Knowing how to slice, cook your onions makes big difference

SARA MOULTON, THE ASSOCIATED PRESS

Back in the ’80s and ’90s, I used to work behind the scenes with Julia Child during her appearances on “Good Morning America.” It was my job to prepare the food she would put before the cameras.

Once, when I knew in advance that I couldn’t be there for one of her upcoming appearances, I invited a pal of mine — a culinary professional — to try out for the gig. We prepped the food as usual, and at the end of the day I thought my friend had done a dandy job. Julia flatly disagreed and said she wouldn’t hire her. I was flabbergasted. “Why not?” I asked.

“Because she sliced the onions the wrong way,” Julia replied.

Yikes! I simply hadn’t focused on how my friend sliced the onions. I didn’t think this detail was that important. But all these years later, I realize Julia was right. Exactly how you slice an onion makes a difference. So does how you cook it.

Everyone knows that chopping onions can literally bring tears to your eyes. Here’s why. When an onion’s cells are ruptured, they give off pungent sulfur fumes. The more roughly an onion is treated — such as when it is chopped with a dull knife or pulsed in a food processor — the more fumes it gives off.

There are any number of quaint folk remedies for this problem. Put a piece of bread in your mouth while you’re chopping. Do your chopping near a running faucet. And so on. None of them works.

What does work — at least when you’re chopping up a lot of onions — is wearing onion goggles. Modeled on welder’s goggles, these babies prevent the onion’s fumes from reaching your eyes. But the best everyday tactic is to chop or slice the onion quickly and with a very sharp knife. Chilling the onion for an hour or two ahead of time also is a good idea.

Having managed to blunt an onion’s ability to bring you to tears, let’s turn to the correct way to slice one, a la Julia. Lengthwise, not crosswise, is the way to roll. Cutting an onion in half through the root end and then slicing it from stem to stern stimulates far fewer sulfur fumes. These lengthwise slices also happen to hold together much better than crosscut slices, precisely because you’ve sliced with the grain instead of against it. This is especially important for a dish like onion soup, when you want the slices to maintain their shape.

Finally, we come to how to cook an onion, which affects not just the flavour of the onion, but of the whole dish. If you throw it into a hot pan and quickly saute it over high heat, the onion and the dish it’s added to will be bland. If you do it slowly over low heat, you’ll maximize the onion’s flavour.

All of these tips apply to making my Alsatian onion pie. The French call it tarte flambee. The Germans call it Flammkuchen. It strikes me as more like a pizza than anything else. I tasted it for the first time on a river cruise in France a couple years ago, and I was really knocked out by its combination of simplicity and big flavour. Accompanied by a fresh salad, this treat would make the perfect light supper for the beginning of spring.

ALSATIAN ONION PIE
Start to finish: 1 hour 15 minutes

6 oz bacon, thinly sliced crosswise
4 cups thinly sliced yellow onion
kosher salt and ground black pepper
8 oz creme fraiche
1 large egg yolk
pinch nutmeg
1 1/2-lb ball purchased pizza dough, room temperature
3 oz coarsely grated Gruyere cheese

1. In a large skillet over medium, cook the bacon, stirring, until it starts to brown, 5 to 8 minutes. Transfer the bacon to paper towels to drain and pour off all but 2 tablespoons of the fat from the skillet. Return the skillet to medium heat and add the onions. Cook, covered, stirring occasionally, until very soft, about 10 minutes. Remove the cover and cook, stirring occasionally, until golden, about another 30 minutes. Season with salt and pepper, then set aside.
2. Heat the oven to 500°F. Arrange one of the oven racks on the oven’s bottom shelf.
3. In a small bowl, stir together the creme fraiche, egg yolk, nutmeg and a pinch each of salt and pepper.
4. Divide the dough into 3 even pieces. On a lightly oiled surface, roll out each piece into a 10-by-12-inch rectangle about 1/8-inch thick. Transfer each to a 15-by-17-inch sheet of kitchen parchment. The dough may shrink and lose its shape. If so, roll it again on the parchment.
5. One at a time, transfer each piece of parchment and dough to a bak sheet (unless your oven can fit 2 sheets on one shelf, you’ll need to bake these one at a time). Spread a third of the creme fraiche mixture over the piece of dough on the baking sheet, then top with a third of the onions and bacon. Sprinkle with a third of the cheese, then bake on the oven’s lower shelf for 10 minutes, or until the crust is crisp. Repeat with remaining dough and toppings. Serve right away.
makes three 10- to 12-inch pizzas

Nutrition information per half pizza: 640 calories; 310 calories from fat (48 per cent of total calories); 35 g fat (16 g saturated; 0 g trans fats); 120 mg cholesterol; 1260 mg sodium; 60 g carbohydrate; 4 g fibre; 6 g sugar; 17 g protein.

Land Gold Women puts focus on honour killings

Louis B. Hobson- Calgary Herald
This year’s Oscar for best documentary short went to Sharmeen Obaid-Chinoy’s A Girl in the River: The Price of Forgiveness.

It focused on the plight of an 18-year-old girl in Pakistan who incurred the wrath of her father and uncle when she eloped with a man she loved who was not her family’s choice for her.

As Obaid-Chinoy explained in her acceptance speech, every year more than 1,000 young girls and women fall victim to barbaric religious practices which sanction honour killings.

Moved by the international outcry surrounding Obaid-Chinoy, the president of Pakistan announced he will have his justice ministers look into changing the laws that protect the men from any repercussions especially if it is a family member who dies at their hands.

Watching the Oscars, and especially the win for A Girl in the River, Niru Bhati, the artistic director of Calgary’s Hidden Gems Film Festival, knew she had to find a film about honour killings for Hidden Gem’s March offering.

Bhati also knew that film had to be Avantika Hari’s 2011 award-winning film Land Gold Women, so she called the filmmaker at her home in England to get permission to screen the film on March 20 at 2:30 p.m. in the amphitheatre of the Alberta College of Arts & Design in the building adjacent to the Jubilee Auditorium.

“When we see films about honour killings in Pakistan or India — and there are some very disturbing ones — it’s too easy to dismiss the subject because it’s happening in those countries,” Bhati says.

“The thing about Land Gold Women is that it is set in contemporary Birmingham and the father is not an uneducated man. He teaches at the University of Birmingham.

“It’s only when his very traditional brother arrives from Pakistan that he is drawn back into a cultural mindset that condones punishment for women who disobey their fathers,” says Bhati.

“This man’s great dilemma is whether to risk losing his daughter or all family ties.

“He’s not a monster but what he might do is definitely monstrous.”

Bhati says the film also “looks at how western countries try to punish these cultural crimes in modern courts and that is not always easy.

“It also asks very clearly and effectively what’s honourable about any killing.”

Bhati stresses that Land Gold Women is “not only a timely film but the only one I thought was appropriate for our audiences.”

While she had Hari on the phone, Bhati asked if she could also screen the filmmaker’s short film Hat Day, which had impressed Bhati for its ability to move audiences in such a brief time.

“Anushka was thrilled that I wanted to show Hat Day as short films get so little exposure.”

Tickets are $15 at the door for cash only.

The popular Chai Cafe opens from 1:30 to 2:15 p.m.

A drink a day may not keep the doctor away

By kelly Sinoski & Randy shore, Vancouver Sun
If you’ve been toasting recent headlines that declared alcohol a life-extending elixir, you might want to put a cork in it.

A party-pooping new study from the University of Victoria took a closer look at data from 87 long-term studies, many of which suggest that moderate drinking has protective health benefits such as reducing the risk of heart disease, stroke and diabetes.

Sadly, many of those studies goofed. Tim Stockwell of UVic’s Centre for Addictions Research said previous research has over-estimated the health benefits of alcohol.

The studies — involving nearly four million people — did not properly define those who abstained from drinking, many of whom may have been heavy drinkers before they stopped the tipple altogether, he said.

At first glance, the data analysis showed that low-volume drinkers (those who had up to two drinks a day) had lower mortality risks than those who abstained from alcohol.
But abstainers include many people whose poor health has led them to cut down or completely abstain. They make the health and life expectancy of moderate drinkers look good by comparison.

Once the authors adjusted for errors such as how abstainers are defined, they found that the protective effect of light drinking disappeared.

“The bottom line is that we need to be more skeptical of claims that low-volume alcohol consumption is good for you, and take a long, hard look at how studies around alcohol and health are designed,” said Stockwell.

The authors also suggest that improved methods are required to make unbiased estimates of alcohol’s health impacts, and that although alcohol is recognized by international health authorities as a leading cause of preventable death, illness and injury, the extent of this is underestimated.

This could have major implications for the crafting of alcohol policies and for physician advice about low-risk drinking, Stockwell said.

“If you’re going to drink, drink under the low-risk drinking guidelines: less than two drinks for women and three drinks for men,” he said. “Drinking in these limits, you’re unlikely to have a problem.”

The study was published Monday in the Journal of Studies on Alcohol and Drugs.

South Asian history initiative helps Royal Columbian cardiac care

100 Year Journey supports campaign to upgrade hospital’s cardiac cath lab

New Westminster, B.C. – {December 10, 2015} – An effort to preserve and share the stories of South Asian pioneers to Canada has also resulted in generous support to BC’s busiest cardiac care centre.

Proceeds from the 2nd annual 100 Year Journey gala are included in a $30,000 donation presented to Royal Columbian Hospital Foundation’s Cardiac Care Campaign.

The gift to the Foundation will help bring the latest technology and equipment to Royal Columbian Hospital’s cardiac catheterization lab – the busiest in the province and serving the entire Fraser Health region.

“Royal Columbian’s cath lab serves one in every three British Columbians, including one of the country’s largest populations of South Asians,” notes entrepreneur Rana Vig, who launched the 100 Year Journey last year and joined the board of Royal Columbian Hospital Foundation this past June. “In light of concerns about heart disease in the South Asian community, my family knows a donation to the cath lab will help save lives.”

The 100 Year Journey aims to provide Canadians with a better understanding of the South Asian community and the contributions they have made to the country. A 150-page book was released on November 29, 2014, sharing the history of 100 South Asian pioneers to Canada. The 2nd annual gala was held on October 3, 2015.

“Royal Columbian Hospital’s origins, just like the pioneers of the South Asian community, go back more than a century in this province,” notes Royal Columbian Hospital Foundation President and CEO Jeff Norris. “It’s an honour to be associated with such a worthy and informative project as the 100 Year Journey.”

The Foundation’s Cardiac Care Campaign has a $3.3 million dollar fundraising goal to upgrade Royal Columbian Hospital’s two cath lab suites, which are available 24/7 for cardiac emergencies like acute heart attacks. The interventional cardiology team performs high-levels of angioplasty to restore blood flow to blocked arteries and conducts angiograms to diagnose heart disease and other cardiac problems.

Donations from individuals, businesses, community groups and foundations will help replace the cath lab’s imaging equipment and hemodynamic monitoring technology. Both are essential components of the lab and work in tandem to provide accurate information for safe and efficient patient care.

Those suffering from heart attacks across the health region are regularly rushed from their homes straight to Royal Columbian’s cath lab, at times arriving by air ambulance for immediate, emergency care. Annually, the interventional cardiology team performs 2,300 angioplasties and 3,100 diagnostic catheterizations – the most in the province.

Royal Columbian Hospital Foundation is appealing for your help today to renew the hospital’s two cath lab suites without further delay to ensure they continue to provide the most advanced care to those who urgently need it. Donate today to the Cardiac Care Campaign by visiting www.rchfoundation.com/heart or phoning 604.520.4438.

Province launches MRI strategy, funds increased number of scans

Demand for medical imaging in B.C. has never been greater. Premier Christy Clark and Health Minister Terry Lake today announced a new four-year strategy for magnetic resonance imaging (MRI) services to help health authorities increase patient access to MRI scans.

“With an ageing population, health authorities face increasing demand for medical imaging services,” said Premier Clark. “This is what having a strong, growing economy allows us to do – invest in a new strategy to address waitlists throughout the province, and continue to deliver the services British Columbians depend on.”

“We recognize that access to MRIs has been a challenge and this strategy will make sure we better meet the health care needs of British Columbians now and into the future,” said Health Minister Lake. “By improving how we manage MRI diagnostics, we can provide families with peace of mind that comes with faster diagnosis and treatment.”

The MRI strategy takes a two-pronged approach. The first priority is to increase the number of scans—adding up to 65,000 more annually by the end of four years to help address increasing demand and existing wait lists. The ministry and health authorities will also review the governance, service delivery and funding models for MRIs, to ensure an accessible, sustainable medical imaging system.

“We see the difference access to MRIs make in the lives of patients each and every day,” said Dr. Stuart Silver, clinical section head and acting medical director, medical imaging services, Island Health. “On the ground, we look forward to the strategy enhancing patient care and improving speed of diagnosis to get people back to their lives.”

Health authorities are currently finalizing plans for increasing their MRI volumes, including how quickly increases can be put in place. Health authorities have committed to increase the number of MRI exams performed annually by 45% by year four of the strategy. Budget allocations for MRIs will increase correspondingly, providing up to an additional $20 million in annual funding for these services by year four. Health authorities will also be developing plans for improving timeliness, ensuring appropriate referrals for service and increasing geographic access to MRIs in the future.

MRI scan volumes will be increased by extending operating hours for MRI machines, so more patients can be served each day. This means that some patients will be scheduled to receive their scans during evening or night-time hours. Health authorities may also contract private facilities to perform additional procedures.

British Columbia’s strong economic growth and fiscal discipline have enabled government to return a dividend to British Columbians by investing to further improve patient access throughout B.C. Over the past decade, B.C. has acquired 16 new MRI scanners for hospitals, for a total of 25 – a 178% increase. This has helped B.C. significantly increase the number of MRIs done in the public system over the past 10 years from 67,030 in 2004-05 to over 143,000 in 2014-15.

Health authorities will also provide more evidence-based guidance to physicians to ensure they order the best type of scan to meet each patient’s specific medical needs. MRI scans are important diagnostic tools; however different types of medical imaging can be used to diagnose certain conditions. In some cases, an x-ray, ultrasound, Computed tomography (CT) or Positron Emission Tomography (PET) scan may be more appropriate.

Ensuring the right advanced imaging service is provided to British Columbians in a timely fashion will help manage wait lists and provide for smarter, more effective service at the patient level. Today’s announcement supports government’s priority of timely and appropriate access to needed health services through a truly integrated health care system that works for patients.

Magnetic resonance imaging (MRI) is a safe and painless test that uses a magnetic field and radio waves to produce detailed pictures of the body’s organs and structures. MRIs are used to diagnose a number of medical conditions, including abnormalities of the brain, as well as tumours, cysts and soft-tissue injuries in other parts of the body.

Below are facts based on extensive evidence compiled by police departments on their interactions with street level Dial-a-Dope involved youth.

Dial-a-Dopers are drawn to gang life by the prospect of making a great deal of money.

Dial-a-Dopers make very little money.

Dial-a-Dopers will front (provide without payment) drugs to their trusted customers.

Dial-a-Dopers are at risk of being ‘ripped off’ of their drugs.

Dial-a-Dopers are almost always held responsible for any losses.

Despite the strict control of the gang leader, it is common for Dial-a-Dopers to accumulate debts.

The gang leader will not always know who his Dial-a-Dopers are and the Dial-a-Dopers do not always know whom they are working for.

Dial-a-Dopers are not well protected by the gang leaders. Given the secrecy of gang life, the families of Dial-a-Dopers are not well-protected from any direct involvement in the transactions.

Dial-a-Dopers almost always have a valid driver’s license.

Most gangs do not give the Dial-aDopers access to stolen vehicles for transporting drugs.

Before being hired by a gang, Dial-a- Dopers do not need to show loyalty by stealing from a rival gang.

Despite their low level in the gang hierarchy, it is not easy for Dial-aDopers to leave the gang at any time.

How to cut your monthly grocery bill in half, from a woman who lived on $14,000 a year

Associated Press

Kathleen Elkins, Business Insider

A simple way to trim your grocery bill is to buy less meat. “Try substituting beans and wheat berries for meat in your favorite recipes,” Wagasky suggests. “Enchiladas, spaghetti, and casseroles taste just as good with the meat omitted.”

If you have a harder time parting ways with your meat, start by establishing one meatless day a week. Eliminating meat just once or twice a week can make a significant difference in your grocery bill.

Go generic

Go generic whenever possible. It will save you money.

“There are some things my husband and I have learned truly taste the same as the name brand, while others can’t compare,” Wagasky writes. “The only way to know if you’ll like a product is to try it.”

Her pro-tip when shopping for generics: “Make sure to look up and down the shelves of food. Most grocery stores put the name brand items at eye level. They want that to be what the consumer focuses on. Generic brands are usually on the bottom shelf or the top shelf, so keep those eyes open.”

Stock up seasonally

Sometimes, when you buy is more important than where you buy.

“Buying seasonally is a great way to save and build up a stockpile,” Wagasky writes. “Each month grocery stores offer certain sales on items.”

For example, in the summer, barbecue items will be at rock-bottom prices, making it the perfect time to stock up on chips, crackers, ketchup, relish, mayo, and mustard.

Along the same lines, seasonal fruits and vegetables are cheaper, and they also taste better.

Eat produce in order

Flickr / Jamie McCaffrey/Business Insider

Produce can be tricky to shop for, as their expiration dates are not very forgiving. To make fruits and veggies last significantly longer, eat them in order, starting with the things that will go bad the soonest.

Here’s Wagasky’s guide:

First: bananas, berries, cherries, kiwis, avocado, spinach, lettuce, and grapes

Second: tomatoes, mango, peaches, pears, melon, apricots, and zucchini

Third: cucumbers, pineapple, and pomegranates

Last: carrots, potatoes, celery, apples, grapefruit, and oranges

Go homemade

Thinkstock

“Over the years, I have learned that the more we can make at home, the better off our grocery budget will be,” Wagasky writes. “In our home, we try to make as much from scratch as possible.”

One item she’s saved significantly on by going homemade is bread, a staple in her household: “If I were to buy bread from the store, I would be paying over three dollars per loaf. Thirty-six dollars a month is a hefty fee to pay for something I can make in minutes for one-third the cost.”

Wagasky also chooses to make homemade granola bars and trail mix rather than spending on prepackaged snacks, which tend to be pricey and unhealthy.

British Columbia’s education by the numbers

BC- A snapshot of facts about the British Columbia’s education system, shows that BC  has 1,581 public schools and 350 independent schools and there will be estimated 521,038 full-time public school students this September.  Following are the facts as to how the funding, enrollment, achievements, capital, healthy schools and  what the class sizes are in the current school systems.

Funding

  • This coming fiscal year (2015-16), total funding to school districts will reach $5.06 billion – up 31% since 2001.
  • The average per-pupil funding is now an estimated $8,902, an increase of 42% since 2000-01.
  • Last school year, total funding for all students (public and independent) with special needs was approximately $920 million.
  • This year, school districts will receive $51.7 million through CommunityLINK, which help them fund programs to support vulnerable children and youth. Districts use this funding to fund breakfast and lunch programs, inner-city and community school programs, school-based support workers and counselling.
  • Government has increased the Learning Improvement Fund (LIF) allocation to school districts by more than 66% since 2013-14 – to $100 million in 2015-16. The LIF was established to address complex classroom needs and ensure learning conditions are appropriate for all students.
  • Under the new agreement with teachers, LIF will be maintained at $100 million in each of the next three years, and will rise to more than $106 million in 2018-19.
  • This past school year (2014-15), districts told the Ministry they intended to use the LIF to:
    • Hire 1,100 new teachers;
    • Hire 352 new support staff; and
    • Increase the hours of nearly 2,600 support staff and teachers from part-time to full-time.

Enrolment

  • Estimated 521,038 full-time public school students this September.
  • Since 2000-01, there has been a decrease of nearly 77,000 students.
  • Estimated 58,513 English Language Learning (ELL) students – 640 fewer than last year.
  • Estimated 55,414 Aboriginal students – 252 fewer than last year.
  • Estimated 25,337 students with special needs (eligible for supplemental funding) – 277 fewer than in last year.
  • Estimated 3,415 non-graduated adult students – 103 more than last year.
  • Nearly 78,500 students took at least one online (distributed learning) course in 2014-15. That compares to approximately 33,000 students in 2006-07.

Achievement

  • The provincial six-year completion rate has increased by more than 10% since 2001 and was at 84.2% in 2013-14 (public and independent schools). Over that same period:
  • The six-year completion rate for Aboriginal students has increased by 45.6% and now is at 61.6%;
  • The six-year completion rate for ELL students has increased by 12.5% and now is at 86.6%;
  • The six-year completion rate for students with special needs has increased by 86.2%and now is at 62.2%.

Capital

  • Budget 2015 provides $1.4 billion over three years to replace aging facilities, build more student spaces in growing communities and improve school seismic safety where needed.
  • Since 2001, government has committed more than $4.2 billion in new and improved schools, including $2.2 billion in seismic upgrades.
  • To date, government funding has built 42 new schools, replaced 70 aging schools, added space through 186 schools additions and seismically upgraded 146 schools.
  • New schools that have recently opened include the:
    • $7.4-million NorKam Trades and Technology Centre in Kamloops;
    • $23.8-million École Qayqayt Elementary in New Westminster;
    • $26-million Yorkson Creek Middle school in Langley;
    • $51.6-million Oak Bay High in Victoria;
    • $56-million Chilliwack Secondary.

Healthy Schools

  • The BC School Fruit and Vegetable Nutritional program provides snacks of fruits and vegetables right in the classroom to children, allowing them to sample B.C. produce such as plums, blueberries, apples, tomatoes and carrots. The Ministry of Health and the Provincial Health Services Authority have provided combined funding of $21.5 million to the BC Agriculture in the Classroom Foundation since 2010-11 to support the program.
  • In May 2015, government announced $3.5 million in new funding for the program to ensure it continues to bring fruits, vegetables and milk to more than 489,000 children in 1,463 public and First Nations schools.
  • The Guidelines for Food and Beverage Sales in BC Schools are to be used in every school district to maximize students’ access to healthier options and fully eliminate the sale of unhealthy foods and beverages in B.C. schools.
  • Through the Daily Physical Activity requirements, students in all school districts are required to achieve daily activity targets:
    • Students in kindergarten to Grade 7 will engage in 30 minutes of daily physical activity at school;
    • Students in Grades 8 and 9 will engage in 30 minutes of daily physical activity or 150 minutes of physical activity per week;
    • Students in Grades 10 to 12 will engage in 150 minutes of physical activity per week as part of their Graduation Transition program.

Class Size

  • Class sizes in B.C. remain low and stable. The average number of students per class was near historical lows last school year (2014-15) and well below the maximum size allowed in provincial legislation.
  • Of the 66,596 K-12 classes in B.C. public schools last year:
    • 41% had fewer than 24 students;
    • 57% have between 24 and 30 students;
    • Only 1.6% of classes had more than 30 students and the majority of these are classes such as band, drama and gym where it is appropriate and beneficial to have a larger number of students.
  • Average class sizes:
    • 19.5 students for Kindergarten;
    • 21.5 students for grades 1-3;
    • 25.6 students for grades 4-7;
    • 23.2 students for grades 8-12.
  • There were nearly 9,400 full-time educational assistants working in schools in 2014-15, an increase of 42% compared to 2000-01. Approximately one-in-three classes in B.C. have an assigned educational assistant.

Independent schools

  • Independent schools enrol nearly 81,000 students, which is approximately 13% of B.C.’s K-12 population.

All kinds of Canadians neglect their feet, but that can be a life-altering decision for people with diabetes.

The chances of having a toe or foot amputated due to an infected wound are about 20 times higher for a diabetic. And a lower limb amputation often starts a spiral of decline: up to two-thirds of patients die within a year.

“There’s a high risk of death following amputation. In fact, the mortality rate is greater than some cancers,” explains Dr. Jan Hux, chief science officer for the Canadian Diabetes Association.

That organization is on a mission to remind the growing number of people with diabetes to baby their feet like never before. Thousands of Canadians are expected to lose their toes or feet each year despite advances in care that have brought the rate of amputations down among diabetics. That’s because the sheer number of people diagnosed is forecast to rise to 4.2 million by 2020.

There were 4,400 diabetes-related amputations across the country in 2008, the last year for which reliable data are available. That marked a small increase from 4,020 10 years earlier, according to the Canadian Chronic Disease Surveillance System.

The road to the operating room starts with foot numbness called diabetic neuropathy.

“Pain is an important defence mechanism. If you or I had a pebble in our shoe, we wouldn’t walk three steps without taking it out. The person with diabetes will walk on it all day,” says Hux.

That creates a sore that remains unnoticed because nerves to their feet have been damaged due tohigh blood sugar and a lack of oxygen from poor blood flow. That same lack of circulation — again coupled with high blood sugar — creates the perfect environment for infections to grow.

“They’re more likely to get an injury and they’re less likely to be able to heal it,” says Hux. That’s why diabetes accounts for up to 70 per cent of all non-traumatic limb amputations.

Wayne Sidsworth, a 56-year-old management consultant from Hamilton, Ont., watched the process claim his foot in a matter of days. He had been diagnosed at 37 with type 1 diabetes and thought he had it under control. It turned out that a blockage in the main artery of his leg — likely formed before he knew he had diabetes — couldn’t be repaired through several surgeries.

He knew then his lower leg would have to come off, but was unprepared to watch a tiny cut on the sole of his foot transform from a dime-sized sore to a gangrenous limb over the course of a weekend. A surgeon removed it in an emergency operation on the Monday morning.

“I woke up at 9 o’clock without my leg,” Sidsworth recounts. “I got through that part OK. The hard part was rehabilitation, learning how to walk again.”

His advice to others? Get diagnosed. Sidsworth believes he could have avoided some of the damage by getting his blood sugar down from its sky-high levels earlier.

Hux agrees, but goes further. The CDA says 57 per cent of diabetics don’t follow doctors’ orders because they can’t afford the medical supplies to monitor their blood sugar levels or the medications that can help. As a result, only half of Canadians with type 2 diabetes have their blood glucose levels under control and therefore run the risk of slow-healing wounds along with heart diseasekidney damage and blindness. That’s why the CDA endorses proposals for a national Pharmacare program to make sure low- and middle-income patients receive proper care.

“If people can manage their blood sugars well and have the resources they need to do that, then the damage to the nerves won’t happen. This cascade can be avoided where a barefoot walk in the park leads to a below-the-knee amputation,” says Hux.

Sole searching

Foot care advice from the Canadian Diabetes Association:

  • Wear shoes that fit with clean socks.
  • Avoid going barefoot — even in the house — or wearing flip-flops or footwear that presses in one spot.
  • Check your feet daily for cuts, sores and cracks, using a hand mirror to see the bottoms if needed.
  • Don’t use over-the-counter corn and wart removers.
  • Seek help if you notice a wound. Foot specialists can offer advice for protecting a sore.
  • The CDA’s Clothesline program is collecting gently used shoes to distribute to homeless shelters across Canada. For more information call 1-800-505-5525 or download the Clothesline app to find the nearest drop box.

Diabetes in brief

Blood sugar. The key factor in all diabetes is the body’s inability to process sugar. It can be caused by a lack of insulin — the hormone produced by the pancreas to regulate it — or insulin resistance, which is a key indicator of pre-diabetes. Regular finger-prick blood tests throughout the day show diabetics their blood sugar levels so they make changes in food intake, exercise or medication to keep them stable. Uncontrolled high blood sugar causes damage throughout the body. Prolonged high or low blood sugar can cause a diabetic coma.

Type 1 diabetes. Also known as juvenile diabetes, the disease is often diagnosed in children and teens and typically require insulin injections to stabilize blood sugar. It accounts for about 10 per cent of cases and is a serious chronic illness that requires a lifetime of attention.

Type 2 diabetes. This condition is a fast-growing plague in North America that now makes up 90 per cent of all diabetes. It can be brought on by carrying extra weight, a lack of exercise and poor diet. It can sometimes be controlled by lifestyle changes. Damage to the body accumulates the longer it goes uncontrolled.

The epidemic. In 2000, 1.3 million Canadians had diabetes. Ten years later that number more than doubled to 2.7 million. It affects every sphere of society, but has hit First Nations particularly hard, with prevalence about 40-per-cent higher than the rest of Canada.

Sources: Canadian Diabetes Association, National Diabetes Surveillance System

Vancouver Sun

Diabetics face thousands of amputations each year

ERIN ELLIS, VANCOUVER SUN

All kinds of Canadians neglect their feet, but that can be a life-altering decision for people with diabetes.

The chances of having a toe or foot amputated due to an infected wound are about 20 times higher for a diabetic. And a lower limb amputation often starts a spiral of decline: up to two-thirds of patients die within a year.

“There’s a high risk of death following amputation. In fact, the mortality rate is greater than some cancers,” explains Dr. Jan Hux, chief science officer for the Canadian Diabetes Association.

That organization is on a mission to remind the growing number of people with diabetes to baby their feet like never before. Thousands of Canadians are expected to lose their toes or feet each year despite advances in care that have brought the rate of amputations down among diabetics. That’s because the sheer number of people diagnosed is forecast to rise to 4.2 million by 2020.

There were 4,400 diabetes-related amputations across the country in 2008, the last year for which reliable data are available. That marked a small increase from 4,020 10 years earlier, according to the Canadian Chronic Disease Surveillance System.

The road to the operating room starts with foot numbness called diabetic neuropathy.

“Pain is an important defence mechanism. If you or I had a pebble in our shoe, we wouldn’t walk three steps without taking it out. The person with diabetes will walk on it all day,” says Hux.

That creates a sore that remains unnoticed because nerves to their feet have been damaged due to high blood sugar and a lack of oxygen from poor blood flow. That same lack of circulation — again coupled with high blood sugar — creates the perfect environment for infections to grow.

“They’re more likely to get an injury and they’re less likely to be able to heal it,” says Hux. That’s why diabetes accounts for up to 70 per cent of all non-traumatic limb amputations.

Wayne Sidsworth, a 56-year-old management consultant from Hamilton, Ont., watched the process claim his foot in a matter of days. He had been diagnosed at 37 with type 1 diabetes and thought he had it under control. It turned out that a blockage in the main artery of his leg — likely formed before he knew he had diabetes — couldn’t be repaired through several surgeries.

He knew then his lower leg would have to come off, but was unprepared to watch a tiny cut on the sole of his foot transform from a dime-sized sore to a gangrenous limb over the course of a weekend. A surgeon removed it in an emergency operation on the Monday morning.

“I woke up at 9 o’clock without my leg,” Sidsworth recounts. “I got through that part OK. The hard part was rehabilitation, learning how to walk again.”

His advice to others? Get diagnosed. Sidsworth believes he could have avoided some of the damage by getting his blood sugar down from its sky-high levels earlier.

Hux agrees, but goes further. The CDA says 57 per cent of diabetics don’t follow doctors’ orders because they can’t afford the medical supplies to monitor their blood sugar levels or the medications that can help. As a result, only half of Canadians with type 2 diabetes have their blood glucose levels under control and therefore run the risk of slow-healing wounds along with heart diseasekidney damage and blindness. That’s why the CDA endorses proposals for a national Pharmacare program to make sure low- and middle-income patients receive proper care.

“If people can manage their blood sugars well and have the resources they need to do that, then the damage to the nerves won’t happen. This cascade can be avoided where a barefoot walk in the park leads to a below-the-knee amputation,” says Hux.

Sole searching

Foot care advice from the Canadian Diabetes Association:

  • Wear shoes that fit with clean socks.
  • Avoid going barefoot — even in the house — or wearing flip-flops or footwear that presses in one spot.
  • Check your feet daily for cuts, sores and cracks, using a hand mirror to see the bottoms if needed.
  • Don’t use over-the-counter corn and wart removers.
  • Seek help if you notice a wound. Foot specialists can offer advice for protecting a sore.
  • The CDA’s Clothesline program is collecting gently used shoes to distribute to homeless shelters across Canada. For more information call 1-800-505-5525 or download the Clothesline app to find the nearest drop box.

Diabetes in brief

Blood sugar. The key factor in all diabetes is the body’s inability to process sugar. It can be caused by a lack of insulin — the hormone produced by the pancreas to regulate it — or insulin resistance, which is a key indicator of pre-diabetes. Regular finger-prick blood tests throughout the day show diabetics their blood sugar levels so they make changes in food intake, exercise or medication to keep them stable. Uncontrolled high blood sugar causes damage throughout the body. Prolonged high or low blood sugar can cause a diabetic coma.

Type 1 diabetes. Also known as juvenile diabetes, the disease is often diagnosed in children and teens and typically require insulin injections to stabilize blood sugar. It accounts for about 10 per cent of cases and is a serious chronic illness that requires a lifetime of attention.

Type 2 diabetes. This condition is a fast-growing plague in North America that now makes up 90 per cent of all diabetes. It can be brought on by carrying extra weight, a lack of exercise and poor diet. It can sometimes be controlled by lifestyle changes. Damage to the body accumulates the longer it goes uncontrolled.

The epidemic. In 2000, 1.3 million Canadians had diabetes. Ten years later that number more than doubled to 2.7 million. It affects every sphere of society, but has hit First Nations particularly hard, with prevalence about 40-per-cent higher than the rest of Canada.

Sources: Canadian Diabetes Association, National Diabetes Surveillance System