Someone I love is being bullied – and it is breaking my heart. We spend lots of time talking about bullying, wear our pink shirts, react to stories on social media, but really we have done absolutely nothing as a society to address bullying. Sorry, let me correct that – in actuality what we have done is lots to reward the bully, and make life a living hell for those being bullied.
My loved one’s bullying began in elementary school, ironically it was easier to handle then. As parents we could intervene, we could tell the school what we expected to happen and we controlled where our kids went. Wow – that’s right, this bullying actually began in elementary school – and the whole experience in dealing with the bully was a nightmare, extending beyond school into sports. And then came high school and suddenly it stopped, perhaps there were new targets for a few years. And we enjoyed a couple of years of relative peace, although still had some issues when playing sports on teams where the bully was present. And then out of the blue, the bully struck again, same old behaviours including a threat to kill my loved one. This was the 3rd time this individual has made such a threat. So we did what we needed to, contacted the police (again for the 3rd time), contacted the administrators at the school (can’t even count how many times we have done that). A physical altercation occurred, and my loved one stood their ground and defended themselves. My loved one did what they should have and needed to do to end this, but it didn’t end there. Because the bully did not get the result they wanted, so it continues. We have followed the advice of the police to a tee, and yet my loved one suffers because of that. Because in the you tube age where everyone just wants to get a good video to share, my loved one is called names because they refuse to engage (as directed by the OPP). And the OPP have been clear there is substantive evidence to support charging the individual in this instance, but my loved one refuses to do so fearing it will actually make things worse. Right, because in Ontario the Youth Criminal Justice Act ensures that very little can be done to the bully. Hmm, maybe you should talk to the parents – well been there done that, got the scars to show it. Because there is no accountability, in fact when these discussions have taken place the parents of the bully have never accepted responsibility. But they have been quick to throw it on everyone else, that’s right the bully bullies because of the actions of those he bullies. Makes sense right? But wait, I’m an academic and here is what I know from the research – bullies bully because it is known behaviour, it is behaviour they are exposed to, generally from one or the other parental unit! That’s facts folks, cold hard facts – not opinion. I’m sure the parents of the bully will read this somehow, and know there will be no insight into the behaviour of the bully or themselves – and hey the bully bullies them too so really they have no control.
So personal stuff aside, we have had it in dealing with this. We have done everything one is supposed to do when experiencing bullying and yet it continues, maybe just a little more covertly now. And we see the changes in our loved  one who tells us everything is fine, yet we know that is not the case. I had the good fortune to have coffee with a friend from high school this week. We both shared stories of our loved ones experiencing bullying – eerily similar stories. We commented on how our very large group of friends never experienced any of this when we were in high school, and in fact we had all been getting together again recently and at those events it is as if the years between now and high school never happened. So how did we go from a time when this behaviour was not acceptable to what happens today? How is it ok that we laud platitudes about not tolerating bullying yet the reality is that we are very reluctant to really and truly do anything?
Our efforts at controlling bullying as a society have failed. Our educational institutions fail to really keep our kids safe. Our laws, intended to protect the vulnerable, really only make them more vulnerable. When it comes to bullying the person with all of the rights and freedoms is the bully. No wonder young people are reluctant to report it when it happens. They know the only outcome will be further grief for themselves. Our kids are told to report instances of cyberbullying, to notify adults when there are threats made against them – but for what purpose? Nothing happens to the bully. And if the bullied person follows the advice to avoid the bully, they are chastised by their peers for being weak. The victims of bullying are the ones who feel restricted from attending social events or playing sports for fear of what may happen to them. But no one tells the bully they can’t do any of this. And even when sharing past events with coaches of sporting teams, there is never any sense of obligation to help the person who has experienced bullying.
There is a viral video right now of a mom eating ice cream and telling other parents that it is their job to not be their kids friend. I could not agree more, but I would also say to parents that you know when your kid is being an asshole – and it is your job to stop that behaviour in its tracks. Maybe what we need to do is to start going after the parents of the bully – I mean after all they are the ones who have raised the kid right?! Because when you raise a kid who has never had any regard for rules, never ever known a consequence and had every single wrong action they have made fluffed off as being out of their control, you are going to raise a bully. A bully who not only has no respect for the laws or for other people, worse has absolutely no respect for you, his parents.
It’s time to do more then feel sad when a young person takes their life because of bullying, or wear our pink shirts. We need to do more and we need to focus on the person being bullied – and limit the rights and freedoms of the bully not the victim. How many more examples do we need? For now, I will do what I can to protect my loved one – and count the days until the bully is of age, because at least then I know something more can maybe be done. Until then you won’t catch me wearing a pink shirt, rather I will be more overt in addressing bullying, beginning with calling it what it is. Because bullies act out because they are powerless, and I for one refuse to give them any more power.

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Autism doesn’t end at 5

Recently the Ontario government announced improvements in funding for kids with autism. The idea sounded like a good one — increase funding to support greater access to IBI. Certainly the evidence supports the notion that earlier support can make a huge difference in outcomes for young kids diagnosed along the autism spectrum. We have long needed another look at funding mechanisms for autism diagnosis and treatment in Canada, so this should be a good thing right?  

The challenge with the current proposal is that the cut off age for kids to access these funds is 5 – 5!!!  Our ability to diagnose autism – and particularly classical presentations of autism has gotten better – but those involved in care of kids with differences will tell you that a confirmed diagnosis of autism before the age of 5 is a challenge. Why? Because at this age often times it is a chess game of determining what is unusual and what is part of the spectrum of development for children, so Tommy is not talking in full sentences at 3 do we worry about that or do we decide that Tommy might just take a little longer?

The more glaring issue with the current funding proposal is that it completely negates the needs and experiences of every person on the autism spectrum who is soon to be 5 or over the age of 5. Those nearing the age of 5 will receive a payment of $8,000 to assist with support. But wait, doesn’t the cost of effective treatment for any child on the autism spectrum cost so much that it essentially bankrupts families — what the hell will $8,000 dollars do? Maybe allow a family to start treatment that they will soon have to stop because they can’t afford to sustain it. Further, families are told that monies will be going to provide better support in the school system. So again, tell us a story that we haven’t heard before – those of us with kids well beyond the age of 5 have been hearing for years about all of the additional supports that will be added into the school system. While there are improvements, in no way is the system prepared to take on the rigorous support needed to help those on the spectrum reach their potential — and regardless of degree of disability they do all have significant potential.

Which leads to the other group again completely shut out of any funding or supports — adolescents, teens and young adults who are on the spectrum. Yes, Virginia, kids who are on the autism spectrum grow up to be adolescents, then teens and then adults living with autism. Supports for this group are almost non existent, where is the equity in that?   I have a child on the spectrum, considered to be high functioning which is just part of the labelling that follows these kids. He was diagnosed at the age of 5 – a diagnosis I fought for. At the time, the developmental pediatrician providing the diagnosis commented that it was highly unusual to diagnosis a child with an autism spectrum disorder ( in our case Asperger’s Syndrome) at the age of 5. He did not receive ABA or IBI, but I did spend a lot of money on treatments, assessments and interventions that were not covered. I spent his entire elementary school period fighting  – to get him supports (which were often shared with other kids who needed more support), to have his needs acknowledged, to educate his educators that he wasn’t a “bad” kid or a “difficult” kid but that he needed a different type of support.  And if you simply acknowledged that and planned for it he would do fine, while he has a “disability” poor behaviour has never been excused and he has always had consequences applied – he might tell you that the consequences were greater for him than his siblings. All of this was an effort to ensure that he grew into a valued and productive member of society – he wasn’t getting the supports elsewhere so it was up to us to ensure he got them from us.  The best example of lack of supports came in the shape of a phone call about a year ago. I received a phone call from an agency that had provided behavioural supports when my son was in public school, services we had long since outgrown. They were calling to give me the good news that he had finally  reached the “top of the list” to receive Special Services at home and they wished to know how I would like to use the supports.  I was dumbfounded and replied “Well he is now 17 and does not need them”. The person on the phone was equally stunned that I would say no to the supports – but honestly at this point my son is where he is in life because of the work I have done with him. So here is a waiting list that I have been on for so long (10 years) that I completely forgot about — 10 Years????  Were this any other wait list in the healthcare system we would address it, we don’t see those waiting for joint replacements spending 10 years on a waiting lists, how do we justify a young child waiting from the ages of 7 -17 to receive supports that may have helped him? Now he is in post secondary education and has had some bumps in the road – he is preparing to launch a career and intends to be successful. Yet, aside from accessing accessibility services at his school there are no supports (except me!) to help him.  Yes we are the parents of kids who have disability and expect to be fully involved in our children’s care, but in the case of those on the autism spectrum it seems like the majority of this is downloaded onto us. And the evidence suggests there are a great many challenges for young adults on the spectrum, in managing post secondary education, navigating personal relationships and finding and keeping a job. So in essence, not providing funding to create supports for this group means that there will be a need to provide them supports financially if they are not able to work. 

No one will disagree that our current funding system is broken, but a response that excludes a significant portion of those affected is morally reprehensible, this decision needs to be reconsidered.

What should really come after the words “congratulations you are having twins…”

What should really come after the words “congratulations you are having twins…”

18 years ago I got to experience such a moment – but not quite like that. In my instance it was during my first ultrasound for my first pregnancy, part way through the procedure the ultrasound tech stopped what she was doing and said she would be right back. And my nurse radar went off—you don’t do that unless something is outside of the norm. On her return she was accompanied by the radiologist and I heard the words – “There are 2 babies there…” and life changed. Not right away because there really is not much to do until the babies arrived – although we did live through some shell shock in the first few days after receiving the news. I knew the “risk” for multiples was there as I have a familial line of fraternal twins and my maternal grandmother is one. Though I knew it could happen, I didn’t really think it would – until it did!

Even after the babies arrived I still wondered a bit about the “fuss” around having multiples – ok my kids were in the NICU for 3 weeks and while we spent large chunks of our day there it wasn’t the same as having them home. Even when I roomed in to prepare for their arrival home the nurses would often do things for the babies as well. The “fuss” around having twins became much more apparent after being home for a day. Now those same babies are getting ready to head off on their own, which has led to a lot of reflection on my part. So I decided to create a list of the things “they” really should tell you after the words “congratulations you are having twins are uttered”. And here it is:

 You will be absolutely amazed at these little ones and how, no matter what, they gravitate towards one another.

 You will also be amazed at the things people will say to you about having twins. There are the lovely happy twin stories, the very sad and heartbreaking twin stories and then the really creepy I wished you had not stopped me twin stories. Those are the moments that you notice your spouse has conveniently left you with the creepy story person and wandered away with the twins.

 My twins are fraternal (boy/girl) – people will constantly ask if they are identical. At the moment a health care provider asks this question your spouse will lean in and say, “ well not exactly – one of them has a penis”. And you will again be stunned that someone actually asked that question.

 People will feel a need to comment on your reproductive status and presume that because you have multiples they must have been conceived using fertility treatments – no drugs just genetics!

 You will have all kinds of grand ideas (based on what you read in your many, many books on parenting multiples), including their need to be together all the time. Then on one sleep deprived night too many you will find yourself moving one crib into the spare room at 3 am to avoid having 2 little sets of eyes staring at you when you go into the room.

 You will be amazed at how you function on so little sleep and think that you must have been really self absorbed and lazy before they came.

 You will be stunned at the many lengths you will go to simply get some sleep.

 You will love watching them play together – and throw all of those nature vs nurture arguments out the window as your son drives his truck over barbie.

 They will talk at the same time, walk at the same time and , oh crap discover the stairs at the same time

 They will be each others best buddies – which becomes even more apparent to their younger sibling who will tell you he wishes he was a twin too…to which you respond “Oh but mommy is so glad that you are not..”

 They will hit the terrible twos and all of those other milestones together and you will think wow I can’t wait until we are past this stage.

 They will start school together and for the first time begin making friends that are not each other.

 During their school years one may feel the need to provide regular updates about what the other has been doing in school – and you have to stop yourself from responding to it, even though you really want to hear it.

 They will navigate public school and you will wonder and worry about their relationship with one another – its not easy always having your sibling with you, especially if one has different needs than the other. But you will battle those who want to put them in separate classrooms out of some personal notion that they need to develop their own identity – again boy-girl, think we’ve got that one covered.

 They will start high school together – oh boy. Now the dynamics of their relationship change – they may share the same friends as mine did. Which can be an issue. Or one may not approve of the other’s friends. Their relationship with one another may be tested as they try to figure out who they are individually when they have this other entity.

 They will learn to drive at the same time, sigh, suddenly you will never be able to leave the house without someone popping up and saying “Hey mom where are you going? Can I drive?”

 They will both get their licence – and then always want your car.

 They will demonstrate their own version of twin telepathy, maybe not for awhile but it will be there. My grandmother always talks about how she knew when things were not going well for her brother, who lived in another province, before he contacted her. I did not see this happen with my own twins until they were in their adolescence and it increases as they age. The first time it was really apparent was when my son was in a minor car accident and his sister experienced neck pain – he had suffered mild whiplash. That one freaked us all out!

 They will enter Grade 12, how the heck did that happen – and start planning for their futures. Prom and parties and more time with friends then family will become their life – and yours. You will witness fractious points in their relationship, and then increasing moments of coming together and being together.

 They will fight and argue, yet continually check in on their twin and express concerns about them.

 They will prepare to go off to post secondary school, in different cities away from each other – and it will break your heart. At first you will think that you are more bothered about them being away from one another then they are. But as the time to leave draws closer you will see how much it bothers them too as they navigate towards one another more often. You will take comfort in knowing that no matter the physical distance between them they have a connection like no other and will always have the presence of their twin. You will burst with pride at being the parent of these lovely young adults who are embarking on the exciting next steps of their lives – even if you secretly long for the days when they were babies – how ironic is that?!

Coming to terms with Asperger’s

Bell Let’s Talk Day seems an appropriate day to talk about why youth and adolescent mental health has become a passion of mine.  During my career as a Registered Nurse, I had exposure to and compassion for those living with mental health challenges,  but it was never the setting in which I chose to work. For many reasons that has changed and I am now an advocate for appropriate and efficient access to mental health care for youth, particularly those living in rural settings and those attending post secondary education.

First, more about the journey to get to where I am today.  In 1997 my fraternal twins were born, 4 weeks early, induced  due to some complications, a boy and a girl – just like my own maternal grandmother. Despite being preemies, they thrived and hit all developmental milestones, that rough period seemed to have passed by and we enjoyed our growing babies.  The year 2000 brought empty threats of a y2k meltdown, a new baby brother and a very sudden and life changing illness for the eldest of our twins. For 3 weeks he was acutely ill, we never found out with what but all signs point to a likely strep infection. The acute period of that illness passed, but significant changes had occurred in our boy. He was now completely withdrawn, no longer sleeping,  and refusing all food except chocolate milk. He stopped playing with his sister and started watching Toy Story endlessly, all the while constantly rocking on the couch. Unfortunately this coincided with my return to work and the children starting a new daycare. When I came at the end of the day, the staff would tell me how he had spent the day sitting in a chair, completely withdrawn from the other children – including his twin. I don’t support the “anti-vax” movement or think things “cause” autism – I prefer to rely on science, it was however becoming increasingly apparent that there was more going on for this little boy then the physical illness he had been battling.  I think Aspergers would have presented itself at some point in our life, but I believe the illness he suffered provided some fuel for the fire. When I look back at videos of him as a baby and toddler the signs and symptoms are so obvious, the illness just seemed to be the tipping point.

Trying to get some sort of a diagnosis for a child under the age of 5 is damn near impossible! We have been blessed with an incredible pediatrician who listened to everything I said about what was going on and agonized as much as we did about trying to figure it out. I started visiting numerous specialists (both medical and developmental) to try and determine what was going on. What an experience to test one’s patience and resolve. Travels to Sick Kids, appointments with Allergists,  Rheumatologists and Psychological assessments, and no answers.  I was given “diagnoses” that never really fit:  Pervasive Developmental Disorder Not otherwise Specified (PDDNOS) – which basically amounts to “we don’t really know what to call it so we will call it this”, tourettes (because of what I now know was echolalia), even PANDAs, a term used to describe a rare disorder that occurs after a streptococcal infection. None of these diagnoses fit – and of greater concern he was about to start school. From a behavioural perspective this was going to be a real issue as he would be physical out of frustration, spend his time rocking, disengaged from others and experienced frequent meltdowns. He could not tolerate certain sounds, smells,  textures and the feel of certain clothes. He became obsessed with things: Toy Story, Thomas the Tank Engine and then Nascars. He had one spot in our house where he liked to line his Nascars up and would lose it if anyone even touched them.  At this point we decided to move back to our home town, thinking that he would have a better shot living in a community that knew us and would support us – and to a large extent he has had that, although not without challenges.

At the age of 5 I was finally able to have confirmed what was becoming increasingly apparent. A developmental pediatrician reluctantly provided the diagnosis of Asperger’s Syndrome. I say reluctantly because I was told that this MD did not necessarily believe that  diagnosis because my child did  make eye contact but was providing it as there were some identified concerns – this MD has since apologized to me for generalizations as further evidence has noted not all kids with ASD present like the text book says.

But a diagnosis did not provide peace, rather it became a stepping stone to years of advocating for the supports he needed to be successful at school. Regular meetings at school, regular calls from Principals and teachers, regular battles reminding them about his diagnosis and the need for appropriate supports.  I had become “that” parent. My next blog will focus on issues around access and supports for parents and children, particularly in rural areas. Let’s just say it was a battle – but then it seemed to get easier.

Until Grade 8,  when suddenly his twin started having a difficult time. Siblings of children with ASD live with lots of stress themselves, more so when they share the connection of being twins. Our daughter has always felt the need to be his protector (and also to share what he had done at school that day – not always to be supportive!).  When they were in Grade 8 our daughter’s mood and behaviour changed substantively. She became very restrictive in her eating and began exercising religiously. She also began making comments  that reflected body image issues. Very quickly her health declined and we needed to seek treatment for anorexia.  The initial experience in seeking treatment for our daughter was horrendous as we were referred to a program in Toronto, where I was told I would have to drive her to that facility every morning to spend an 8 hour day. When provided an explanation about the reality of where I live, the fact that I have a job and two other children – one of whom needs a fair amount of support – there was very little flexibility. Fortunately, we were able to get into an incredible program close to home, a program that made all the difference for our daughter.   This was one of the most difficult times in my life, my daughter was on the verge of being sent to CHEO in Ottawa for treatment, and at the same time, her brother began another rough period, likely due to concerns for his sister and beginning the preparation to transition to high school.  I had to make an incredibly difficult choice, take the bed at CHEO and leave my son to cope on his own, decline the bed at CHEO and hope my daughter began to recover. The choice made was the latter, I had great faith in the team we were working with and my daughter. Fortunately, that was the right choice as she began to slowly recover and is now healthy, although will always live with an eating disorder.

My twins are now 17, preparing to leave home in the next few months. This raises new concerns and worries, this transition will be a bigger one for my son. Along with being away from us, he will be away from his twin – and from friends he has had since he was 5.  Over the past few years I have worked to ensure he is able to advocate for himself, I stopped attending school meetings once he started high school. He knows that he needs to learn to do this on his own. He and I have battled for the past 4 years over the need for his IEP to remain in place – he telling me it wasn’t necessary as he didn’t need help – me insisting it was to help him transition to post secondary education.  At 17 he has a very strong support network of friends – 2 have been his friends since he was 5 and know what he went through when he was little.  He is very social – disputing the label that all kids with Asperger’s are “anti-social”. But he still has struggles – he continues to be unbelievably rigid – something I challenge him about regularly. He continues to struggle with a “rules based focus” and feels the need to regularly share his opinion and I have to remind him that there are some conversations that should ONLY occur in your head.   He feels the need to share with his siblings every single thing he thinks they do wrong.  At 17 he still has many fine motor skill issues and thank god for computers as he struggles to write legibly. He still has restricted interests and obsessions – so no longer NASCARS but his own car that he purchased with his money. There is lots to celebrate too though – as mentioned he has a very large group of friends, his teachers like him, he has a part time job and is preparing for post secondary education and a career. He remembers the time when he was little and talks about that and what it was like for him. He feels he no longer has “Autism” and tells me I think everyone has Aspergers (I think I have a pretty good radar for those that do!). Then  we will catch him rocking or telling someone to get out of “his spot” ala Sheldon Cooper.

So what have I learned? To know when to speak up for my son (and daughter) and when to back off. The harmful impact of words – my daughters eating disorder was precipitated by bullying comments made by another girl in her school in Grade 7, when she sought help from within the school she was not listened to.  I have learned the difference between what is fair and what is equitable – they are not the same thing.  I have learned that I while I support the terminology “Special needs” and those who truly have special needs. I hate the term used by some as a way of excusing what is essentially bad behaviour – my son has some life challenges but that doesn’ t mean he gets a “get out of jail free card” because of his diagnosis, it simply means he has to work a little harder than everyone else.  There have always been consequences attached to behaviour — being disrespectful or hurting another child was never rewarded.  I have learned that while there are many “experts” and I appreciate their knowledge and expertise – it is I who am the “expert” when it comes to what is best for my kids. I am learning about the need to let go, while still being a support. Most significantly I have learned about the absolute disparity of services available to youth transitioning to post secondary education and employment, about the limited access and supports for parents and youth living in rural settings.  I have learned that sometimes you do need to become “that parent” in order to make a difference.

Respect our elders…

Suddenly there seems to be an increase in violent outbursts amongst elderly residents of long term care facilities. Those working in such facilities, however, will tell you that such incidents are not new. What are new are the tragic outcomes. Long term care facilities care for our elderly relatives at a point in our lives when we are no longer able to do so. The residents are often frail, physically debilitated and/ or living with dementia. Increasingly those living with dementia can also be violent.

People can be quick to lay blame in situations such as those involving the residents of a facility in Toronto where one resident was killed. Some might blame the staff, others various levels of government. Staff in long term care facilities does not get the support and understanding deserved. They are expected to care for our loved ones, whose health challenges we cannot manage at home, day in and day out. They do so with limited support and limited resources. They may bear the brunt of violent behavior from residents with no recourse.

The government certainly has a role to play at both Federal and Provincial levels by ensuring that long term care facilities have adequate funding to provide the care residents deserve, something that is not happening. But we as a society also have a role in this tragedy; we have allowed the creation of a system of care that devalues our elders. We have not challenged funding decisions that ensure we do everything possible to save a preemie at unfathomable gestation (22 weeks) who may live with life long illness. We can now sustain life where it was never possible before – and yet don’t ask the question if we should be. But  we think it is ok that the 83 year old who fought for our rights in the war is only ALLOWED 2 adult briefs in a day, that there is never enough staff to ensure he gets repositioned enough to prevent bedsores. We have decided that the system works when there is not enough staff to ensure that residents eat enough or that they don’t choke when they eat. We have decided that it is okay for residents of long term care facilities to live in fear of other residents. We are all to blame for not demanding those we have elected fixes this system, for not speaking up for those who can’t. We are at blame for not making this an issue in each Provincial and Federal election. We are all at blame for not speaking up for those who can’t. I, for one know that I will be speaking out and I hope others join me. If not for your parents, grandparents, aunts and uncles; then do it for yourself. One day you too may be in that position.

Does politics influence health in rural settings?

There are many changes occurring in the political landscape – Ontario has a new premier, federally, there is movement towards redefining the electoral map. Does this make a difference for rural residents? Yes, and it is significant enough that we need to be informed and involved. The new premier brings many positive attributes in her leadership abilities, she is also very Toronto centric. While she has expressed an intent to understand rural issues she may not fully understand the context of rural health.  So how is this related to our health??  Because we are handing over decision making regarding policy that has an effect on our health to those who may not understand issues affecting rural communities.

 

A study conducted by physicians at St Michael’s hospital a number of years ago noted that a substantive number of traumatic injuries occur in rural Ontario. Of those injured, 62% are taken to their closest – most likely rural – facility for treatment. Further, 69% of those taken to a smaller community hospital are NEVER taken to an urban trauma centre. What does this mean?? This finding demonstrates that small, rural hospitals do an exceptional job of providing initial trauma care to those in need. This is important right now as we hear news of more local facilities changing processes that may result in negative outcomes for rural residents. One change that is common is the closure of maternity units – generally the decision is made that it doesn’t make economic sense for smaller centres to deliver babies. As a result expectant moms are must travel to access care.  Which becomes a theme for rural residents — there is an expectation that individuals will travel to access care that is needed. This has been apparent in many of the outcomes attributed to the Local Health Integration Networks (or LHINs) that define how healthcare is provided in the Province. The LHINs were introduced as a means of decreasing duplication and ensuring accountability. While that may have occurred in some areas, there has been a more negative impact for rural communities. While we expect that we might have to travel to access some services – it wouldn’t make sense after all for a small rural hospital to have a Neuro-trauma unit for instance – we also have a right to access those services that maintain our health and prevent illness. We need to ensure that the decision makers we elect value this same access to exceptional care in rural settings. We need to demonstrate the value that rural healthcare providers bring to us as residents of the community as well. We need to be educated about changes in policy that will affect us. Finally we need to challenge to misnomer that we have made a choice to live where we do – while that may be true nowhere was it written that means we deserve less when it comes to healthcare access.

Is Facebook an effective tool for health

Facebook has become a useful tool in – for some even a necessity! While it can be useful to use facebook to share photos, it has the potential to be harmful when used to share health and medical information. As a Registered Nurse I have been astounded at the ease with which people will accept “facebook advice”. I have seen postings where people are sharing some illness or symptoms they are experiencing, which then leads to a long list of “suggestions”. While I agree there are many “natural” or historical remedies that are helpful, there are many others that may or may not have an effect except to make you feel as though you are getting better. Far more often the suggestions have the potential to cause harm.  Putting Vicks on your feet when you have a cold will not physically harm you – it won’t cure your cold but it won’t damage your liver.   Mixing Tylenol and Ibuprofen is another story – I mean why not just wash that concoction down with a swig of Scotch! Makes me wonder if I’ve entered into the Keith Richards School of medicine? When I see this occurring, I question my role– do I have an obligation to share my knowledge? Or do I simply let it go?? As a regulated health professional, my college, the College of Nurses of Ontario has guidelines about how to respond should someone seek my advice. It is clear what is expected of me and where I might be overstepping my boundaries. Unfortunately our regulatory bodies have only begun to look at the role of social media, and certainly not addressed it from the perspective of simply reading other’s facebook posts.

While I fully support people being empowered to manage their health, I also see a need for caution about where you gather information from. Check that you are on a reputable website whether it is conventional medical information or natural health remedies; there are an abundance of both available. Be careful of anyone calling themselves an expert, most of us working in the health field would never call ourselves experts as we are constantly learning and being challenged. If we won’t call ourselves experts than should the person looking to profit from your purchasing their products call themselves experts?? Just because I might sell wellness products does not make me a wellness expert, your Nurse Practitioner, Physician or Registered Nurse have passed completed rigorous educational programs followed by National examinations that certify their competency to practice. I know whose opinion I would trust when it comes to my health!