Post Archives

Drs. Terence Yung and Steve Ham
December 5, 2018

Postoperative “troponinitis” is not benign: highlighting the importance of surveillance

All postoperative troponin elevation should be treated seriously. Troponin elevation after surgery is associated with significant mortality at 30 days. Myocardial injury after non-cardiac surgery (MINS) diagnosis is made after other causes of troponin elevation are ruled out. Up to 90% of patients with a troponin elevation postoperatively do not exhibit any symptoms, yet their outcomes are still poor. read more...

Mark W. Hull MD MHSc
November 13, 2018

HIV pre-exposure prophylaxis (PrEP) for individuals at risk for HIV infection

Over the last five years, on an ongoing basis, we have seen new HIV infections occurring in young gay, bisexual and other men who have sex with men (MSM). The majority of these individuals had had a prior negative HIV test within the last year, or were presenting with signs or symptoms supportive of an acute HIV infection, suggesting recent exposure and transmission of HIV infection, highlighting the need for novel HIV prevention strategies. read more...

Dr. Diane Villanyi
October 31, 2018

Driving assessment in older adults

Under Section 230 of the Motor Vehicle Act, in addition to physicians, registered psychologists, optometrists and nurse practitioners are obliged to report a patient who may be unfit to drive. RoadSafetyBC has a dedicated phone line for medical professionals to help with complex cases. read more...

Michelle C. Danda, RN, BN
October 10, 2018

Learning to meet my patient where they are at – how letting go changed my practice

I realized that engagement is paramount when working with an ambivalent patient, because the change that they want to make is often important in their life, even if the clinician views it as a problem behavior. Motivational interviewing education has been shown to improve patient alliance and treatment adherence. read more...

Dr. Martha Spencer
September 19, 2018

Fecal incontinence: just ask!

Fecal incontinence (FI), defined as the involuntary passage of stool or the inability to control the expulsion of stool, is a common but under-reported condition that can affect people of all ages but has increased prevalence in older adults. read more...

Dr. Carol-Ann Saari
September 5, 2018

Trauma Informed Practice (TIP) makes perfect (or at least it is a good start)

In the general population, approximately 75% of Canadians will report having experienced an adverse and potentially traumatic experience in their lifetime, with 9.2% meeting criteria for PTSD. We have to become trauma informed. Trauma informed practice (TIP) is a way of providing services that recognizes the need for physical and emotional safety, choice and control in decisions affecting one’s treatment and an environment where patients do not experience further traumatization. read more...

Lily Zhou
September 4, 2018

Better than sex? Building mind wandering tolerant presentations

I used to feel crushed when looking up from notes during a presentation to a packed lecture hall of colleagues intensely concentrating... read more...

Dr. Colleen Varcoe and Dr. Heather Smith
August 15, 2018

Equity-oriented health care

Health equity-oriented care is now part of my daily practice; the tools created with, and provided by, the EQUIP study have helped to make health care inequity an issue that I can screen for and offer options for management. read more...

Drs. Terence Yung and Tony Wan
July 24, 2018

Baby aspirin for extended DVT prophylaxis after elective hip and knee arthroplasty

For those who had an elective hip or knee arthroplasty who have no other risk factors for VTE, after initial 5 days of DVT prophylaxis with rivaroxaban 10mg a day, I complete the remaining DVT prophylaxis with aspirin 81mg once daily for an additional 30 days for hip arthroplasty and 9 days for knee arthroplasty. Those who already were on once-daily 81mg aspirin prior to surgery will receive 162mg aspirin once daily instead in this period. read more...

Dr. Maia Love
July 4, 2018

Wellness and self-care for professional excellence

Defining yourself as a person first, and your role as a professional second, has benefits in preventing burnout and creating more personal energy. Put your own oxygen mask on first. read more...

Dr. Min S. Phang, MRCP, FRCPC and Stacey Miller, PT
June 13, 2018

Hip surveillance in children with cerebral palsy

I now refer all children with cerebral palsy, or suspected cerebral palsy, to the Child Health BC Hip Surveillance Program. Information about the program is available at www.childhealthbc.ca/hips, including a referral form for physicians. The incidence of hip dislocations can be significantly reduced! read more...

Dr. Kelly Luu
May 23, 2018

The power of storytelling in clinical encounters

Evidence shows that the strategy which physicians frequently employ, educating and training, is only the first step in the process of behavioural change. By helping patients shift their narratives about themselves, we can strengthen their ability to have sustained behavioural change. read more...

Dr. Andrew Howard, Tyler Schwaiger, Dr. Noah Silverberg, and Dr. Will Panenka
May 2, 2018

Concussion management: time to give “brain rest” a rest

Rest might increase symptoms and recovery time following concussion or mild traumatic brain injury. Inactivity has been associated with physical deconditioning, social isolation, discouragement about recovery, and reactive anxiety and depression. Early mobilization and graded exercise programs can reduce post-concussive symptoms and recovery time. read more...

Dr. Vanessa Brcic and Dr. Devon Christie
April 18, 2018

Trauma as a determinant of health

What changed our practice was a fundamental recognition of trauma as a determinant of health, and furthermore, that PTSD is only the tip of the iceberg when it comes to trauma. Much lies under the surface for our patients. read more...

Dr. Leslie Sadownik
April 4, 2018

Practice Tip: “SAIL” through a vulvovaginal examination

Women with chronic vulvar disorders will often report years of symptoms before an accurate diagnosis is made, and effective treatment is started. read more...

Dr. Vincent Hanlon
March 14, 2018

The practice of mindfulness

Mindfulness is the awareness that emerges through paying attention to the unfolding of experience moment by moment. This paying attention is done on purpose, in the present moment, and it’s non-judgmental. read more...

Dr. Duncan Etches
February 21, 2018

Guidelines

In summary, in place of pattern or algorithm driven medicine, clinical experience and ability to determine what is best for our patient lies at the heart of the art of medicine. read more...

Dr. Laura Sauvé
February 7, 2018

Adverse events following immunizations (AEFI)

Vaccines are safe, but sometimes adverse events following immunizations do happen, and can be very concerning to families. If your patient has an AEFI, there is a voluntary reporting system. Public Health Officers in your local Health Authority will be able to answer most questions or concerns. read more...