Sex & Relationships

Why I Went To Sex School And Why You Should, Too

As a sexual overachiever, I thought I had seen (and done) it all. But a groundbreaking online platform taught me some new tricks—and made me realize how little we learn about our own pleasure

“You go up and down, and stuff comes out,” Luna Matatas says to the camera while stroking a dildo that looks like a very realistic penis. Matatas is a Toronto-based sex and pleasure educator, and she’s talking about how most people think about hand jobs. She will spend the next hour disabusing me of that notion. Or rather, deepening it: Hand jobs are not just about going up and down, and stuff coming out. They’re not just about foreplay, or at least they don’t have to be. And they’re not just about making someone with a penis have an orgasm, though they can be. They’re also—maybe especially—about the person giving the hand job. Seriously.

I’m watching Matatas’ “10 Tips for Hotter Handjobs” tutorial, which lives on the pleasure-education website O.school, and it’s much more than the video version of a Cosmo headline. It’s part instruction, part commiseration, part therapy. I will laugh. I will be humbled. I will find my erotic centre in the act of a hand job.

O.school is an online, sex-positive sex-ed platform that includes more than 300 videos (and dozens of articles) and could best be described as a thorough post-secondary education in the arts and acts of pleasure, including biology, psychology and philosophy. O.school was founded in 2017 by Andrea Barrica, a queer woman who had spent seven years working in San Francisco’s start-up scene and who raised more than US$1 million from investors to launch the site. It has since amassed a significant video library on topics as varied as choosing a dildo, dating after divorce, healing from sexual trauma and putting stuff in your butt (among many other subjects). All tutorials are taught by experienced instructors (a.k.a. “pleasure professionals”) who have been vetted by Barrica and her team, including medical professionals, sex educators and counsellors. Did I mention the site’s offerings are free?

There is a sizable gap between the sparse sex ed of youth and the experiential sex-ed of adulthood, and gaps always threaten to turn into vacuums if unfilled. The sex ed most of us get is about the drawbacks of sex—scary all-caps phrases: UNWANTED PREGNANCY! DISEASE! DEATH! A BAD REPUTATION! But what if we had also been taught about sex’s vast landscape of pleasures?

How much time would we have saved ourselves? How much would we have gained? What would our sexual selves be like now if we had spent as much time learning that the clitoris has 8,000 nerve endings as we did learning about chlamydia?

Quite simply: O.school is online sex school, with a focus on the pleasure you derive from sex as opposed to its potential dangers. And it’s unlike anything else that currently exists in the realm of adult sexual education.

***

In the 1999 Alexander Payne film Election, high school senior Tracy Flick, played by Reese Witherspoon, is an overachieving, pushy candidate for student council president with a profusion of extracurriculars.

In 1999, I was 16. I was student council president. And president of the drama club. I had a key to the school, as Tracy does. But there was an important distinction. In Election, Tracy is f-cking her math teacher (and, she thinks, is in love with him). I wasn’t f-cking anyone…yet. Except myself, and barely. In the dark living room, under a blanket, to Scully and/or Mulder, on Sundays between 9 and 10 p.m. Mountain Standard Time, only.

Twenty years later and I’m still Tracy Flick-ish, but in another way: I am the Tracy Flick of Sex (Tracy F-ck? Sorry). I’m sexually smart, capable, capacious; I make plans and schedules. I get up early to do it. I stay up late. I pack a sensible bag. I do it with many, many people (see my series on non-monogamy). I am extracurricularly dedicated to the pursuit of carnal knowledge (by day, I am a writer and director of TV and film). I am borderline arrogant about my level of dedication. I am proudly slutty, I know it, and so will you.

So when I stumbled across O.school while on an Internet deep dive about squirting (as one does), I thought it was a cool idea that I didn’t need. What could the Tracy Flick of Sex have to learn from an online sex school? As it turns out, more than I might have thought—and it made me realize that most adult women could benefit from some sexual re-education.

I grew up in the public school system of the 1990s. Sex ed amounted to a few hours, divided by binary gender, in a beige classroom. Mine was taught by a well-meaning but deeply desexualized public health nurse who coughed with Freudian realization when one of the projector slides said “Pubic Health Nurse” under her name.

Because of videos shown in my grade 7 classroom, I knew how my period worked with clinical accuracy; I didn’t know the joys of period sex until I started having it.

Enter O. school.

“If you go to Reddit [for sex ed], it can be abusive. On YouTube, there’s millions of videos but they’re not curated,” says Barrica, who grew up in a Filipino Catholic home and is a victim not just anemic sex ed but abstinence-based obliteration. “I got the fear-based, shame-based stuff,” she says. “You’re this perfect white flower. And when you have sex, you mash the flower, and you’re never going to be the same.” Barrica started O.school to close the gap that she herself faced.

What Barrica and her team have done is not revelatory on its face: Other sex- and pleasure-ed sites exist, though most favour articles over video content. OMGyes, another California-based start-up, which launched with a lot of fanfare in 2015, is the only close analogue to O.school in terms of extensive video content. It uses anecdotal, direct-to-camera interviews with women about their own first-hand experiences of pleasure as a form of education-by-conversation. This can be informative, certainly, but it also means you’re only hearing from one woman—who is not a pleasure educator—about why she specifically likes what she likes.

OMGyes also features some explicit content in the form of demonstrations, which show real women’s anatomy in close-up; it also offers a touch-screen stimulator so you can test out the methods of pleasure you hear women describing on an onscreen vulva. However, OMGyes costs $59 per season of content, and it’s surprisingly heteronormative and relationship-centric for 2019—we’re largely talking about straight, cis, committed sex here.

O.school is different. To start, it’s “exclusively inclusive,” says Robin Milhausen, a Canadian sexologist who has no affiliation with the site. “It’s totally inclusive related to sexual and gender identities. And it’s trauma-informed, taking into account people’s experiences.” This means that O.school has taken pains to exclude nudity and to present information in a way that doesn’t assume everyone is approaching pleasure ed from a place of complete acceptance (for example, if someone has been raped and is trying to rediscover their body, certain depictions of frank sex, or nudity, can be triggering).

O.school is also made for everyone to learn about their own pleasure on their own terms, from a basis of science, no matter their relationship type, body or gender. Or, importantly, age. “A lot of the YouTube sex educators are younger,” says Milhausen. At O.school, on the other hand, many instructors appear to be in at least their 30s, which may be more appealing to women in that demographic and beyond.

Milhausen, who considers sex a matter of academic importance even more than I do, is truly impressed by the site. “There’s never been a better time to be a sexual being, because there’s never been more information available, for free, and it’s so accessible. There’s a community for everyone,” she says, “so sometimes the amount of information can be overwhelming, which is why a website like O.school—which has really strong, vetted information—is helpful.”

As a brand, O.school wants to be the first place you think to look when you wonder about pleasure, because you trust its teachers to steer you right, just as you know to search, say, IMDb for factual information about films (such as what year Election came out). Barrica’s eventual goal is to provide pleasure education to a billion people; it’s a lofty aim, and she won’t divulge the number of current O.school users to put that in perspective. Right now, however, she just wants to make space for quality, zero-judgment pleasure-not-just-sex ed.

a bunch of fruits and veggies laid out on a blue counter, all cut in half, looking very phallic.

Photo, Erik Putz. Food styling, Lindsay Guscott.

Indeed, while watching O.school videos like “Buttstravaganza,” I felt gratitude that the fledgling Flicks of today could take ownership and power over their own bodies. For me, it was a lot of teenage, pre-Internet fumbling toward ecstasy (the first time I came on my own fingers, my horror was Carrie-bleeding-in-the-shower level intense). I didn’t really learn about my own body and sexuality until I started meeting cool, queer, sex-positive pals in university for whom sexuality was more than just f-cking—it was political, radical, about bodily autonomy. It’s no coincidence that that’s what O.school’s instructors come across as: Trusted friends, who know not just their own bodies but many other people’s bodies as well. They embrace the empowerment that comes from sharing knowledge within and outside of their communities.

Most importantly, it’s funny and fun, like a great conversation with a very smart friend. I often fancy myself that smart friend. But I needed to be sure. Hence, “10 Tips for Hotter Handjobs,” my gateway video.

I watched as Matatas lifted the dildo up and coated it in silicone-based lube (best for prolonged contact, as it isn’t absorbed as quickly as water-based). She gripped the shaft with her left hand and, with a smile, held the fingers of her right hand on the tip of the dildo and drew them downward. Her fingers looked like the legs of a jellyfish stretching down to push off—if a jellyfish was hanging out on a giant sea penis. In other words, this technique looked ridiculous. But, she said, the jellyfish was an amazing sensation for the ultra-sensitive penis head.

My Flickian brain couldn’t deal. “That move?” I balked. I was dubious. So, like any good student, I field-tested it.

“I am doing this for research,” I told my lab partner, who I will call V. “Of course,” he said. I gripped his lubed-up shaft with my left hand and drew my right fingers downward, looking V in the eyes (another top-10 tip, by the way). His eyes rolled back slightly, and he made a sound that told me I was on to something.

Finding: The jellyfish move is legit. I stopped to record said finding in my notebook. (JK, I saw the experiment through to its conclusion. I’m dedicated.)

“I think silliness is sexy,” says Matatas, who has more than a decade of pleasure-ed experience, in Canada and elsewhere. She started as a public health educator, branching out into pleasure ed when she saw that none of the sexual health education she was giving addressed it, even though everyone she met and talked to was seeking it. She came up with the jellyfish on the fly while being playful with a partner. “We should practise curiosity, communication and creativity” when it comes to sex, Matatas asserts. Aside from being a pathway to discovery, employing these qualities is also how we get over performance anxiety.

In contrast with the seriousness of traditional sex ed, pleasure ed acknowledges that sex can exist beyond reproduction for the pursuit of fun and connection with yourself and others. Its teachers reflect that: They’re happy, self-actualized people who have chosen their profession because they love feeling good. They know, and teach, that playfulness, being present and allowing for mistakes makes sex better. “It adds to the vulnerability,” Matatas says.

And while learning from seasoned pros like Matatas can feel intimidating, that’s where the one-on-one factor of the Internet comes in. “It provides safety and the ability to suss something out in private, away from our sex-negative culture,” she says. Milhausen echoes that sentiment, although she also recommends books. (“Middle-aged people grew up getting information from books,” she says, “so it’s often more comfortable than trying to wade through the Internet.”) And learning tricks from sexually fluent, diverse humans—according to Barrica, half of O.school’s instructors are people of colour, more than 70 percent are queer and more than 15 percent are trans or non-gender-conforming—doesn’t mean you have to be one yourself, or even a non-monogamous Tracy F-ck.

If you’re intimidated by the cool/queer aspect, consider this: Would you trust a carpenter who only owns Ikea furniture, or an agoraphobic travel agent? Likely not. So why would you want pleasure education from someone with a less dynamic prism of sexual understanding and ability? “Women may feel more comfortable learning from somebody who looks like themselves,” says Milhausen, “but I want all of us to step outside that and learn about our sexuality from people who have amazing knowledge and experience.”

And while the demographic that flocks to O.school tends to be younger (20s to early 30s), some of the most engaged and vocal users are, anecdotally, women in their 30s to 50s. That’s no surprise to Milhausen. “Mid-life is a time when we start to reflect on all different parts of our life,” she says. “How do we feel about the job we’re in, how do we feel about the relationship we’re in, how do we feel about our bodies and our health? It’s a common time to look inward and think about your sexuality.” Matatas also sees a lot of thirty- to fifty-something women in her in-person classes, in part because they’re in a “few f-cks left to give” phase of their lives, as she puts it. Along this line, Barrica tells me that one of O.school’s users, a woman in her 70s, had her best orgasm ever after watching one of their videos.

After watching several O.school videos myself, I realize the site’s most important lessons are more philosophical than technical. What choice most empowers you sexually? What makes you happiest? How do you have that conversation with yourself? For this Tracy Flick, these were the true aha moments (aside from the jellyfish thing). Good sex is not about skill, but about discovery; not what you know, but how much you can play, experiment and enjoy yourself while seeking knowledge. Watching O.school’s videos will teach you new techniques, but like any good class, they will do something better than that: They’ll teach you how to think differently. To see yourself not just as a body but also as a brain and heart, in pleasure-seeking terms.

And furthermore, they’ll remind you that the best students are the ones who never stop learning. I am no longer a 16-year-old control freak furtively masturbating to David Duchovny’s smirk in the dark, and the sexual self I am now will continue to evolve.

Cut to: The slut formerly known as the Tracy Flick of Sex. She watches “F-ck Lube Shame: Why You Need It.” She takes notes on water- vs. silicone-based, liquid vs. gel vs. cream. She nods vigorously when instructor Jess Melendez—a frank and friendly sex-toy expert with a winning smile and an admirable eyebrow game—asserts that lube shame stems from patriarchal notions of what our bodies are supposed to do when sexually excited. “I’m here to tell you that there is nothing wrong with your body. If you wanna use lubricant, that is super rad, okay?”

Then our Former Flick learns, for the first time, that “buttholes are super thirsty,” and so a liquid lube is not best for anal. She nods studiously. She goes to her local sex shop and buys new gel lube, for she has more experimenting to do, more learning.

And when learning involves dildos, then school ain’t bad at all.

This piece was originally published in 2019; updated in 2021.

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Health

Will This Flu Season Be Worse Than Usual?

In 2020-21, Canada saw just 69 confirmed cases of influenza. Some experts worry we may have lower immunity to the flu, after nearly two years of social distancing.

A pedestrian walks by a sign in a store window encouraging people to receive a seasonal flu shot in Toronto on Tuesday, October 19, 2021. (Photo: The Canadian Press / Evan Buhler)

A pedestrian walks by a sign in a store window encouraging people to receive a seasonal flu shot in Toronto on Tuesday, October 19, 2021. (Photo: The Canadian Press / Evan Buhler)

The email from FluWatchers arrives in my inbox every Tuesday morning, asking me to click through to a Health Canada website to answer two questions: have I had 1) a fever or 2) a cough in the past week? The entire process takes five seconds. I’m one of tens of thousands of volunteers from across the country who answer that brief weekly survey (depending on answers, there may be a few more queries), a low-tech but key part of the national flu surveillance system.

For those who shrug off influenza as nothing more than a bad cold, consider this data from Statistics Canada: Between 2015 and 2019, on average, “influenza and pneumonia” was the sixth-leading cause of death in the country, killing an estimated 7,333 Canadians annually. Like COVID, it hits the most vulnerable hardest, yet it is also capricious, striking the young and healthy as well.

Every flu season starts with uncertainty. As the vaccine is reformulated annually, depending on flu strains that are expected to dominate, it can take months of real-world data before experts can determine its effectiveness. In 2019-20, the last year for which there is large amounts of data, the flu shot offered “moderate protection for influenza A(H1N1), at 43 per cent, and good protection against influenza A(H3N2) and influenza B, at 50 per cent and 65 per cent, respectively,” Health Canada reported.

The 2019-20 season ended “abruptly,” eight weeks earlier than normal, in late March 2020, Health Canada reported. The cause was the closing of schools and businesses as well as people staying home at the start of the pandemic. “All of our measures against COVID squashed influenza,” says Dr. Jeff Kwong, a professor of family medicine and public health at the University of Toronto

The 2020-21 season was even more unusual because of “very low influenza circulation,” Health Canada reported. By the very tail end of the flu year, only 69 cases of influenza had been confirmed in laboratories, a precipitous decline from “the past six seasons where an average of 52,169 influenza detections were reported.”

There are concerns that the coming cold and flu season may be more “normal.” Vaccines mean people are mingling in ways that were unthinkable a year ago. Schools are back in session, and in many provinces, indoor dining is returning to full capacity. And that means people have a lot more opportunities to pass viruses to each other, including the flu.

“As COVID-19 containment measures are relaxed around the world, cases of other respiratory viruses whose activity was suppressed under COVID-19 measures in 2020-21 have started to make a resurgence,” noted authors of a pre-print study that modelled what the flu season could be like in the United States for the Centers for Disease Control and Prevention (CDC). They point to Western Australia, which found cases of the respiratory syncytial virus (RSV) among children to be much higher than previous seasonal peaks after the nation relaxed its social distancing measures. And the number of RSV cases began rising in the United States this summer, well ahead of the usual time, according to the study. As well, Hong Kong has reported seven times the number of large school outbreaks of acute upper respiratory tract infections this year.

In Canada, doctors are already seeing more patients with colds and respiratory viruses. The return of common rhinoviruses and RSV worries Kwong. “If they are spreading, then why not influenza?” he says. In particular, he notes the number of cases of RSV in Quebec and, more recently, in Ottawa. The virus, which mostly affects children, is second to influenza in causing severe illness, he says.

In the United States, there is rising concern that nearly two years of pandemic precautions mean that our immune systems haven’t been updated with new viruses and are operating with increasingly out-of-date information, much like smartphones before operating system upgrades. In a usual flu season, there are around 500,000 hospitalizations in the United States, according to the preprint study for the CDC. Its modelling suggests there could be 100,000 “additional hospitalizations in 2021-22” in “a large compensatory influenza season in 2021-22 due to a light season in 2020-21.

“I’m not so convinced about that,” Kwong says, regarding the study’s modelling. For one, he notes that immunity can last for a long time. For example, he says, when the H1N1 pandemic hit in 2009, older Canadians were less affected than expected, likely because they had been exposed to a similar version of the flu years before. “If you can have some immunity from decades ago, then having no influenza for a few years may not make that much of a difference,” he says.

“Control the things that you can control,” is Kwong’s simple advice. “We’ve learned so much from COVID,” he says, that we just need to “use some of those tools to prevent influenza,” including getting a flu shot, and other basic public health measures that have become standard during this pandemic: washing hands, wearing masks and minimizing social contacts. Improving ventilation, including through HEPA filters like those being used in schools, will also help.

Canada is also getting ready. On Oct. 7, the National Advisory Committee on Immunization (NACI) advised that all seasonal influenza vaccines “may be given at the same time as, or at any time before or after administration of other vaccines, including COVID-19 vaccines.” Already, provinces and their local health units are ramping up flu vaccine drives for the most vulnerable, such as seniors and those in congregate settings like long-term care homes. In Ontario, flu shots for the general population under 65 will be available as of Nov. 1.

As in previous years, the flu season may turn out not to be as bad as expected. Current surveillance updates in Australia, which has an earlier seasonal influenza season, report that “influenza-like-illness activity in the community remains at historically low levels in 2021,” though that may be partly due to recent strict lockdowns in the country.

Though no one is sure how Canada will fare this winter, they all agree on one thing: After nearly two years of COVID-19, with a health care system stretched to the limit, making sure as many people as possible get flu shots is more important than ever.

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Health

How Race Is A Risk Factor When Getting Treated For Fibroids

Most women will suffer from fibroids in their lifetimes—but for Black women, who are often neglected in health care settings, the threat is greater and more insidious.

Illustration of a person standing with their hands on their stomach. Their stomach is wrapped in vines and there are two wilted roses in front of it.

(Illustration: Chelsea Charles)

On an early march morning in 2010, I awoke to a pain that felt like a metal fist crushing my abdomen in its grasp. This sensation would repeat in an endless loop for three weeks. I was 32, four months pregnant and afraid.

I didn’t know it then, but growing alongside my son were unwelcome guests: multiple uterine fibroids, benign tumours attached to the lining of my uterus. They’d ballooned during the early weeks of my pregnancy—one as big as a grapefruit—and were now “dying.” At the time, I didn’t even know what fibroids were.

After my emergency hospital visit, I tried to but couldn’t secure an extra appointment with my gynecologist, since the receptionist took it upon herself to decide I didn’t need one. I later learned that my first ultrasound had revealed the fibroids, but I hadn’t been told. Despite my concerns, my doctor dismissed the tumours, a fact that disappointed me first and angered me later. My healthy son arrived on time, albeit by emergency Caesarean section. I didn’t receive follow-up treatment for the fibroids, and I wouldn’t for years.

Though it seems unbelievable, my story may be familiar—especially if, like me, you’re a Black woman.

Most fibroids grow in the uterine wall, though they can also grow outside it or in the uterus itself. Up to 40 percent of women older than 40 have them, and prevalence increases with age until menopause. Around 20 to 50 percent of fibroids are symptomatic, boasting a group of symptoms that include heavy periods, anemia, pelvic pressure and chronic pain, as well as fertility and pregnancy challenges. Fibroids can enlarge or misshape the uterus and aggravate the bowel or nearby organs like the bladder. Degeneration, which I’d endured, often happens during pregnancy, as the blood feeding the fibroid diverts to the baby.

For Black women, fibroids are a numbers game—we’re two to three times more likely than white women to have them; we’re also more likely to have related symptoms. Almost 25 percent of Black women between 18 and 30 have fibroids, compared to about six percent of white women the same age, according to some U.S. estimates. By age 35, 60 percent of Black women have fibroids. Our tumours are also two to three times more likely to be large and abundant, develop at a younger age and require hospitalization.

The data is clear: Race is a risk factor.

No one knows what causes fibroids or how to prevent them, so it’s like carrying around an explosive device with an invisible countdown to detonation.

If nine people report one experience but a 10th reports the opposite, that result is probably an outlier, right? But if you’re that one in 10 experiencing daily pain and discomfort, you want a doctor who doesn’t make assumptions. Otherwise, the help a patient needs can be trapped on the other side of an individual doctor’s opinion.

Dr. Jamie Kroft agrees. An ob-gyn and surgeon at Sunnybrook Health Sciences Centre in Toronto who treats fibroid and endometriosis patients, she notes that once doctors mischaracterize fibroids as harmless, they’re more likely to be dismissive when women ask for help.

“Seventy-five percent of women report painful periods, so unless your doctor screens for other symptoms or commonalities, dismissal is possible,” says Kroft. “Add how little women know about what’s ‘normal’ for periods and you have a problem affecting their quality of life left untreated for years.”

Jonsaba Jabbi, 31, a communications specialist and writer in Toronto, was surprised to learn in 2018 that she had a fibroid, following an ultrasound for abdominal pain she’d thought was a flared appendix. “The doctor told me I had a medium-sized fibroid on my uterus, and I was alarmed,” she says. “I think of myself as a healthy person, and suddenly, I wasn’t.”

Jabbi grew up hearing about fibroids from her mom, who had several removed in the 1980s. Jabbi tried to follow up with her doctor in September 2020 after noticing changes in her periods. The doctor, explaining that she had no serious symptoms, told her to wait until the pandemic subsided to schedule an ultrasound. They did notice hormonal changes, but told Jabbi those changes could be attributed to weight gain. “It’s just really frustrating because I feel like I’m waiting for something to happen instead of being proactive about my health.”

For many, the symptoms of fibroids can be demoralizing. But when you’re a Black woman, advocating for yourself in the health care system is necessary, especially when experiences of neglect and disbelief have long been documented. Imagine living with chronic back pain, digestive challenges or the onerous fatigue of chronic anemia, or missing out on social or career opportunities because your heavy periods demand it, and being made to wait until your circumstances are urgent and dire. Meanwhile, your quality of life crumbles.

The surprise was more violent for Sabrina Young Blair, a 44-year-old licensed social worker and psychotherapist from Ajax, Ont. “I was six months pregnant when I felt a sudden, unrelenting abdominal pain,” she says, speaking of her first pregnancy in 2012. “I called my midwife, scared. She said, ‘It’s your new normal. Sounds like round ligament pain,’ which sounded like ‘Suck it up, buttercup.’ ” Young Blair already knew she had fibroids, but they’d been downplayed by her family doctor. “The doctor didn’t seem to care, so neither did I.” Her midwife never followed up on her abdominal pain.

Instead, Young Blair went to the emergency room, where they diagnosed her degenerating fibroids. The attending ob-gyn took her on as a patient on the spot, putting her on bed rest until her full-term delivery. She has never received treatment for her fibroids. According to Kroft, it’s common for the pain to go away after pregnancy, which is what happened for Young Blair—though flare-ups persist to this day.

Few options exist to treat uterine fibroids, and for the most part, a hysterectomy is the only permanent solution—approximately 30 percent of hysterectomies in Canada are done to treat fibroids. Procedures like uterine artery embolization, which cuts off the fibroid’s blood supply, or laparoscopic myomectomy, which removes only the fibroids, preserve fertility and delay more invasive methods. But with these options, there’s a 40 percent chance the fibroids will return within five to 10 years.

Access to these procedures varies across Canada, as do the comfort and knowledge levels of doctors. Both factors influence whether you receive timely and appropriate treatment. Add in racial bias, and the outlook is more dismal. Research data proves that racial bias in pain perception influences treatment recommendations. Even some experienced medical professionals perceive Black women’s pain as less serious than that of white patients because of pervasive false beliefs about biological differences.

All the women I interviewed for this piece are Black, but there are substantial gaps in the race-based health data collected in Canada.

A report on inequities in health for Black Canadians, released in September 2020 by the Canadian government, states plainly that health inequities are more than just a difference in numbers—they result in unjust differences in care. Still, the lack of sufficient data means we have an inaccurate picture of the health realities and experiences of Black Canadians.

In their study “Dying to Learn: A Scoping Review of Breast and Cervical Cancer Studies Focusing on Black Canadian Women,” researchers including the University of Toronto’s Aisha Lofters, Onye Nnorom and Nakia Lee-Foon found a dearth of health research on breast and cervical cancer in Black Canadian women, with women from sub-Saharan Africa appearing to have lower cervical and breast cancer screening rates, likely putting their health in greater jeopardy. Lee-Foon noted that insufficient data means the inability to prove claims of race-based discrepancies regarding treatment and care.

After enduring the long list of physical, emotional and societal effects of fibroids, apathy from those qualified to help adds insult to injury.

A hysterectomy was one of the only treatments offered to Nadine Djimbi Ayaba, 37, a mutual investment company vice-president based in Montreal. Diagnosed with lupus in 2006, she had a checkup in 2016 that sparked her fibroid journey.

“My session was quick,” she says. “The doctor told me I had fibroids, but I spent more time talking to the resident. They didn’t take the time to explain or answer questions. I left feeling dismissed and lost.” Three years later, she was back for answers, and an ultrasound revealed five fibroids. This time, hysterectomy seemed to be the only treatment offered, even after she asked her doctor for other options.

“I was just asking questions,” Djimbi Ayaba says. “I told her I hadn’t decided whether I wanted children and wanted to keep the option open. She jumped to a choice that’s mine to make.”

My mom, Yvonne, a 69-year-old retired registered nurse living in Unionville, Ont., had heavy periods that caused years of pain, chronic anemia and migraines.

She wasn’t diagnosed with fibroids until 1975, after immigrating to Canada. Her suffering continued until a fateful referral to a new ob-gyn for my siblings’ births. “Meeting that doctor changed everything,” my mom says. “He took my suffering seriously, saying, ‘Let’s talk when you’re finished having children.’”

They did. At 33, my mom had a partial hysterectomy—no more fibroids or symptoms. My mom doesn’t understand why, a generation later, her daughters’ experiences match hers. My sister has fibroids, too. This past May, the largest of her five fibroids wrapped itself around one ovary, causing acute abdominal pain. She ended up in the ER and had the offending fibroid removed via an emergency myomectomy within two days.

Despite the often dark outlook, there is light on the horizon, teasing brighter days for fibroid sufferers. Kroft is hopeful about trends in research, care and treatment. “I’m excited by the focus on early and less invasive treatments, more patient-centred research and exploration into possible genetic factors.” She adds, “This all leads to improving the quality of life for sufferers, faster.”

I think the most exciting changes have little to do with data.

“I’ve noticed a cultural shift in medical training with more engagement and sensitivity toward ethnic groups,” says Kroft. “Incoming residents are more cognizant of race and gender bias and misinformation. It’s very encouraging for the future of care.”

Things are moving in the right direction, but it’s hard to keep faith when the progress is slow and finding answers remains a non-priority.

Until I can say with confidence that you won’t have an experience like mine or those of countless other sufferers, that you’ll get the treatment you deserve at the time you need it, we continue to wait while the silent timer ticks.

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Health

Why I Got Laser Eye Surgery

Clear vision very quickly became the status quo for me, but there are still moments that take my breath away.

(Photo provided)

Name: Gina Badger
Procedure: Custom LASIK
Year: 2017
Location: Vancouver, B.C.
Cost: $1,890 per eye

I was pretty strongly near-sighted for most of my life. If I wasn’t wearing a corrective lens I could see clearly for about eight inches, and beyond that, the world would be blurry. I hear some people are comforted by that, but it’s not something I ever liked—I didn’t wake up and make coffee with a soft glow around me. I always wore contact lenses because I didn’t like having a frame around my vision. Opening my eyes and being able to see clearly was something I definitely desired.

Conceptually, though, it’s super freaky to think about getting your eyeball sliced open. I’d also been told that I’d need a more advanced tier of laser eye surgery because I have large pupils, a strong prescription and astigmatism. But in 2017, I started feeling like it was now or never. I was turning 34 that year and I thought that if I wanted a corrective-lens-free life, I had to get on it, because the era of reading glasses can begin in your 40s.

As freaky as laser eye surgery seemed, it was in practice not that bad. The lights were dim and there was music playing—hip hop, but laid back. There’s this spring-loaded device to hold your eyelids open, which is not uncomfortable, though I’m sure it looked horrifying. They put some numbing drops on your eyes, everything feels cool and slippery, and then they create a thin flap on your cornea and fold it over. That’s how they’re able to make the correction.

While that’s happening, you’re looking up at green and red lights, there’s quiet little beeping and then—this is the part they warn you about, because it freaks people out the most—they pressurize your eye and your vision goes black. But they walk you through it, and it’s only for a brief period. The worst of the recovery was over quickly: I felt like I had sand in my eyes, but I had a big, long, awesome nap, and then I felt better. Over the next week, my vision climbed to where it’s supposed to settle.

In my case, I experienced a rare form of regression in my right eye [about six months after the surgery], which is my dominant eye. I was told that, technically, I had 20/20 vision and the procedure was considered a success. I could see clearly enough to drive, I could recognize people on the street, but there was still this subtle buzz or halo around my vision. I tried wearing one contact and it was terrible—it made me sad that the surgery hadn’t worked.

I decided to have a second surgery, and in some ways it was harder than the first time. Here I was, with a technically successful procedure that I wasn’t happy with, so I was going back to tinker and take on more risk. The thin flap in my cornea hadn’t totally healed, so it was a bit of an easier procedure, because they could just open up the same flap. Within a couple of days I could tell I got the result I wanted, which was a relief.

I assumed before the procedure that I would notice my clear vision in the morning and get emotional, but I have to say that I take it for granted. It very quickly became the status quo for me. That’s the really cool thing about our bodies: We can get used even to fundamental changes that affect every single thing we do. The times I notice my vision most are when I’m hiking, when I’m up at a height with a vista and I can see the outlines of trees or the texture of rocks with such clarity. Those are the moments that take my breath away.

I do think, sometimes, it can be hard to have a sense of the fact that I will need this body for my whole life. We don’t know what the long-term results of this procedure are, and I don’t know whether I’ll feel it was worth it to have clear vision for a decade if it means that vision might deteriorate dramatically in my old age. But I make decisions in my life based on what I want and need for myself, not what I’m afraid of. If I made decisions based on what I was afraid of, there’s so much I wouldn’t do.

Published October 2020; updated October 2021.

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Health

How To Navigate Breast Cancer Screening Guidelines

Mammograms can spot cancer two to three years before physical symptoms develop, but screening guidelines vary between provinces. Here's what you need to know.

(Paper art by Ali Harrison of Light + Paper)

In 2018, 47-year-old Adriana Ermter found a lump in her armpit. Her doctor referred her for a mammogram, but the clinic said it was likely just a calcification in her breast tissue. After months of requests for additional screening, the Toronto resident received a second mammogram, an ultrasound, an MRI and a biopsy. The biopsy confirmed the lump was cancer. “If I hadn’t advocated for myself, under the guidelines I wouldn’t have had regular mammograms until I was 50,” Ermter says. “Who knows what stage of breast cancer I would have progressed to?”

Although Ermter caught her cancer early enough, her story is familiar to Jennie Dale, executive director of Dense Breasts Canada, a non-profit that advocates for breast density awareness and better screening. She’s spoken with countless women who were diagnosed with later-stage cancer because they weren’t screened earlier.

Mammograms can spot cancer two to three years before physical symptoms develop, but the guidelines for referrals vary between provinces—which is why Dense Breasts Canada just launched mybreastscreening.ca, a website that helps navigate those guidelines. Women who are 40 or older in British Columbia, P.E.I., Nova Scotia and the Yukon, for example, can refer themselves for a mammogram. But, in provinces that require physician referrals, patients might not know how to self-advocate if their doctor doesn’t recognize a need for screening. And only six provinces inform all women of their breast density—a crucial piece of info, as women with dense breasts are at higher risk of breast cancer and have extra tissue that can make it harder to spot cancer on a mammogram. Finding cancer early, says Dale, shouldn’t depend on your postal code.

The Canadian Task Force on Preventive Health Care recommends that women start regular mammograms at 50, a guideline that’s been called outdated and dangerous. Many experts, like Dr. Anat Kornecki, head of the breast imaging division at Western University, say women should have annual mammograms in their 40s because that’s when the chances of finding breast cancer increase. The task force also doesn’t advise women with dense breasts to get additional screening, nor does it recommend doing self-exams—practices that 130 Canadian breast cancer experts recommended in a 2019 letter criticizing the guidelines. The task force’s recommendations also don’t address racial disparities: Black women, for example, are more likely to develop aggressive forms of breast cancer than white women, and at younger ages. The new site suggests raising these disparities with your doctor if you’re refused a referral.

With some MDs following guidelines that don’t reflect widely established expert advice, women are finding cancer later—which can be deadly. Ermter, who has been cancer-free for three years, is an advocate of early testing. Kornecki agrees: “I cannot tell you how frustrating it is to see cancer diagnosed at advanced stages, usually as a result of no screening.”

Four things you might not know about screening

1. Family history isn’t everything.

Women with a family history are at higher risk of developing breast cancer, but 75 percent of patients have no family history of the disease.

2. Age increases risk. 

Yes, women in their 20s and 30s get breast cancer, but risk increases with age—which is why women in their 40s should have annual mammograms.

3. There isn’t always a lump. 

In the early stages of breast cancer, you may experience other symptoms—such as changes to the size and shape of your breast—or none at all.

4. Patients have the final say.

If you’re in your 40s, your doctor can’t deny you a mammogram referral. You can also ask to know your breast density if this information isn’t disclosed to you.

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Living

What It’s Like Living With An Invisible Illness

Yes, I DO deserve that accessible parking spot.

An image of accessible parking spots for a piece on what it's like to live with an invisible illness

(Photo: iStock)

I had just pulled into the accessible parking spot at the supermarket. You know: the one that’s right by the front door, so that those who have difficulty walking don’t have to venture too far afield. Out of the corner of my eye, I saw her.

Like me, she was middle-aged and visibly tired. Unlike me, she had parked further afield from the main door of the store. She eyed me suspiciously and I detected a flicker of anger in her gaze.

“She doesn’t look like she needs that spot,” she was probably thinking. I know the look; I’ve seen it many times before.

I’m sure she would have liked to have parked closer to the entrance, as I did. I’m also sure that she wouldn’t want the ailments that have, unfortunately, afforded me the “privilege” of an accessible parking permit.

I have lupus, an autoimmune disease. At its core, it means that my body’s immune system attacks its own tissues and organs. It’s an illness marked by inflammation, which can cause a multitude of ailments ranging from joint pain and swelling to chest pain, shortness of breath and skin lesions, to name a few. Photosensitivity, fever and chronic fatigue are also common. Kidney failure is another unfortunate side effect for some who suffer from this disease.

According to Statistics Canada, 1 in 2,000 Canadians suffer from lupus and two million citizens battle with various, also often invisible autoimmune diseases.

Lupus is chronic and unyielding. There is no cure, but there are medications that can treat its symptoms. They can mitigate the disease, but they’re not perfect. As someone who, since diagnosed, will be on medication for the rest of my life, I can speak to this firsthand. While the regimen of prescribed drugs I take daily help, they don’t eliminate all symptoms. For the most part, they mitigate and lessen them to some degree, but pain is always present.

I work, I play, I live. All of which is done in relative normalcy and relative pain, depending on the day of the week. You see, this illness that I have is unpredictable. It hides away or recedes enough that I can function on some days. On others, I’m rendered immobile, bed or couch prone, often for days at a time. There’s no relief and no reprieve from the aches and pains that emanate from deep in my bones. And the ancillary ailments that come with these events—well, they’re not fun. Simple tasks that many take for granted become seemingly insurmountable when in the throes of a lupus flare. Mere walking exacerbates the joint, back and leg pains, and “lupus fog” depletes any semblance of social acuity.

Depression, skin rashes and lesions, general malaise…I could go on. Suffice it to say that the full package is not for the faint of heart.

The nature of lupus and similar autoimmune diseases is its unpredictability. “Flares,” as they’re called, will come out of nowhere, with no rhyme, reason or warning. One day, I’ll be fine (relatively speaking). The next? It’s bad. Yet, on the surface, to those who aren’t aware of its existence, I always look fine. And therein lies the problem.

“But you don’t look sick,” I’ve heard more times that I’d like to admit. No—I don’t look sick. But I am. Feeling sick and functioning on a daily basis can coexist. And that’s what I and others like me who live with invisible illnesses would like people to understand.

“Invisible illness” can be defined as any medical condition that is not immediately visible to others. The term is often used as an umbrella phrase to address chronic illnesses such as diabetes, arthritis and epilepsy.

One of the more commonly recognized signs of lupus is the butterfly-shaped rash that is often found on the faces of those afflicted. Spanning the nose and both cheeks in some cases, it is this indicator that resulted in the name that we commonly use for this illness. “Lupus” is Latin for wolf, and in the thirteenth century, the name was attributed to the illness that was marked by a rash that looked like the bite of a wolf. The name stuck. Those of us—including me—who don’t display this obvious sign of the disease are often questioned about whether we’re “really” sick because all ailments are certainly visible, aren’t they?

To this end, invisible illnesses perplex some and anger others. I’ve found that people, upon learning of my illness, have a range of reactions, including shock and confusion. I do not fit with their ingrained perceptions of those who are “sick,” therefore they question my diagnosis—or the nature of the disease’s effects. Some may question whether I really “deserve” to use an accessible parking spot. Others insist that I “look fine

I’m not. But I seem that way on the outside. Looks can be deceptive.

As a result, I often feel like I always have to explain myself and my actions, in one way or another. Whether it’s cancelling plans last-minute due to a sudden flare, or sending regrets in advance in response to an invitation for an event that I know is well-beyond my stamina level. Extended walking, standing or staying out late can have detrimental physical effects for lupus sufferers, so social activities are limited. For those who are fortunate enough to have escaped this (and other types of) invisible illness, be thankful that you’ve avoided both the physical and psychological effects of the afflicted.

Guilt, shame, anger and resignation are on the daily list of emotions that are experienced by me and people like me who “look fine.” Even well-meaning friends often miss the mark, forgetting what is realistically within my range of activity.

“But you don’t look sick,” they continue to say.

But we are.

We’ve just become used to keeping a stiff upper lip, smiling through the pain and getting on with it. On the days when none of these options are possible, you’ll find us in our beds, on our couches and in our homes, nursing our aches and pains and wishing the current flare away. Sometimes we’re crying. Often we’re angry. Always, we’re resigned to this reality in which we exist, its lack of rhyme and reason and its brutality of force.

“But you don’t look sick.”

I don’t—but I am. And so are so many of the multitudes of people passing you on the street daily, all looking healthy and well. They may be none of the above, but the veneer of healthiness is just that—for some of us, the reality of inflammation and worse continually festers beneath the surface. Invisibility doesn’t mean invulnerability.

The woman in the parking lot continued to scrutinize me as I walked towards the grocery store’s main door. As she studied my gait and calculated the possibility of my misuse of the accessible parking spot, I continued on to my destination. I’d like to say that I stood up straight and unashamed, head held high in the knowledge that I had done nothing wrong. No dice, however. My aching joints wouldn’t allow it.

This piece was originally published in 2020; updated in 2021. 

Health

Everything You Need To Know About Burnout

By this point in the pandemic, burnout may be a given. Here’s how to spot the symptoms—and what you can do to deal with them.

A person with their head laid on her laptop burntout from work.

(Photo: iStock/biscotto87)

When the pandemic hit, our lives changed drastically as we adjusted to new ways of working, coped with fewer support systems and were bombarded by stress and worry. It’s only natural that, at some point, we all started to feel exhausted. While the cost of adapting to added responsibilities looked different for everyone, some people may have experienced burnout without even realizing it. Two psychologists weigh in on how to spot the symptoms of burnout and what you can do to help prevent it.

What is burnout?

Burnout is the result of prolonged stress that comes from taking on more roles and responsibilities—at work and in your personal life—than you can handle. It can leave you feeling like you unexpectedly have no more gas left in your tank, says Toronto-based psychologist Nicole McCance. Getting through the day will feel more tiring than usual and completing simple tasks might require more energy and motivation.

It’s worth noting that burnout isn’t a medical diagnosis with a clear set of symptoms to look for. But McCance says that in most people, burnout typically shows up as exhaustion or feeling depleted even after a good night’s rest. “I’ve had clients tell me that when they wake up for work, they’re already fantasizing about the end of the day,” she says.

Why does it happen?

The World Health Organization describes burnout as the result of chronic stress in the workplace. If unaddressed, it can lead to symptoms like exhaustion, negative feelings towards your job and reduced performance at work.

Burnout has a quantitative aspect to it, says Toronto psychologist Eliana Cohen, that can come from taking on too much work. But there’s also a qualitative aspect that has to do with how you feel about your job: Some people find themselves motivated and excited by complex, consuming projects. “If you have a sense of mastery and you feel you’re doing great at your job, you’re not going to burn out,” Cohen says. “People start to burn out when they hit walls.” If you don’t find your job meaningful and that sense of fulfillment isn’t provided by other areas in your life, McCance says that work can become taxing and can contribute to burnout.

Although the WHO frames burnout only as a workplace phenomenon, psychologists say it can extend to your personal life as well. Having a number of roles—parent, child, friend, caregiver, etc.—and trying to juggle each of their responsibilities can take a toll mentally and emotionally. If work is one reason you’re feeling overwhelmed, for example, but you’re also worried about finances, your kids and taking care of elderly parents, that combined stress can be enough over time to cause burnout.

How do I know I’m burned out?

If you wake up exhausted in the morning, have brain fog, feel irritable or find it hard to concentrate during the day, you could have burnout. You might also find it hard to motivate yourself to do activities you usually enjoy, like meeting friends or going for walks. One of the easiest ways to spot burnout, says McCance, is that you don’t feel like yourself—while you might have once looked forward to the start of your day, it may now require extra effort to get things done.

That’s not the same as regular fatigue, which you can treat with sleep and rest. With burnout, fatigue and exhaustion don’t go away. “Sometimes clients will tell me that they feel tense, or their body feels really heavy,” said McCance. “Burnout is a different level of exhaustion that you can’t shake off.”

Cohen adds that burnout shares some of the same symptoms as depression, such as listlessness, fatigue, irritability and difficulty staying motivated. A psychologist will be able to spot the difference between the two, but depression tends to come with prolonged feelings of sadness that burnout doesn’t.

How has the pandemic impacted burnout?

The pandemic in some ways set the stage for burnout: It came with added responsibilities at home and worries about not getting sick, while removing our regular outlets to de-stress, like meeting friends for dinner or going to the gym. For some people, says Cohen, that resulted in “horrible levels of stress.” And for others, there’s a listlessness that settled in—sometimes described as pandemic fatigue—because many of us were isolated at home and had little stimulation.

“That kind of chaos mixed in with inertia and the stress and uncertainty of the unknown is a lot to take in for a nervous system,” Cohen says. And so pandemic fatigue has made us more vulnerable to burnout because we’re already dealing with fear and anxiety. Any cognitive task on top of that, she says, can exhaust us more easily.

What can I do to prevent and deal with burnout?

Eating healthy, getting a good night’s sleep and exercising are the most effective strategies when it comes to combatting burnout, says McCance. But if you don’t have the time to make drastic changes to your schedule, she suggests building positive habits that prioritize self-care. Sitting down for breakfast in the morning while listening to your favourite music or ending your night with warm tea are some simple ways to de-stress. “You might not have time to do yoga or meditate, but small changes can fit into almost anyone’s schedule,” she says. Cohen adds that reminding yourself of why you enjoy the things that you do can also help. Burnout can be both the cause and the result of you losing passion for the things that interest you—so a workshop or class can reignite your curiosity.

It’s also equally important to set boundaries where you can and turn down tasks you’re not able to complete without compromising your mental or physical health. “There’s a bit of momentum that can happen with burnout, where if you don’t catch it early, it can get worse,” says McCance. If you do start to notice symptoms of burnout, addressing it early, with the help of a therapist or practicing self-care on your own, is key.

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Lady bits

Do Period Undies Really Work? We Tried It

We went padless in three popular options.

Image of dusty pink Thix period undies against a pink backdrop

Thinx

These nylon-elastane hip-huggers from NYC-based Thinx look like a sporty take on granny panties, with a gusset that’s reportedly able to soak up to two tampons’ worth of blood. I wore them sans plug on my heaviest day, and they were comfy-ish and leak-free, though by mid-afternoon I noticed an of-putting metallic scent, so I reached for a tampon. I’d wear them again, but on a light day or as backup protection.
$44, shethinx.com.

Image of Knix period panties against a pink backdrop

Knix

Toronto-based Knix’s bikini panty with a leak-proof liner is designed to act as backup to your go-to mode of protection or for going solo on light-flow days. I tried a pair minus other trusty hygiene allies and found it readily absorbed and concealed my end-of-cycle dribs and drabs. One caveat: The crotch was a bit stiff to begin with—and after a few hours took on a slightly starchy texture.
$34, knix.ca.

Image of someone holding up Lunapads period underwear against a pink backdrop

Aisle

This Vancouver company Aisle, formerly Lunapads, makes cotton-spandex undies with a pocket built into the crotch, where you insert a washable cotton pad. I wore them on day three, which is traditionally a bloodbath, and the removable liners held up well for about eight hours. The only drawback? The silhouette in my leggings: camel toe in front; soggy hot-dog bun in back. They’re good for nighttime but not discreet enough for day. $44, lunapads.ca.

How do you wash period underwear?

Each pair can be treated like regular underwear when used. Pop them in the washing machine and then the dryer.

Yes, artisanal and alternative period products exist… but that doesn’t mean you should use them

Tempted to buy some cute knit tampons or a sea sponge to staunch your flow? Don’t: These products could put you at an increased risk for all kinds of infections, one of which is toxic shock syndrome, says Susan Thorne, the department chief of obstetrics and gynecology at Queensway Carleton Hospital in Ottawa. “Blood is a really good petri dish,” she explains.

According to one study, women who used sea sponges during their periods had signifcantly more bacteria in their vaginas—including the staph bacteria that produce the toxins that cause TSS—than women who wore tampons and pads. Homemade tampons aren’t any safer; unlike mass-produced hygiene products, they’re made without set regulations, and loosely knit products could encourage the growth of staph bacteria. As well, neither menstrual sponges nor knit tampons are approved or licensed for sale by Health Canada.

Originally published in 2019, updated in 2021.

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Health

This Is Why I Got Vaccinated During My Pregnancy

The alternative—gambling that you won’t catch COVID for those nine months—just seems much more terrifying to me.

Child wearing a blue winter coat holding their pregnant mother's hand walking to school

(Photo: iStock/SolStock)

The day I got my first COVID vaccine, I wept with relief. It was the weekend of Mother’s Day, and I couldn’t think of a better gift to give to myself and to my toddler son, who goes to daycare all week.

This shot, this absolute miracle of modern science, was for me a light at the end of a tunnel lined with thousands of deaths, overburdened intensive care units, and the daily anguish of staying apart from loved ones in hopes of keeping them safe.

Then, in the weeks before becoming eligible for my second dose, I got pregnant.

The day I missed my period, I joined a high risk group—a population considered extra vulnerable to respiratory viruses and serious illness, and COVID-19 specifically. In the third and fourth waves of the pandemic, unvaccinated pregnant people are getting admitted to hospital ICUs at an alarming rate. In fact, the Centers for Disease Control and Prevention (CDC) has just issued an urgent warning with updated data: Pregnant people with symptomatic COVID have a 70 percent increased risk of death. There’s also an increased risk of preterm birth, stillbirth or NICU admission for the baby.

Despite these very real, very scary outcomes we now know about, provincial data in Ontario, where I live, shows that as of September 12, only 54 percent of pregnant people were double-vaxxed. (This is compared to over 81 percent of the general adult population.)

In the U.S., rates are even lower: the CDC says only 31 percent of currently pregnant people are vaccinated, even though the surging Delta variant is more infectious and more deadly. (Health Canada does not track the vaccination rate of pregnant people across all the provinces.)

In fact, under the umbrella of high-risk groups in Ontario, pregnant women have the lowest vaccination rate of all. People with a history of organ and stem cell transplants, neurological diseases that affect respiratory health, blood cancer and kidney disease are all getting vaccinated more than pregnant people are. It’s alarming, but, on some level, it makes sense, given the high-stakes, high-judgment experience of pregnancy.

When we’re pregnant, we’re medically and socially conditioned to be extremely careful with what we put in our bodies, now shared with a vulnerable growing fetus. Is it OK to exercise? Is my skin cream safe for pregnancy? Will a sip of wine or bite of sushi harm my baby? What if this bath I’ve drawn for myself is just a little too hot? It’s hard not to obsess over even the smallest risks, or feel overwhelmed by the sheer volume of questions and anxieties. We also routinely face judgment from perfect strangers policing our behaviour and commenting on our choices, even if it’s just one cup of coffee a day.

But if you’re skipping or delaying vaccination during pregnancy because you’re worried about your unborn baby’s development, you should also consider the risks of getting a COVID infection in pregnancy—in addition to the heightened risk of maternal death, it can cause you to go into labour too early. And longitudinal research links preterm birth to poorer health and social outcomes, including heart and lung issues, and greater risk of ADHD.

This is one of the reasons why I was not among the vaccine-hesitant, even after learning I was expecting. The minute I could snag an appointment for my second shot, I leapt at the chance. I didn’t just want it because I craved hugs with vaxxed friends and family and a worry-free meal on a patio. I did it because I knew it was the single best thing I could do to protect myself and my baby. We now have reassuringly solid data to prove that the vaccine does not penetrate beyond the placenta, but the good stuff—like the COVID-19 protective antibodies your body makes after vaccination—does get passed on to the fetus, and may protect your vulnerable newborn from infection.

The alternative—gambling that you won’t catch COVID for those nine months—just seemed much more terrifying to me. After I read news stories about ICUs becoming packed with unvaccinated pregnant patients in particular, I couldn’t shake the horrific images from my mind. These extremely sick patients are hooked up to ventilators or ECMO life-support machines, and have to lie prone on their pregnant bellies (cushioned by lots of pillows). They often need to deliver their babies by C-section, while in a medically-induced coma, even if the babies are too young to survive outside the womb.

I think about it this way: Delaying a vaccine during my pregnancy does me—or my unborn baby—absolutely no good if neither of us survive that pregnancy. It would also leave my toddler son without a mom.

It’s true that this horrifying scenario isn’t, typically, what a pre-Delta COVID infection looked like for a healthy woman in her thirties. And it isn’t what COVID looked like back in January, when health agencies first started issuing vaccine recommendations for pregnant people like me. But the virus has changed since then—and so has my own personal risk calculation.

As vaccines became more widely available and their impacts studied, the conversation about safety for pregnant people has “evolved,” says Tali Bogler, the chair of family medicine obstetrics at St. Michael’s Hospital in Toronto, and co-founder of the Pandemic Pregnancy Guide, a popular social media resource for anyone expecting during COVID.

The ever-changing messaging and lack of evidence earlier in the vaccine rollout was extremely frustrating to women’s health advocates like Bogler, who worried about the “downstream impacts” of the way the safety guidelines were handled. “If [pregnant people are] systematically excluded [from trials], we lack safety data from the get-go,” she says. “Then there’s unequal access to vaccines and conflicting messages from Health Canada and other health agencies about whether pregnant individuals are eligible.” Sometimes, initial messaging sticks, she adds, even if it isn’t, ultimately, the most accurate information.

Bogler says the number one question she gets from her pregnant patients is an understandable one: “What about the lack of long-term data?”

“We actually have great long-term data on other vaccines we give in pregnancy, and there are no adverse effects and no red flags,” she says, pointing to two major studies about flu and whooping cough (also known as pertussis) vaccines. These are shots routinely given in pregnancy, she says, right there in the obstetrician or midwife’s office.

Neither of these shots are mRNA vaccines, however, which alarms some patients who are hesitant about COVID vaccines, but feel comfortable with other vaccines during pregnancy. “The mechanism is slightly different in how it’s delivered,” explains Bogler, “but our immunological response is exactly the same.”

She says the third wave of COVID, in April and May 2021, became a “turning point.” Once experts began to recognize how at-risk pregnant people are of COVID complications, some provinces started prioritizing vaccine clinics for anyone expecting.

That’s where I got my shot—a pop-up run by my local hospital, specifically for pregnant people. This gave me an extra dose of confidence that this was the best decision I could make for my baby, with the information I had. After all, I will ultimately trust the capable staff at this very same hospital to deliver my baby.

Bogler wishes the COVID vaccine could be administered in OB/GYN and midwives’ offices, just like other vaccines given in pregnancy, because that’s an important venue of trust. Approaching the issue with compassion is key, she says. Pregnancy is an already heightened time, so ignoring the context, and all the unknowns pregnant people already have to navigate without a pandemic interrupting their prenatal care, is not going to get more shots in arms.

Despite not being vaccine-hesitant myself, I really feel for those still holding out. Pregnancy is a strange, anxiety-riddled state during which so much is at stake—and it can feel like it’s all on you.

Ariel Dalfen, a perinatal psychiatrist at Mount Sinai hospital in Toronto, says that there’s a “range from cautiousness to anxiousness in pregnancy, so if you fall anywhere on that continuum, which most people do with pregnancy, getting vaccinated is understandably a very momentous decision to make.”

On that spectrum, she notes that I sound relatively laidback. It probably helps that this is not my first baby, my pregnancy isn’t considered high-risk, and that I didn’t experience any difficulties with conceiving or pregnancy loss in the past. It can be an understandably more tense experience for first-time pregnant people or for those who encountered complications with previous pregnancies, Dalfen says.

Five months later, I can happily report that being vaccinated has indeed given me the security to live my life a little bit more, prior to our new baby’s arrival. My partner and I got to take a babymoon trip, and I was able to safely throw my son a small outdoor party to celebrate his third birthday. I have had no side effects, and, best of all, I get to enjoy a whole lot of peace of mind.

My great hope is that this pandemic will be on its last days by the time my new little one arrives, and I truly believe the fastest way to get there is to vaccinate as many people as possible.

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Health

How To Treat And Prevent Ingrown Hairs

All the best tips for problem-free hair removal.

Full length shot of an attractive young woman shaving her legs with a razor and shaving cream in the bathroom

(Photo: iStock)

If you’ve noticed red bumps on your body after your hair removal routine, you could be dealing with ingrown hairs, a common—and irritating—issue. But fear not, these pesky bumps are easily treatable. 

We tapped two dermatologists for the low-down on how to treat and prevent ingrown hairs at home—and when it’s time to consult a doctor.

What are ingrown hairs?

Ingrown hairs are an unfortunate by-product of most types of hair removal, such as shaving, waving and tweezing, and happen when a growing hair follicle meets a blocked pore and curls in on itself or grows sideways. They leave behind uncomfortable, itchy red bumps that can sometimes become infected or scarred.

What causes ingrown hairs?

This issue most often develops on commonly waxed and shaved areas of the body, such as the faces, necks, legs, armpits and bikini line of those who shave. 

Hair texture can also be a factor. Those with curly or coarse hair tend to experience ingrown hairs more often, as curved hair naturally grows toward the skin rather than away, according to the Canadian Dermatology Association (CDA).  

How do you treat ingrown hairs at home?

“The first thing is to avoid irritation,” says Dr. Marlene Dytoc, a clinical professor of medicine at the University of Alberta Division of Dermatology. “Wash the skin with a mild, gentle cleanser.” After cleansing, it’s recommended to use a shaving cream or gel before using your razor, which “gives some lubrication so that you can soften the hair when you’re shaving,” she says.

How can you prevent ingrown hairs?

A little prevention goes a long way when it comes to ingrown hairs. Dytoc recommends using new, clean tools and shaving in the direction that the hair grows in rather than against the grain, avoiding pressing hard into the skin, as well as rinsing the blade after each stroke. 

However, those experiencing persistent ingrown hair issues may want to partake in a thorough weekly care routine. 

“To start, we always recommend exfoliating two to three times a week,” says Rachel Kerr, the director of brand and marketing for Bushbalm, an Ottawa-based company and product line focused on solving “common skin challenges that aren’t often talked about.” She says that doing so will help soften body hair and smooth skin before hair removal. 

Dr. Susan Poelman, a certified dermatologist, co-director of Beacon Dermatology in Calgary and board member of the CDA, encourages exfoliation using gentle acid exfoliating products such as the Skinfix Renewing Body Cream or the CeraVe Renewing SA Lotion, which contains salicylic acid. 

“Those types of exfoliating acids can prevent the buildup of dead skin cells that can perpetuate ingrown hairs,” says Poelman. 

When should you consult your doctor? 

While ingrown hairs only rarely require a visit to the doctor or prescribed antibiotic creams, it’s important to consult a medical professional if you notice signs of infection, including pus build-up, red bumps increasing in size or pain that lasts for more than a few days. 

It’s possible for an untreated ingrown hair to develop into a cyst known as a pilar if the first layer of skin breaks. When this happens, it can fill with keratin (a protein found in nails, hair and skin) and create an inflamed bag around the affected area. Cysts need to be extracted by a dermatologist; don’t attempt to squeeze it yourself, as it will simply refill and can also complicate the extraction process. 

“If you squeeze the cyst, it becomes partially absorbed, so it’s harder to remove it,” says Dytoc. “There will be some foreign body inflammation and scarring. So, when a cyst has been squeezed or manipulated, then even with excision … it tends to recur.” 

Poelman also warns about a condition known as hidradenitis suppurativa (HS), in which a patient can experience painful boils under the arms and breasts and in the buttocks and groin area. It is often misdiagnosed as ingrown hairs, as they initially can appear as red bumps or cysts in common areas in which ingrown hairs occur, but is actually a condition that causes significant pain, frequent flare-ups and scarring.

“[Hidradenitis suppurativa] is a condition that people often struggle with in silence. They’re isolated and even a lot of doctors are not aware of this condition or don’t know that treatment options exist for it,” says Poelman. 

Is there a cosmetic treatment for ingrown hairs? 

For some, turning to laser hair removal is a cosmetic treatment that can help prevent ingrown hairs and related complications in the long run. 

“The advantage of laser hair removal is that over time, you need to do it less and less, so there’s less reason to shave in between,” says Dytoc, who also recommends a hair growth inhibitor cream known as Eflornithine, a prescription treatment that can be applied after any hair removal process, including laser hair removal, to decrease the enzyme in the human body needed for hair growth.

Are ingrown hairs discussed enough? What’s the hesitancy? 

In the age of body positivity and normalization of topics around skin health including acne, psoriasis and more, ingrown hairs and hair growth on commonly shaved parts of the body are becoming part of a more public conversation. Due to the clean-shaven beauty standard that has persisted for years, it is not surprising that an individual may be hesitant to speak about ingrown hairs, or feel the need to cover them up. 

“[Ingrown hairs] is something that happens all the time. If you’re removing hair, there’s really no way around it, you’re likely going to get some redness, irritation,” says Kerr. “And obviously, it’s nothing to be ashamed of. But we think it’s also really normal to want to treat something like this.” 

Public figures have also echoed this idea, including Nadya Okamoto, founder of the global non-profit Period Movement, which aims to eradicate the stigma behind periods. 

“Normalize pubic hair (stubble) and ingrown hairs,” writes Okamoto in an Instagram post from November 2020. “Part of me wanted to airbrush the stubble I have in my armpits, too, but then I caught myself and thought how tf have we started to hold ourselves to a hairless standard?” 

 

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Health

Race, Religion And Mental Health: Therapy Should Be Culturally Relevant

Mental health care urgently needs to be more adaptive to the needs of different communities. What’s available now is often unhelpful, insensitive or worse.

Illustration of various women getting therapy. In foreground, a Black woman sits in an office with a white therapist. In the middle, two Indigenous women sit amidst nature, as per Healing From The Land course, in the background, two Muslim women in hijabs speak.

(Illustration by Cornelia Li)

Years ago, when Rod McCormick was teaching psychiatrists-in-training at the now-defunct Riverview Hospital in Coquitlam, B.C., he suggested a healing technique that wasn’t in his students’ textbooks.

McCormick, a psychologist and professor whose career has centred on counselling and Indigenous mental health, asked a group of interns what they did for their own healing. All the examples they gave shared a common thread: reconnecting with nature.

“Do you use that for your own patients?” asked McCormick, who is a part of the Kanien’kehá:ka (Mohawk) Nation and the director of All My Relations, a research centre aimed at advancing Indigenous wellness at Thompson Rivers University in Kamloops, B.C. The interns told him they didn’t, while admitting their current techniques weren’t working very well.

So McCormick offered up an alternative. Riverview was a psychiatric hospital located on some of the most beautiful grounds in the Lower Mainland, an idyllic location. McCormick knew local elders who would be willing to join the group in the surrounding forests to explain how to use trees, rocks, water and sky in their healing. The interns were excited—they thought it was a great idea. But the plan never came to fruition.

“I guess somebody higher up thought, ‘That’s silly. That’s not the medical model,’ ” says McCormick. He has plenty to say about the medical model, though, including who it was created for. “I’ve trained psychologists and counsellors for about 25 years now,” he says. “I always remind them that all those theories and interventions they learn come out of textbooks, and they’re all based on a European-Western world view.”

The term “mental health” usually invokes psychology, and Europeans lay claim to its modern formulation: Its early growth and foundational research was focused on a homogeneous demographic, one that was entirely white (and, usually, male, able-bodied and heterosexual). Its frameworks were derived from Euro-Western conceptions of the human experience, and its implementation has largely suited that same population. But psychology’s roots extend far past the 19th century, and wider methods of approaching good mental health—drawn from ancient civilizations, religious communities and other populations—often go unconsidered.

Today, the inattention to other cultures, races and religions is palpable when considering access to mental health care in Canada and the effectiveness of the treatment that patients receive. In such a diverse society, it’s been clear for a while that culturally specific modes of therapy are an urgent necessity. Progress has been slow, stalled by pushback and a lack of research or funding. But in recent years, a few innovative frameworks have emerged to successfully treat the mental health needs of various communities and individuals.

Sometimes, it’s possible to adapt existing treatment models to suit particular communities. Farooq Naeem, the chief of general and health systems psychiatry at the Centre for Addiction and Mental Health (CAMH) in Toronto, pioneered techniques for adapting cognitive behavioural therapy (CBT) for South Asian patients. One of the most popular forms of therapy today, CBT is typically a structured, short-term form of psychotherapy that focuses on the here and now. It helps patients analyze how their thoughts affect their feelings, and how those feelings affect their behaviours. Naeem’s adapted model retains the basic techniques of CBT, while adjusting certain language, and taking culture and religion into consideration. He found that behavioural and problem solving techniques were more acceptable to South Asians than other CBT tactics, and a more directive approach was more effective than a collaborative one.

The CAMH adaptation process expanded to encompass other cultures and identities, and in 2009, psychologist Natasha Williams was approached to help adapt CBT for English-speaking Black Canadians with roots in Africa and the Caribbean. Black people are particularly neglected by the current system—on average, they wait 16 months for provincially funded mental health treatment, which is double the already-long average of eight months.

Again, language was one of the first problems Williams’ team noticed during the adaptation process: The Western diagnostic manual being used prevented practitioners from recognizing specific terms that African or Caribbean Canadians might use when expressing mental health-related symptoms. “Somebody may not say they’re ‘sad,’ but they may be ‘vexed.’ Not understanding what that means in this context…it can be pushed aside and not seen as a possible criteria for depression,” says Williams.

Also important in mainstream CBT is the concept of “core beliefs,” or absolute notions of oneself learned through childhood experiences, parenting and overall environment. Those need to be understood through a culturally aware lens, as well.

“Colonialism…racism [and] transgenerational trauma, those types of things had to be part of the conversation to fully understand somebody’s core beliefs,” says Williams. “In traditional CBT, those things typically are not explored.”

Then there’s the issue of who’s administering the therapy. Williams’ pilot program and the manual that followed only included input from Black clinicians, an approach that was rewarded when several participants indicated they had trouble opening up to white therapists. “They feel that [they’re] speaking to their colonizer: ‘How can the person that oppressed me actually aim to heal me?’ ” Williams explains.

Marian is a Black Muslim woman living in Ottawa. Finding therapists who can understand the intersections of her identity has been difficult—she’s been trying for a year, and she’s hesitant to consider a white therapist. “For Black folks, or Black Muslim folks, we’re always living in an existence of trying to explain every part of our identity or validate [our] experiences to people,” she says. “It’s already hard enough.”

Williams says that while clinicians and patients don’t necessarily always have to be the same race or ethnicity, there does need to be an exploration of the dynamic between therapist and racialized clients if the clinician is white. And the feedback from the adapted CBT model has been heartwarming. Participants reported increased social interaction, decrease in depressive moods and a reduction in shame or stigma previously associated with mental health care, particularly those who went through group therapy.

The failure to address systemic racism, bias and colonization in traditional CBT is a microcosm of the issues that plague mental health care generally. It demonstrates how Indigenous, Black and communities of colour are often left out when it comes to developing models of care. Too many racialized people end up in therapy situations in which they don’t feel safe exploring issues pertinent to their lived experience.

“It’s a systemic issue. There’s just so much that needs to be done,” says Williams. Funding is always an issue, although important acknowledgements have been made: In 2018, the federal government committed $19 million over five years to mental health programs in Black communities.

But cultural insensitivity is still a barrier and, Williams says, it can lead to a reluctance to go to psychotherapy at all. That reluctance is often justified. Black youth are four times more likely to enter the mental health system through hospital emergency departments than white youth—and 2020 has shown just how dangerous emergency mental health situations can be for Black, Indigenous and other racialized people.

Between April and June of 2020, six racialized Canadians died during police interactions instigated by their mental health emergencies. That includes 62-year-old father of four Ejaz Choudry, who was shot by police while experiencing a schizophrenic episode in his Mississauga, Ont., home in June.

According to psychiatrist Yusra Ahmad, “there was such a lack of any attempt to even understand the root of [Choudry’s] distress”—his family had called for paramedics, not police. “Fear of being judged and misunderstood is so profound that the last thing you’d want to do is trust a system that has not even taken you into consideration and doesn’t really want to.”

Ahmad, who is also a clinical lecturer at the University of Toronto, has spent years devising new approaches to treating Muslim patients. “A lot of mindfulness programs profess to be holistic, [but] there is an uncanny discomfort with issues of the spirit,” she says. “I know just how valuable faith and spirituality is to many people…and yet these were rarely addressed, if at all, in meaningful ways by the psychiatric establishment.”

In 2017, Ahmad started Mindfully Muslim, a 10-week group therapy program for Muslim women with anxiety or depression that combines mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction and mind-body work with Islamic wisdom. At the centre of the program is the poem “The Guest House,” by 13th-century Persian poet and scholar Rumi, which calls for compassionately receiving whatever life brings, accepting every feeling and experience as a guest to the soul: “Be grateful for whatever comes/Because each has been sent as a guide from beyond.”

The poem is actually part of the official MBCT model used worldwide, but non-Muslim practitioners usually aren’t taught its spiritual connotations. “Many presentations of Rumi are highly decontextualized,” Ahmad says. “The fact that he was an erudite Islamic scholar and [memorized the] Quran seems to have been set aside.”

Muslim participants and community organizations have embraced Mindfully Muslim, but Ahmad says that her peers have had mixed reactions. Some were very supportive, nominating her for the Ontario Psychiatric Association’s Breakout Community Psychiatry Advocacy Award—which she won last year. But other colleagues simply ignored her faith-based perspective when she first proposed the project, and some straight-out said that her “emphasis on faith was cringeworthy.”

Ahmad believes this hesitancy comes from a general discomfort with faith traditions, as well as negative stereotypes of Islam that have engendered fear and ignorance. “It only emboldened me to continue chipping away, because if I was experiencing that as a mental health professional, as a psychiatrist from my own colleagues, imagine what it’s like for a patient,” she says.

For Salma Hindy, who works in biomedical engineering and is also a stand-up comedian in Toronto, the pursuit of mental health care that acknowledges her experience as a Muslim woman has meant seeing multiple therapists at the same time.

Her first and long-standing therapist is agnostic, and while they clicked on the more textbook aspects of therapy and psychology, she felt judgment with regards to her faith early on. Like Marian in Ottawa, she feels that having to explain religious practices and modes of thinking on top of issues like depression and anxiety can be exhausting.

“I felt like I had to almost defend my religion. I felt like I was on trial,” she says. While the two were able to build a rapport over time, Hindy says that her therapist still won’t touch issues that centre around religion.

For Hindy, an integrated framework of spirituality and psychology has meant building a personal roster, with a medical mental health professional on one end and an imam, or Muslim religious leader, who can speak to her spiritual struggles on the other. Putting it all together took up a lot of time.

In Kamloops, McCormick has also found Western views on spirituality problematic. “I grew up in Catholic schools, and the world was sort of like a triangle: on top was God, in the middle was humans, at the bottom was nature,” he says. “[In] an Indigenous cosmology, you got three points on the circle: God, human and nature. It’s not hierarchical, and it’s not compartmentalized.”

The Western model wouldn’t necessarily look to God or spirituality for healing, he says, and it certainly wouldn’t turn to nature, which is seen as below humans. “Whereas, in an Indigenous world view, you would look to both sources for healing because they’re all part of creation, equal to humans,” says McCormick.

His “Healing from the Land” course did eventually come to fruition: He taught alongside local elders and traditional knowledge holders, and classes often started by piling into a bus and heading straight into nature.

The course was popular, and more than half of the students present were Indigenous. Day one was trees and forests, then rivers, then lakes and water, then earth and plants, and finally, hills and mountains on the fifth day.

“They learn things like how nature can be grounding, connecting…how it can be calming, how nature can provide perspective and guidance, and be empowering,” says McCormick.

To explain its success, the psychologist considers a theory put forth in 1946 by Jewish psychiatrist Viktor Frankl, a Holocaust survivor. “He said that individuals and cultures can survive if they have a strong reason for living,” says McCormick, noting reasons such as spirituality, work, relationships and contributing to one’s culture or community. “The process of colonization for Indigenous people was to separate us from those sources of meaning.”

When McCormick was researching suicide, for example, many of his participants (who had been suicidal in the past) expressed a desire to reconnect to their cultures and communities. “Five out of the 25 interviewed mentioned getting an Indian name, a traditional name,” McCormick says. So he explored naming ceremonies on the west coast of B.C.: Often, part of the tradition is having the community present to hear the family describe those who have had that name in the past, what the name means, and the teachings and responsibilities that come with it.

In many communities, such names mark different stages in a person’s life. But treatment centres where such ceremonies are possible are rare, and McCormick says they often aren’t equipped to help participants reintegrate with their everyday lives and community afterward—which is of utmost importance to the naming ceremony. Further exploration of these ideas has been difficult, given both the lack of resources and general discomfort with integrating spirituality into the existing mental health framework.

It’s clear there’s a long way to go to make mental health care more relevant and accessible. The barriers are many, from Eurocentric curricula and teaching methods, to the social determinants of health that make racialized people more likely to experience mental distress, to the financial barriers that make it difficult for many people to access treatment at all.

Ahmad shares the hope that more people will come forward who are willing to think creatively and push the boundaries of what’s possible. “The culture is not as supportive as it needs to be,” she says. “It’s changing pretty rapidly at certain levels, but whether it permeates at all levels, we have yet to see.”

Clearly, a one-size-fits-all mode of therapy too often fails communities who need help the most—in worst-case scenarios, its oversights can be catastrophic. Openness and evolution are needed to give medicine its best chance at doing what it was created for: healing people.

This article was originally published in 2020; updated in 2021

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Health

The COVID Vaccine For Kids 5 To 11 Years: What Parents Need To Know

If you have a school-aged child, it's almost their turn for a COVID-19 vaccination, and you may have questions. Here are the answers.

A young girl rolls up her sleeve to look at a band aid on her bicep

(Photo: iStock/portishead1)

When the COVID-19 vaccine became available to teenagers in Canada back in May of 2021, many parents rejoiced. After all, being vaccinated is highly protective against the nasty virus, which has now taken the lives of more than 27,000 people in Canada, and infected more than 1.5 million of us. Widespread use of the vaccine is also a key element of the larger plan to end the pandemic.

But now that it’s almost time for younger kids the get the COVID-19 vaccine, parents have questions. Here are some answers.

What do we know about the safety and effectiveness of the vaccine in kids aged 5 to 11?

At the moment, only one vaccine manufacturer, Pfizer, has discussed the results of its studies on how the vaccine works in school-aged kids.

In a press release published in September 2021, the company said that its trials showed the vaccine had a “favorable safety profile” and “robust neutralizing antibody responses” in children aged five to 11. Put simply, it was found to be highly safe and effective in that it created the necessary antibodies, just as it does in adolescents and adults. It was also well-tolerated as far as side effects—no new side effects were identified. Such good news!

Will kids need one vaccination or two?

Parents of needle-phobic little ones will inevitably be wondering if their child will need one shot or two. Kids are small and light, so do they really need two doses?

Pfizer said that in its study, which was conducted on 2,250 kids aged five to 11 years, kids received two needles administered three weeks apart. It’s worth noting that the dose given was a third of what teens and adults received—10 micrograms per shot as opposed to 30 micrograms.

It remains to be seen if other vaccine manufacturers are developing shots that can be administered in just one dose.

Why is the dosing based on age, not weight? What if my child is heavy for their age?

With most medications, weight plays a big role in dosage. But that’s not the case for vaccine doses. “This is because your immune response is not weight dependent,” explains Sabina Vohra-Miller, the Toronto-based founder of Unambiguous Science, a platform that aims to make science accessible to Canadians. Instead, researchers look for a dose that creates a strong immune response in that age group while minimizing side effects.

When can we expect the vaccine roll-out for kids in Canada to begin?

While some experts, including B.C. provincial health officer Bonnie Henry, are predicting the vaccine could be available for five- to 12-year olds by the end of October, it really depends on how quickly the next few steps can happen.

Pfizer must first formally submit the results of its trials to government regulators, which it says it will do shortly, although it hasn’t given a specific date. “We are pleased to be able to submit data to regulatory authorities for this group of school-aged children before the start of the winter season,” says Ugur Sahin, CEO and co-founder of BioNTech, which partnered with Pfizer to create the groundbreaking vaccine.

Once the data is in the hands of Health Canada, it could be mere weeks or several months before it is approved and the roll-out begins. Previously, Health Canada moved quite swiftly to authorize the use of the vaccine in teenagers after receiving clinical study data.

What are the vaccine’s side effects in children?

Pfizer reports that in the study, the vaccine’s side effects in kids were similar to the side effects seen in teens and adults.

According to the World Health Organization, reported side effects to COVID-19 vaccines have mostly been mild to moderate and short-lasting. They include fever, fatigue, headache, muscle pain, chills, diarrhea and pain at the injection site. More serious or long-lasting side effects to vaccines are possible—but extremely rare.

You may have read about myocarditis (inflammation of the heart muscle), and pericarditis (inflammation of the outer lining of the heart) occurring after an mRNA COVID19 vaccination. In Canada, there have been “a small number” of these reports, according to a report from SickKids hospital in Toronto. As of September 11, 2021, there have been 369 reports of myocarditis or pericarditis after the COVID-19 mRNA vaccines in Ontario, out of the more than 21 million doses received. The symptoms of these conditions include chest pain, shortness of breath and feelings of having a fast-beating, fluttering, or pounding heart, and are more likely to occur after the second dose. Adolescents who developed myocarditis or pericarditis after their vaccine generally experienced mild illness, responded well to conservative treatment and rest, and their symptoms improved quickly, says SickKids.

It’s not clear yet whether any of the kids in the trial experienced myocarditis after the shot. However, Stephen Freedman, professor in the department of paediatrics at the Cumming School of Medicine at the University of Calgary, told the Globe and Mail that kids infected with COVID-19 have a much greater chance of experiencing severe illness, hospitalization or other severe outcomes compared to those with vaccine-induced heart inflammation and that vaccine-induced heart inflammation seem to be much milder than those that occur as the result of a viral infection.

Do kids truly need the vaccine?

Since early in the pandemic, parents have been assured that when kids contract COVID-19, it’s almost always a mild illness, and that serious illness and death are extraordinarily rare. This led many parents to believe that vaccinating kids against the virus was unnecessary.

But according to Health Canada, although kids are less likely than older adults to get very sick from COVID, they can still get sick, and some will become very sick and could require hospitalization. Hospitals in the United States have seen paediatric admissions surge with the Delta variant and now that schools are open in Canada many experts worry about a similar situation occurring in Canada. There’s also a very real concern about infected kids experiencing longer-term effects, known as “long COVID.”

It’s also worth remembering that kids with COVID, even if the case is mild or asymptomatic, can spread the virus to others. Many experts believe that, because of the Delta variant, to achieve herd immunity, we need almost everyone in the country vaccinated, including children.

Should any kids avoid the vaccine?

Anyone who has had a severe allergic reaction to any ingredient of the Pfizer vaccine should not get the vaccine, according to Pfizer, but speak to your healthcare provider if this is the case for your child.

What about kids younger than 5?

Pfizer says that data on the other two age cohorts from its trial—children 2 to 5 years of age and children 6 months to 2 years of age—is expected to be released before the end of the year, perhaps as early as October.

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Health

What Parents Need To Know About Rapid COVID Testing

From where to buy them to when to use them—and how useful they are in the first place—we've got answers to all your rapid testing questions.

A mom uses a swab to perform a COVID rapid test on a child

In addition to new running shoes, masks and hand sanitizer for her three kids, ages 4, 7 and 9, Toronto mom Mandy Hergott* bought some rapid antigen test kits as part of her back-to-school shopping. “It won’t replace the proper lab test but in anticipation of testing centres being less available, for my own peace of mind I wanted to have them at the ready,” says Hergott.

As families navigate this stage of the pandemic, where kids under 12 aren’t vaccinated—and some of the adults around them aren’t either—some parents are picking up at-home COVID-19 tests, which come with questions of their own. Are they worth the cost? How accurate are they? Why can I get free tests at my workplace and not at my kid’s public school? And why is this process STILL so haphazard? Here’s what you need to know about COVID-19 rapid tests.

What’s a rapid antigen test?

A rapid antigen test is a screening tool. It can identify the presence of specific SARS-CoV-2 (the virus that causes COVID-19) protein markers in your body, which indicate an infection. You can use the test at home and the results are ready in about 15 to 30 minutes—the sample does not need to be sent to a lab. They work best when you have high levels of the virus (which may or not result in symptoms).

In contrast, the “gold standard” for COVID-19 testing is the PCR (polymerase chain reaction) test, which detects genetic material from the SARS CoV-2 virus. That’s the test where a technician takes a sample from further into your nasal cavity using a long swab, which is then analyzed in a lab. Those results take at least 24 hours. (Or as many of us have discovered, five business days or more, depending on demand and where you live.)

How do you use a rapid antigen test?

Each brand will be slightly different, but generally speaking the process is fairly straightforward. You add drops of a liquid called a buffer (which comes in the kit) to a tube (which also comes in the kit). Then you take the provided nasal swab, put it into each nostril, about a centimetre in, and rotate it gently, following directions about the number of times and where to place the swab. Next, you put the swab in the tube containing the buffer liquid and follow the directions about how to mix the swab with the buffer. Finally, you add a certain number of drops of the swab-and-buffer mixture to the kit’s reader strip, which looks like a pregnancy test. The result will be ready in 15 to 30 minutes. One line means the test is negative. Two lines means the test is positive. “It’s pretty simple to do,” says Janine McCready, an infectious disease physician at Michael Garron Hospital in Toronto.

Is a rapid antigen test suitable for kids?

Right now, the tests are in a grey area with Health Canada, and have not been officially approved for kids. That said, “Because of the pandemic, we’re having to do a lot of things in real time. We’re not waiting for large-scale validation for different age groups,” notes McCready. She says that as long as samples are being collected properly, there’s no reason to think that a rapid antigen test wouldn’t work the same way for a child as for an adult.

How accurate is a rapid antigen test?

False positives—or the test says you are infected with COVID-19 but you actually are not—are rare. In other words, if the rapid antigen test says you are positive for COVID, call your health unit to get advice about getting in touch with contacts, booking a PCR test to confirm, and who in the household should stay home.

False negatives—or the test says you are not infected with COVID when you actually are—are more common. “The range of sensitivity is more like 50 to 95 percent,” says McCready, meaning that 5 to 50 percent of the time, the virus won’t be detected on the day you test, but could be on a subsequent day when the levels of the virus are higher. In an ideal situation, the rapid antigen tests are designed to be used frequently, even daily, to monitor potential infection. “The chance of getting a correct result depends on how infectious the person is…it depends on at what stage you are, if you have symptoms, if you have no symptoms, how much virus you’re shedding,” she says. “Even if you haven’t been exposed and don’t have symptoms, if you test negative on the rapid antigen test it doesn’t necessarily mean that you 100 percent don’t have it, because it could just be missing the virus there.”

The reality is rapid antigen tests are a good extra screening tool, but the risk is that many people will accept a negative result despite symptoms or a known exposure and inadvertently spread the virus.

When should you use a rapid antigen test?

Despite those caveats, a rapid antigen test can be useful to families in a few ways, says McCready.

If your child has COVID-19 symptoms

In this case, the rapid antigen test gives you a quick answer about positivity: You can test as soon as symptoms start and if it’s positive, you call your health unit and follow their recommendations about booking a PCR test and notifying possible contacts. If it’s negative, you still stay home, still book a PCR test and still monitor for symptoms. The advantage is knowing that you’re positive right away, rather than possibly having to wait days for PCR test results.

If your child has a known exposure to COVID

When you’re isolating at home for the set period of time and monitoring for symptoms, using a rapid antigen test means you can test daily or every other day, rather than waiting for a PCR test partway through the exposure period (often day 7 after a known exposure). Although you would still have to go for the PCR test at the recommended time to confirm your child is negative.

If your child has no symptoms, but is going into a different group setting

Some parents are using rapid tests to OK a visit with grandparents, for example, and that’s reasonable, according to McCready. “If your kid is going to go join a group of kids that they don’t usually play with, or you’re going to go to visit grandparents, or you’re going to be indoors with people at a big family gathering, it would add a layer of safety for everyone who is going to that gathering to do a rapid antigen test,” she says. “Again, it’s not foolproof. You’re still screening for symptoms, still trying to be outdoors, wearing masks if you can’t distance, all those good things. But if you’re going to do those activities anyway, the testing would give an extra layer of protection.”

As part of a surveillance program

We’re not there yet in most parts of Canada (although some schools in Montreal hotspots have started using rapid testing to detect cases), but experts say rapid tests can be incredibly useful as part of a surveillance program. McCready points to a program in Utah called “Test to Play,” where public high school students were required to do a rapid antigen test every 14 days in order to participate in extracurricular activities. A similar program called “Test to Stay” had optional rapid testing when a school had an outbreak and if students opted for the test and tested negative, they could continue to stay in school. The result: more than 100,000 days of in-person instruction were saved and 95 percent of athletic events went ahead. Between November 30, 2020 and March 20, 2021, nearly 60,000 students were tested and 1,886 (3.2 percent) had a positive test.

Where do you buy rapid tests?

Right now in Canada the tests are either fairly expensive (about $15 and up) and therefore out of reach for many, or totally free. (In Germany, rapid antigen tests are less than $1 USD and in Britain they’re free for everyone, twice a week.)

Here, parents are mainly buying tests through several Canadian websites like rapidtestandtrace.ca or haventesting.com or getting them through the free federal or provincial program for employees at their workplace. Hergott, the Toronto mom of three, paid $400 plus another $74 in taxes and shipping for 25 tests from a Canadian website, but hasn’t used any yet. “They were so bloody expensive that I want to save them for when one of my three kids inevitably develops symptoms!”

In addition, at participating Shoppers and Loblaws pharmacies in Ontario and Alberta you can pay $40 to have a rapid antigen test done in-store with results while you wait. This is only available if you have no symptoms, no known exposure, and no previous positive test.

If you’re testing at home with a test you bought yourself, there really isn’t a provincial or national system in place yet to help guide you. You still have to isolate and call your local health unit to book a PCR test to confirm the rapid antigen test.

There are at-home PCR tests on the horizon too, at least in some places. In Toronto, McCready co-leads a program that has just expanded to offer a free take-home PCR test (with a swab that’s done inside the mouth and just inside the nostrils, rather than the long swab to the back of the nose), which families at Toronto public schools and child care centres can do at home if a child has COVID symptoms or there is a positive case in a cohort. The sample is then delivered to a set drop-off point and processed in a lab in about 24 hours, with follow-up calls and guidance on what to do next when it comes to isolating and contacting people in your circle.

The bottom line: “We need to make testing as easy as possible for everyone so that it’s easy for families to do the right thing and get tested and not ignore the symptoms,” says McCready. “Everyone needs to look out for their communities and protect the other kids around them.”

* Name has been changed

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How Moderna's mRNA Technology Is Revolutionizing Health Care

In the fight against COVID-19, Moderna stays ahead of the science with their mRNA platform, while also developing vaccine technology in other therapeutic areas

Created by Mediaplanet

This article was made possible with support from ModernaTx

The fall season is upon us and with it brings a lot of unknowns about the ever-changing COVID-19 variants.

In this climate of uncertainty, vaccination will be key to staying healthy and fighting our way out of the pandemic. “Generally, when the public is well vaccinated, whether for flu, meningitis, pneumonia or shingles, we see less disease, and less burden on the healthcare system,” says Dr. Vivien Brown, a family physician in private practice in Toronto.

Dr. Vivien Brown, Family Physician, Assistant Professor, Faculty of Medicine, University of Toronto.

“With COVID-19 specifically, the vaccines have had a significant impact on driving down the number of hospitalizations, and deaths, and in helping to create a cocooning effect to protect people who can’t be vaccinated,” she says.

Ongoing efficacy, adolescent approval, booster shots

Moderna’s efforts are critical in the global fight against COVID-19. To date almost 1461 million doses of the Moderna’s COVID vaccine have been administered in the US and over 7.2 million in Canada.2 As the pandemic evolves, Moderna is staying ahead of the science with mRNA technology.

Though the variants, waning immunity, and breakthrough infections are concerning, new data published in Science3 reported that the majority of individuals vaccinated with the Moderna COVID-19 vaccine, maintained antibodies against SARS-CoV-2 variants for six months after the second dose.

Dr. Beverly Francis, PhD, Director of Scientific Leadership — North America at Moderna.

On August 27, 2021, Moderna’s COVID-19 vaccine was authorized by Health Canada for use in adolescent populations aged 12 and above. “We see that as a major win in the fight against COVID-19, says Dr. Beverly Francis, PhD, Director, Scientific Leadership – North America at Moderna. “Vaccinating as many eligible Canadians as possible limits the human pool that serves as a viral reservoir, limits the spread of this virus, and greatly limits the virus’ ability to evolve and mutate into more transmissible or infective strains,” says Dr. Francis.

Anticipating the combination of the force of the current Delta variant, waning immunity, and pandemic fatigue will require further defensive action. Moderna is already preparing by advancing its mRNA-1273 vaccine as a booster candidate4. “Initial research has found it to be effective in boosting responses broadly against both the ancestral and major variant strains of the virus, and the safety profile of the booster was similar to that observed previously for dose 2 of the vaccine,” says Dr. Francis.

Finally, to ensure a steady supply, Moderna has been working closely with the Government of Canada to secure supply for up to 105 million doses of the COVID vaccine and its booster candidates, when authorized, for delivery through to 2024.5

mRNA technology as the future of medicine

The Moderna COVID-19 vaccine is the first mRNA vaccine that the company has brought to market. mRNA technology is built on the foundation that our bodies can create their own defense mechanism. mRNA-based vaccines are designed to deliver the instructions to our cells to create proteins that help activate the immune response against the virus. “It’s like giving the cell a recipe to follow, in this case a recipe to produce a spike protein, which then stimulates the antibodies,” says Dr. Brown.

Moderna’s COVID-19 mRNA vaccines build on more than a decade of basic and applied mRNA science, delivery technology, and manufacturing. The precision, speed, and flexibility of the platform enabled Moderna to respond quickly to the COVID-19 pandemic, providing an effective vaccine in just under a year. “It’s such an elegant and precise platform,” says Dr. Brown. “It’s just so fortuitous that it was ready at a time when we urgently needed it,” says Dr. Brown.

Moderna’s mRNA platform and approach will enable the company to research, develop, and manufacture medicines in new and potentially ground-breaking ways that can help single patients with individualized therapy, or millions of patients with infectious diseases. “We’re essentially industrializing mRNA technology and scaling the scope of therapeutic targets to address diseases, viruses, and pathogens in ways that were previously considered unimaginable,” says Dr. Francis.

Robust R&D investments lead the way to new ways to treat diseases

In 2020, Moderna invested $1.37 billion on R&D6 – and $2.3 billion over the past three years. Moderna’s mRNA pipeline includes 23 projects in development, and 15 clinical study programs currently underway.7


Within the infectious disease modality Moderna currently has nine vaccines in development for major unmet needs, including next-generation COVID-19 vaccines, influenza, cytomegalovirus (CMV), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), parainfluenza (PIV3), and Zika. It has an additional 12 medicines in development across four therapeutic areas – immune-oncology, rare diseases like propionic acidemia, cardiovascular, and autoimmune diseases.8

“The breadth of the mRNA platform and its capabilities is really energizing,” says Dr. Francis. “If you understand what mRNA is at its core and figure out how to deliver it, as we have done, you can see we’re just at the beginning,” she says.

Clinical trials are underway to assess two of Moderna’s new respiratory vaccine candidates – one is a quadrivalent mRNA seasonal flu vaccine candidate, and the other aims to protect against respiratory syncytial virus (RSV)9. “Our vision is to develop a combination respiratory vaccine for adult and older adult populations, combining seasonal flu, RSV, and COVID-19 booster all in one shot,” says Dr. Francis. “Doing many things in parallel to protect against three serious respiratory viruses at once is typical of the spirit and boldness of Moderna,” says Dr. Francis.

To explore how mRNA science is being used in vaccines, visit Moderna Canada.


Important Safety Information

SPIKEVAX™ (elasomeran mRNA vaccine) is a vaccine used to prevent the coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus. It can be given to individuals aged 12 years and older. As with any vaccine, SPIKEVAX may not fully protect all those who receive it. Even after you have had both doses of the vaccine, continue to follow the recommendations of local public health officials to prevent the spread of COVID-19. Individuals may not be optimally protected until after receiving the second dose of the vaccine.

The most common or very common side effects of SPIKEVAX are pain at the injection site, tiredness, headache, muscle ache and stiffness, chills, fever, swelling or redness at the injection site, nausea and/or vomiting and enlarged lymph nodes. Allergic reactions may also occur.

Vaccination may not be suitable for everyone, so ask your healthcare professional if SPIKEVAX is right for you. Full product information can be found on https://www.modernacovid19global.com/ca/.  To report an adverse event, please call 1-866-MODERNA (1-866-663-3762).

© 2021 Moderna, Inc.

ISI-0006 09/2021

Sources

1 Centres for Disease Control and Prevention. COVID-19 vaccinations in the United States. U.S Department of Health & Human Services: September 2, 2021.

2 Public Health Agency of Canada. Canadian COVID-19 vaccination coverage report. Ottawa: Public Health Agency of Canada; August 21, 2021.

3 Moderna press release, August 12, 2021.

4 Moderna press release, September 1, 2021.

5, 7 Moderna press release, August 16, 2021.

6 Moderna press release, February 25, 2021.

8 2Q2021 Moderna Earnings Call Business Update presentation, August 5, 2021. (slide 9).

9 2Q2021 Moderna Earnings Call Business Update presentation, August 5, 2021. (slide 34).

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What I Wish I’d Known Before Tapering Off My Antidepressant

A stopgap measure morphed into a life-dimming experience. Here’s what tapering under medical guidance looked like for me.

A woman under a red umbrella watches the sun rise through the clouds

(Photo: iStock)

Going off medication because you feel better, says author Glennon Doyle, is like “standing in a torrential rainstorm holding a trusty umbrella that is keeping you toasty and dry, and thinking ‘Wow, I’m so dry, time to get rid of this silly umbrella.’” Sure, you may stay dry. But if you remain under the umbrella long after the skies have cleared, you may never feel the sun’s warmth.

I had not felt that warmth in years.

The storm clouds first appeared when my baby was not yet a year old. I spent most days pushing him around in a stroller, sobbing behind my sunglasses. For months, I waited for those ominous clouds to shift, and when they did not, I made an appointment. I explained to my doctor about the clouds—how they had appeared when I was in university, and now they were back. She prescribed an antidepressant, an SSRI called Celexa, and told me to enjoy my new baby.

Slowly but surely the clouds broke up. My baby grew into a toddler and, eventually, a preteen. My doctor kept refilling my prescription. Every morning, without hesitation, I took the little white pill. Since I had taken antidepressants once before, there was no discussion about side effects. My GP and I never talked about when I should come off the meds, or what I should do if they stopped working (the unfortunately dubbed “poop-out effect”), and I never asked. Instead, I deferred to my doctor’s professional judgment and trusted her implicitly. I was, after all, vulnerable and depressed.

I was also far from alone. According to the Centre for Addiction and Mental Health, by the time most Canadians turn 40, half of us have—or have had—a mental illness such as depression or anxiety. Rates are highest among women aged between 15 to 24, and women are three to four times more likely to attempt suicide than men. I have been that stat. A poster girl for melancholy. In the wake of COVID-related isolation, stress, and trauma, experts predict an epidemic of clinical depression. People who’ve never experienced depression may find themselves in its chokehold and will turn to their doctor for a solution. In many cases, that ‘solution’ will be an antidepressant.

Treatment for depression typically involves pharmacotherapy (drugs) and/or some form of therapy, such as cognitive behaviour therapy, interpersonal therapy, light therapy, or electroconvulsive therapy. According to an article in The Canadian Journal of Psychiatry, only half of Canadians experiencing a major depressive episode receive “minimally adequate care.” While medication is often necessary, the current system for treating mental illness is flawed—particularly for people of colour who face cultural stigma and additional barriers, like finding a therapist of colour familiar with their lived experience. Although I saw a therapist during university, during my postpartum depression, it was not a viable option. Long waitlists are woefully common, and when you’re depressed, you can’t afford to wait six months to a year for help. And at approximately $125 to $175 per session, the cost of therapy in Canada can be prohibitive and is rarely fully covered—even if you are lucky to have private insurance. This is something that needs to change, says Dr. Deanne Simms, clinical director of the Ontario Structured Psychotherapy Program at the Canadian Mental Health Association for York and South Simcoe. “Private providers are encouraged to offer services pro bono or on a sliding scale to those who would otherwise not be able to access them,” says Dr. Simms. “In the public sphere, we are seeing a concerted effort to offer Internet-delivered treatment or remote coaching via phone. Services are also being made available in primary care settings to ensure that people’s mental health care needs are being met at the same time as their physical needs.”

After my postpartum storm had passed, I figured I would simply taper off Celexa like I had in university, and revert to my former self. I figured wrong. What was initially a stopgap grew into what felt like dependency. Although the World Health Organization recommends that patients remain on antidepressants “at least nine to 12 months after recovery,” there are no firm guidelines on when to discontinue medication. That’s because drug treatment is highly individualized, based on a combination of medical history, personal preference and tolerability. For those with a history of depression, says Dr. Georgina Zahirney, president of the Canadian Psychiatric Association, it is often a matter of “weighing the risk of another depressive episode against the burden of a medication’s side effects.”

Since depression tends to be a recurrent illness, some people choose to take antidepressants indefinitely rather than risk a relapse. In other words, some people stay under the umbrella forever.

Initially, Celexa was a magic bullet. It worked wonders for me—until it didn’t. Sexual dysfunction, weight gain, sleep disturbance, emotional bluntness and suicidality were symptoms I experienced the longer I stayed on my SSRI. (Side effects, I later learned, can become more severe when an antidepressant is taken for more than three consecutive years.)

Ultimately, Celexa turned me into a shadow of my former self. I was no longer sad, but I wasn’t exactly happy, either. My doctor went on to have babies of her own, and given my history of depression, my new doctor was wary of my decision to taper. But rather than switch to a different antidepressant, I was determined—under my doctor’s guidance—to give my body a break. The schedule for tapering largely depends on the dose, duration and medication. “Some antidepressants are more difficult [to come off],” says Dr. Zahirney. “If you are on the minimum dose, and it’s a first depressive episode, you can usually halve the dose in two weeks and taper completely by four weeks once you have taken the medication for an adequate amount of time to treat the depression. This should be done after consultation with a clinician.” Because I had been on Celexa for several years, I had to take it slow and reduce my dose incrementally over several months.

Stopping antidepressants too abruptly can cause discontinuation syndrome, so Dr. Simms stresses the importance of tapering under medical guidance. “If you notice physical symptoms, such as tremors, hallucinations, confusion, dizziness, or shortness of breath, you should check in with your prescriber.”

While I didn’t experience those symptoms, nothing prepared me for how hard tapering would be, especially during the COVID-19 lockdown. I couldn’t visit or hug my friends or extended family. I couldn’t pop into a store or check out a gallery to get out of my own head for a while. The silver lining: Any stigma I may have felt about my depression had gone. The pandemic has created what Dr. Simms refers to as a normalizing effect. “It has opened people’s eyes to what some of the population has been experiencing for a while. A lot of us are struggling with fatigue, restlessness, irritability and low mood. People are now more likely to talk about it.”

I had started tapering before COVID-19 hit, and though I was sometimes tempted to reach for a little white pill, I did not. Before long, the black clouds rolled in, blocking out any trace of light. With my husband’s support, I persisted. He weathered my moods (think PMS on steroids) and grabbed me off the ledge more times than I can count. For days, I cycled between mania and rage. There were nights when I barely slept: my mind raced, my restless legs jumped, invisible bugs crawled all over my body. Every day I ran as if to outrun the clouds. I meditated and cried. I texted only my closest friends. I screamed at my husband and son then cried out of guilt and shame. Gradually, almost imperceptibly, the balance shifted; I cried less and smiled more. I started online therapy. Cracks of light seeped through the cloud cover. The storm may come again, so I remain vigilant of any distinctive changes in sleep, mood or appetite that signal a relapse may be on the horizon. At the first sign of something brewing, I will not hesitate to get help. For now, though, the skies are calm and clear.

When I took my last pill a few months ago, I raised a glass to the woman I used to be. I have a hard time remembering what she’s like, but I look forward to getting to know her again. It’s been a long time.

Originally published in 2020; updated in 2021.

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A Canadian Company That Thinks Outside The Honey Jar

Honey’s health benefits have been lauded since antiquity, and modern research backs them up. Now, a Canadian company introduces gummies made with natural honey

Created for Mediaplanet

It’s never been more important to guard our immune systems, as anybody who’s been paying attention to the news for the past year and a half knows all too well. Pathogens like COVID-19 aren’t the only things directly threatening our health. Psychological stress, which has been on the rise for most people, carries real physical risks. Unfortunately, stress can wear down the immune system at the time it’s needed most.

It turns out that a natural way to support the body’s defences is also one of the oldest. Honey — that sweet, sticky liquid we know and love for its delectable flavour and numerous culinary applications — has been the centre of many scientific studies for its anti-bacterial and antioxidant properties. Take it from Democritus, a Greek philosopher who lived to be 109 years old: “The secret of my health is applying honey inside and oil outside,” he once said. Or, take it from many of the modern studies looking at its long-prized health benefits. Free of additives, naturally antimicrobial honey stays fresh indefinitely, which is probably what first sparked the attention of ancient thinkers like Democritus.

The immune-supporting benefits of honey are pretty sweet

Naturally, immunity is an incredibly complex, multifaceted system. Its key players, in simple terms, are white blood cells (also known as lymphocytes). Made in bone marrow, these cells move through the body scouring for harmful intruders — namely bacteria, viruses, parasites, and fungi. This is where honey comes in: research shows that honey has antibacterial and antiviral properties.1 That’s pretty impressive for something that delicious.

If that weren’t enough, honey contains flavonoids and antioxidants that neutralize free radicals, which damage our cells, including the structures that make up the immune system. This damage can lead to chronic disease. Stress is another major cause of oxidative stress (another way to say free radical damage), making it more important to increase our regular consumption of powerful antioxidants like honey. Honey also happens to be a natural source of carbohydrates that’s lower on the glycemic index than high-fructose corn syrup and refined sugar, making it a great pre-and post-workout choice for those who want to reduce refined sugar intake and reap additional health gains while doing so.

Gummies made with honey as the first ingredient

While the power of honey is clear, not everyone is into eating tablespoons of it every day. Honibe, an innovative Canadian brand, created a line of gummies where pure Canadian honey is the number one ingredient.

For essential vitamins along with a daily dose of honey, try the citrus-flavoured Complete Multivitamin + Immune gummies. This multivitamin covers your nutritional bases and gets a boost from vitamin C, echinacea, zinc—and of course, pure honey as the #1 ingredient. Like all other Honibe products, it’s free from all the things you don’t want in a multivitamin: gluten, dairy, soy, artificial colours, flavours, sweeteners, and high fructose corn syrup.

No immune-supporting health regimen is complete without a good night’s sleep. Honibe’s strawberry-flavoured Melatonin Gummie Bees, with 2.5 milligrams melatonin per gummy, are designed for consumers who need a little extra help hitting the hay.

To learn more, visit honibe.com.

References

Viuda-Martos, M. et al (2008) Functional Properties of Honey, Propolis, and Royal Jelly Food Sci 73(9): R117-R124

Abdulrhman, M. et al (2013) Effects of honey, sucrose and glucose on blood glucose and C peptide in patients with type 1 diabetes mellitus Comp Ther Clin Practice 19:15-19

Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders and Charles Perkins Centre, University of Sydney Glycemic Index Research and Index Database

1 Antibacterial Potency of Honey, Antiviral Activities of Honey, Royal Jelly, and Acyclovir Against HSV-1.

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How To Keep Your Pelvic Floor Healthy

Problems with pain, incontinence or uncomfortable sex? You might suffer from poor pelvic-floor health.

An image of a cartoon woman holding her pelvis in pain.

(Photo: Getty Images)

Guess what? Peeing a little every time you sneeze isn’t a normal part of the aging process, but a sign of poor pelvic-floor health. It’s also not entirely your children’s fault: While pregnancy and vaginal delivery can result in poor pelvic-floor control, physiotherapist Amadea Kezar says other culprits include chronic constipation, repetitive impact activities, lower back problems, a loss of estrogen and collagen, and even bad posture.

Kezar, who owns ASK Physiothérapie in Montreal, says pelvic-floor health depends on an entire system: Picture a sling between the pubic bone and the tailbone, made up of 14 muscles along with the nerves and connective tissue inside and at the base of the pelvis. “These muscles are important for bladder and bowel health,” says Kezar. “They also support the pelvic organs: the uterus, bladder, vagina and rectum. And they form part of your core.”

Along with incontinence, poor pelvic health can result in pain, including during sex. The good news, Kezar says, is that there are a wide range of potential fixes, some of which can be done at home. Physiotherapists ensure you’re working the right muscles, so it’s best to consult one even if you ultimately want to go the self-help route.

Get handsy

Manual therapy can be done internally and/or externally by a trained physio. This helps identify the problems and treat them. Techniques include tapping, strumming, stretching, desensitizing and releasing of stiff tissue. Patients will learn to use their own hands, as well, which is empowering.

Muscle memory

Breath work can help coordinate the pelvic floor with the core, while localized exer-cises develop strength, endurance, reflexes and relaxation. More dynamic exercises, like squats, can train the muscles surrounding the pelvic floor. Physiotherapists intervene with tools like dilators and biofeedback.

Game time

Take things into your own hands with Perifit, a joystick-type device that’s in-serted into the vagina, then paired with a smartphone app for strengthening games. Think Angry Birds for your vag: fun, easy and surprisingly addictive

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