaching important goals
  4. Losing or changing a job; embarking on military service
  5. Constant money problems
  6. Health problems such as chronic illness, injury, disability
  7. Recently quitting smoking
  8. Death of a loved one
  9. Family responsibilities such as caring for children, spouse, or aging parents
  10. Retirement; loss of independence

How to recognize depression in men:

  1. If you identify with several of the following, you (or a loved one) may be suffering from depression:
  2. you feel hopeless and helpless
  3. you’ve lost interest in friends, activities, and things you used to enjoy
  4. you’re much more irritable, short-tempered, or aggressive than usual
  5. you’re consuming more alcohol, engaging in reckless behavior, or using TV, sports, and sex to self-medicate
  6. you feel restless and agitated
  7. your sleep and appetite has changed
  8. you can’t concentrate, or your productivity at work has declined
  9. you can’t control your negative thoughts

    Physical pain is an additional symptom of depression often overlooked in men, including a backache, frequent headaches, sleep problems, sexual dysfunction, or digestive disorders that often do not respond to normal treatment (Men and Depression, 2016).

What to do if you are depressed:

1) Seek social support to reduce stress and feel happier. Close relationships are vital to helping you get through difficult times and being around other people helps with managing mood. This may include: reaching out to family and friends, participating in social activities, joining a support group for depression.

2) Exercise for greater mental and physical health. When you’re depressed, just getting out of bed can seem like a daunting task, let alone exercising. But regular exercise is extremely effective in managing the symptoms of depression in men.

3) Eat a healthy diet to improve how you feel. What you eat has a direct impact on the way you feel. Reduce your intake of foods that can adversely affect your mood, such as caffeine, alcohol or comfort foods such as French fries, or sugary snacks.

4) Get enough sleep. When you don’t get enough sleep, your depression symptoms can be worse. Sleep deprivation exacerbates anger, irritability, and moodiness. Aim for somewhere between 7 to 9 hours of sleep each night.

5) Reduce stress. Too much stress worsens depression. A daily relaxation practice can help relieve symptoms of depression, reduce stress, and boost feelings of well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.

6) Seek out professional help. Sometimes, support from family and friends and positive lifestyle changes aren’t enough, and help from a mental health professional is needed. Treatments for depression include;

  • Therapy - Talk therapies are used to help the person find ways to manage mood and learn coping skills to manage everyday stressors.
  • Medication -  Antidepressant medication may help relieve symptoms of depression.

Local Community Supports:

If you are experiencing a psychosocial or mental health crisis, call the following numbers for assistance: OVER THE AGE OF 18: 1-888-379-7699 or UNDER THE AGE OF 18: 1-866-403-5459.

To access mental health services in your area, call 1-866-403-5459 (under the age of 18) or 1-855-222-6011 to be connected with the service provider nearest you.

Contact information for services available in your area is also available on the Prairie Mountain Health website

Mood Disorders Association of Manitoba 1-204-725-1232

References

Centre for Suicide Prevention. (2014, October). Men and suicide: A high-risk population. Retrieved from Men-and-Suicide-2014.

Mayo Clinic Staff. (2017, May 17). Male Depression: Understanding the Issue. Retrieved from male-depression article.

National Institute of Mental Health (2016).Men and depression. Retrieved from men and depression article.

Real, Terrence. (1997). I Don’t Want To Talk About It. New York, NY: Simon and Schuster.

Health Fair – A Client Centered Collaboration  
     A Health Fair was held in October at the Brandon Town Centre for the public. This client –centered collaboration saw Prairie Mountain Health partnering with many programs and agencies to increase awareness and access to all things healthcare. This included information on sexually transmitted diseases, chronic diseases like diabetes, addictions, mental health, midwifery services, chronic lung diseases, and help with quitting smoking to name a few. 
     Many people dropped by the event that ran from 1pm to 6pm gathering information and talking one on one with providers. The hope is to have this become an annual event promoting "A Healthy Outside starts from the Inside".
Telehealth Recognition Event Held In Melita
     Prairie Mountain Health (PMH) and MBTelehealth were very pleased to be a part of a special regional recognition and Telehealth demonstration event Thursday, September 28, 2017. The event, which featured a Telehealth link-up to show aspects of the service, acknowledged financial contributions from community groups, organizations and municipalities that helped purchase the capital equipment required for the Telehealth Program. There was also a local commitment towards five years of operating costs.
    
PMH Regional Manager of Client and Patient Relations, Sandi Allen thanked all of those involved with the Melita and area Telehealth Committee for their community fundraising and information sharing efforts.
     Although the recognition event was held in September, the Telehealth unit went into service at the Melita Health Centre on August 28. 2017. Melita became the 27th community within PMH to offer the service.
     Patients in Melita can now have a clinic-type appointment with their specialist without traveling to Winnipeg (or other urban center). These appointments operate similar to how patients are currently referred to see a specialist in person. Talk to your local Doctor about the possibility of having your specialist appointment by Telehealth (not all appointments are appropriate for telehealth and referrals are required).
Pictured at the recognition event from left: PMH Board Chair Catheryn Pedersen, PMH Regional Manager of Client & Patient Relations Sandi Allen, Donna Revet, Chair of Melita Telehealth Committee, Faye McLoughlin, Chair of Melita Palliative Care Committee and Louise Lusignan, MBTelehealth.
Brandon Fire & Emergency Services Celebrates 100 Years in EMS
     To mark this milestone, an open house was held on September 30th for various stakeholders in the community. This celebration was an opportunity to provide awareness of the structure and challenges of delivering emergency medical services in today’s world.
    
Scenario based stations were set up as paramedics demonstrated various techniques and equipment that are utilized on medical calls.
    
Guests had an opportunity to try some of the techniques and equipment used by the paramedics in delivering emergency medical services.
 

Thank you to everyone who participated and made this a successful event!

Participants watch as paramedics demonstrate the Intraosseous Vascular Access System.

Prairie Mountain Health Hosts Annual General Meeting

     Prairie Mountain Health (PMH) held its Annual General Meeting for the fiscal year of April 1, 2016 to March 31, 2017. The meeting was held October 19, 2017 at the Elkhorn Resort near Clear Lake. The PMH Board, and Executive Management Team, was pleased to report back on the region’s fifth year of operation since RHA amalgamations in 2012.
     The Board’s detailed
Annual Report was unveiled at the meeting.
    
A video review of some of the more significant events and initiatives that transpired during the last year highlighted the first part of the meeting. Guided by the region’s audited financial statements, a 2016/2017 fiscal overview was also provided.
    
Guest presenter, Dr. Brock Wright, spoke on the creation, and progress to date, of the new provincial health organization- Shared Health Services Manitoba. Dr. Wright is the President and CEO of Shared Health Services Manitoba and touched on some key themes of health care change that are underway in the Province.

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In conjunction with Digital Health Week, you are invited to a Telehealth information session.
 
Why Use Telehealth? 
Telehealth allows you to see, hear and talk to a health care provider on a television screen by teleconferencing, saving you time, money and travel.  The open house will include:
 
**Telehealth equipment demonstration**    **Live presentation**     **Audience questions and answers**
Find an open house near you:
*FREE to attend. No registration required. Wed, November 15th
1:15 - 2:00 p.m.
Fri, November 17th
2:15 – 3:00 p.m.
Baldur Health Centre     531 Elizabeth Street Boardroom                --
Benito Primary Health Care Center              200-1st St SE Multipurpose Room                --
Brandon Regional Health Centre                   150 McTavish Ave E. Nurses Residence
Room N242 AND  Room N248
Nurses Residence
Room N248
Brandon Town Centre - Mental Health           800 Rosser Ave Mental Health Boardroom B9 Mental Health Boardroom B9
Brandon Town Centre - Home Care             150B  -7th Street                      -- Conference Room 62
Brandon Western Manitoba Cancer Care        300 McTavish Ave, E                      -- Rounds Room (ON-1-159)
Camperville Primary Health Care Centre     PTH #20 South                      -- Meeting Room A/B
Carberry Health Centre     340 Toronto Street Clinic Basement
Conference Room
Clinic Basement
Conference Room
Dauphin Regional Health Centre                    625-3rd St SW Telehealth Clinic RM246                   --
Erickson Health Centre             
  60 Queen Elizabeth Rd
X-Ray Room X-Ray Room
Ethelbert Primary Health Care Centre 
31 Railway Ave. N
                          -- Telehealth Room
Hamiota Health Centre     177 Birch Ave E Conference Room Conference Room
McCreary/Alonsa Health Centre     613 PTH 50 Boardroom                   --
Melita Health Centre    147 Summit Ave Multipurpose Room Multipurpose Room
Neepawa District Memorial Hospital  
500 Hospital Street
Boardroom Boardroom
Rivers-Riverdale Health Centre  
   512 Quebec St
Doctor’s Office Doctor’s Office
Roblin District Health Centre     15 Hospital St                   -- Boardroom
Russell Health Centre     426 Alexandria Ave                   -- Main Floor Conference Rm
Shoal Lake/Strathclair Health Centre  
 
526 Mary St.
                  -- Multipurpose Room
Souris Health Centre     155 Brindle St Multi-purpose Room B Multi-purpose Room B
Ste Rose Primary Health Care Centre  
 
603 – 1st Ave, E
                  -- Boardroom
Swan River Health Centre     1011 Main St Conference Room C Boardroom
Tiger Hills(Treherne) Health Centre   
  64 Clark St
PCH Lounge                      --
Virden Health Centre     480 King St E Boardroom                      --
Waterhen Primary Health Care Centre 
104 North Mallard Rd
Meeting Room A/B Meeting Room A/B
Winnipegosis & District Health Centre  
   230 Bridge St
Boardroom Boardroom
For more information please call 204-622-6222
More information on Digital Health

More information on MBTelehealth

Nursing Team at Western Manitoba Cancer Centre Wins
"Outstanding Nursing Unit, Program or Interprofessional Team" Award
     Jordana Jones, a nurse at the Western Manitoba Cancer Centre (WMCC) read over the criteria for the Association of Registered Nurses of Manitoba’s (ARNM) “Outstanding Nursing Unit or Interprofessional Team Award” and knew her team had a good chance of winning, and that they deserved to be recognized for working together as a cohesive unit to offer the best care possible to their patients.
     With support from Treena Slate, the Care Team Manager for Prairie Mountain Health’s Regional Cancer Care Program and Jodi Hyman, a nurse Educator with Cancer Care Manitoba (CCMB), Jordana started ticking off all the requirements her team demonstrated to be eligible for the award.
 

> Demonstrating exceptional collaboration, cooperation and respect
All of the nursing staff at WMCC are cross-trained to work in all three areas of our program: Chemotherapy Treatment Room, Radiation Clinic, and Community Oncology Clinic.  WMCC has committed to working without paper charts, relying solely on the CCMB electronic charting system, Aria – the only cancer program in the province doing so.  The benefits of this are seamless communication between care providers, and coordinated care for patients.  Nurses work within a high functioning interdisciplinary team at the Western Manitoba Cancer Center with Radiation Therapy Technicians, Oncology Dietitian, Social Worker, clerks, FPOs (Family Physicians in Oncology) Radiation Oncologists based in Brandon and Winnipeg, and Winnipeg based Medical Oncologists and Oncology nurses.  The chemotherapy team and radiation therapy teams meet weekly to share information and problem solve any issues.  
 

> Consistently strives to improve and maintain a positive practice environment
Working relationships are highly respectful and amiable among the team members.  The team actively embraces and adapts to change and advancing practices.  Nurses are encouraged to attend regular educational opportunities through the Canadian Oncology Nursing Organization and CCMB, and share their new found knowledge with their colleagues.
 

> Achieves positive patient outcomes for patients through a team approach
In 2015, a Client Experience Questionnaire was completed for WMCC. 100% of the patients surveyed reported that they were satisfied with the care/ service provided by the nursing staff.  One respondent stated "The doctors, nurses, and technicians are all better than good. I have come here for 5 years and never had one thing to complain about. Great staff".  This statement proves the cohesive relationship that the staff at WMCC has formed in order to provide outstanding care for patients.
 

> Applies research or best practices to improve patient care
The nursing staff maintains a close relationship with CCMB in Winnipeg, to ensure best practices are followed with chemotherapy administration, appropriate monitoring and observation during chemotherapy treatments, as well as evidenced based wound care for patients receiving radiation treatments.  Last year, two radiation nurses spent a day in Winnipeg to gain a better understanding of radiation skin toxicity management and treatment. These nurses then returned and provided education to the remaining staff to ensure that best practices would be adhered to for all skin toxicity management. 
 

> Uses innovative and creative approaches
Last year, it was identified that nursing staff were struggling to provide adequate education and orientation to new patients during the initial 45 minute visit.  Several discussions were held by the nursing staff and a new procedure was developed that included patients coming in 1 hour prior to their appointment with the physician to meet with a member of the nursing staff for an education/ orientation session.  During this one hour session, patients are provided with information regarding their treatments and what to expect on their first day of treatment.  Referrals to psychosocial services and dietitians can also be made at this time as well as any paperwork (ie, consents) can be filled out with patients prior to their physician visit.  This has allowed for patients to spend their full new patient visit with the clinic nurse and physician without feeling rushed or overwhelmed with information.  The response from both staff and patients has been overwhelmingly positive.
 
Congratulations to the nursing team at WMCC for winning this year’s ARNM
“Outstanding Nursing Unit or Interprofessional Team Award”
Back Row - Brenda Hiebert, Katy Stewart, Jordana Jones, Andrea Kukurudz, Cheryl McDonald
Front Row - Charlyne Wiseman, Karen Doppler, Kelsey Russill, Tania McLaren
Missing - Debbie McNairnay and Heather Chudley
BRHC Redevelopment Project Update
     The Brandon Regional Health Centre (BRHC) redevelopment project continues to progress with the majority of the work taking place on the fifth floor of the General Centre.
     On the east side of the fifth floor, rooms have now taken shape with drywall being installed. The east side will have a bariatric room complete with a full washroom. The remaining rooms on this side are double room occupancy.
     The center area of the fifth floor will be a combination of a nurses/physician station in addition to the main reception desk and offices.
     On the west side of the fifth floor, mechanical and electrical work continues. The framing of all rooms has now been completed. 500 west will feature an isolation room along with two single rooms. In addition, a new tub room for therapy services will also be located on the west side.
     The first phase of the project saw the completion of the Pediatric Ward now located on the second floor. The second phase is the current renovations taking place on the 5th floor. Once that is complete phase 3 will begin with the renovations on the east side of the 4th floor followed by phase 4, renovating the west side of the fourth floor. When complete it will see the creation of 12 new medical in-patient rooms with washrooms that will now be wheelchair accessible, along with expanded and improved areas for patients, staff and family support.
November is Diabetes Month
     Many of us have likely thought to ourselves ‘Am I at risk of diabetes?’ That is a great question because Diabetes Canada states 1 in 3 Canadians has diabetes or prediabetes, and many do not know it. The truth is, diabetes can be a relatively silent disease, and that is why it is recommended that at the age of 40 all Canadians be screened for diabetes (earlier if you have risk factors).

Risk factors for diabetes listed by Diabetes Canada include but are not limited to:

  • being 40 years of age
  • having a first degree family member with diabetes
  • being diagnosed with gestational diabetes
  • history of delivering a large baby (over 8 pounds 13 ounces)
  • member of a high-risk population (Aboriginal, African, Asian descent)
  • extra weight in the abdominal region
  • high blood pressure
  • having other chronic diseases

     Testing for diabetes requires a visit to your health care provider (family physician, nurse practitioner).

     Diet is a common question when it comes to diabetes risk reduction or diabetes management. Five diet tips we can follow for overall health and diabetes risk reduction:
    
1) Meal regularity throughout the day is important. Skipping breakfast can lead to excess intake later in the day because our body is too hungry at this point to recognize the best choices it should make. Our bodies are happier on a set schedule, with regular meals and healthy snacks spaced throughout the day.
     2) Adequate protein (meat and alternatives like eggs, nuts, and seeds, beans, legumes) is important. Protein at meals is what keeps us full and prevents cravings throughout the day.
     3) We need fibre (fruits, vegetables, whole grain, seeds) to meet our nutrient needs and to keep us full. If we can aim for a total of 5 servings of vegetables and fruit daily, we are doing great.
    
4) Low glycemic index foods are often higher fibre food choices that take longer to digest and therefore leave us satisfied longer. Food such as beans and legumes, chickpeas, parboiled or converted rice, and bran are all examples of low glycemic index foods.
    
5) Fluid choices can add hundreds of extra calories to our diet. Good fluid choices include water, two cups of milk or alternative daily, unsweetened coffee and tea in moderation. Fluid choices to limit include fruit juice (including unsweetened), iced tea, pop, frozen coffee beverages, and sweetened milks.
    
Diabetes Canada is a fantastic resource that may guide you and answer some of the questions you may have about diabetes.
    
Another option for diabetes information and education is the Chronic Disease Education Program (CDEP) in Prairie Mountain Health. Our diabetes educators travel throughout the region and are available to answer questions you may have about your risk factors for diabetes or management of your diabetes. Clients can be referred by their healthcare provider and are also welcome to self-refer to the CDEP program by calling our toll free line at 1-877-509-7852.

New Physicians within Prairie Mountain Health
     Twenty-two new primary care physicians have been recruited and are starting to work in communities across the Prairie Mountain Health region. At an event in Neepawa on September 29, 2017, Manitoba Health, Seniors and Active Living Minister Kelvin Goertzen recognized this work.
    
"Prairie Mountain Health has been working to recruit physicians to communities across the region and their hard work is paying off," said Goertzen. "This accomplishment will certainly benefit residents of western Manitoba and help ensure consistent, reliable care for families."
    
Primary care refers to that early contact with the health-care system when patients and their families receive a diagnosis, treatment or help with a new health problem or chronic condition. Services can also include speaking with a health-care provider about staying healthy and preventing illness.
    
"We have remained relentless in our efforts to continue to recruit physicians to the region and those efforts have paid off this year," said Penny Gilson, chief executive officer, Prairie Mountain Health. "We want to acknowledge this is a collective effort and thank the health department, the Manitoba Healthcare Providers Network, the University of Manitoba, the International Medical Graduate training program, the Association of Manitoba Municipalities and physicians who provide mentorship and support to new recruits, and to the communities who are key partners in ongoing recruitment and retention efforts."
    
Continuing recruitment efforts by the region have brought six physicians to Swan River, two to Deloraine, two to Brandon, two to Dauphin, one to Grandview and one to Neepawa. In addition, eight international medical graduates will be practising in Killarney, Roblin, Shoal Lake, Winnipegosis, Virden, Minnedosa, Souris and Glenboro.
    
"My decision to practice in Neepawa was based on the broad scope of practice available in the area - acute care, office care, obstetrical care, and geriatric health," said Dr. Kristen Wareham, a new physician practicing in Neepawa. "This is all supported by the town and surrounding communities and a well-established, experienced and supportive physician group, and I look forward to beginning my career here."
    
The region has also successfully recruited several specialists in the areas of cardiology, radiology, psychiatry, orthopedics, pediatrics and geriatrics over the course of the past 12 months. A general surgeon has recently started practising in Dauphin, with another scheduled to begin full-time practice in Brandon.
    
"The region is continuing to work with communities to promote rural living and with stakeholders such as the University of Manitoba and the Office of Rural and Northern Health to promote careers in rural health care," said Goertzen. "This combination of efforts helps connect physicians with rural communities where they will stay to build their careers and provide quality care to area residents."
     The minister noted that ongoing physician recruitment and retention efforts will be a key priority of clinical service planning that will be undertaken by Shared Health Services Manitoba. This work will support consistent and reliable health-care services, effective health human resource planning, capital equipment investments, construction planning and other initiatives that should be co-ordinated province wide.
    More information on primary care in Manitoba.
Pictured left to right: Dr. Kristen Wareham; Health, Seniors and Active Living Minister Kelvin Goertzen; Penny Gilson, CEO PMH.
PMH Flu Clinics Going On Now...
Check for dates and locations and where appointments are needed.
Copyright © 2017 Prairie Mountain Health, All rights reserved.


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