I received my Bachelor of Science and Doctor of Medicine degree from University of Alberta. My residency training was completed at University of Manitoba.
In my spare time, I enjoy cooking, travelling and exercising. Do you know I hold a certificate of Culinary Arts from George Brown College? I also enjoy reading about personal finance, especially about investing.
GENERAL INFO:
I encourage all my patients to call my clinic for all their health concerns.
Please keep in mind, if I’m not available, you can always book an appointment with other physicians in the clinic – just ask the staff! It is always better to have all your medical information at one place. This helps to reduce medication errors, avoid unnecessary medical tests, and improve your health care experience. Please understand that your information at walk-in clinic is not automatically shared with our system.
COVID 19 Vaccine Resource
1) Pregnancy
**Key points**
- Pregnant women can use Ontario’s vaccine booking system to find out how to schedule an appointment, call the Provincial Vaccine Booking Line number at 1-833-943-3900, or contact their Public Health Unit (PHU). In most cases, extra documentation is not required. The extended dose interval of 16 weeks remains in place.
- The Society of Obstetricians and Gynaecologists of Canada (SOGC) notes that vaccine-induced thrombotic thrombocytopenia (VITT) is not more likely to happen in pregnancy and VITT does not develop through the same process as usual types of bleeding or clotting problems (including in pregnancy). Please feel free the read the official statement in the above link.
- SOGC also “supports the use of all available COVID-19 vaccines approved in Canada in any trimester of pregnancy and during breastfeeding in accordance with regional eligibility.”
- These are some links to useful decision making tools to help you make an informed decision
2) FOR ALL OTHER ADULTS, the message is clear – Please get vaccinated!!
- All of the approved COVID 19 vaccines in Canada have high efficacy rates against severe disease from COVID 19 (hence, hospitalizations and death)
- note – 30-70% of patients admitted to ICU with COVID 19 will develop blood clots in the deep veins of their legs or lungs
3) For first doses, NACI recommends that:
- An mRNA vaccine (Pfizer-BioNTech, Moderna) is preferred to start a vaccine series, unless there is a contraindication, for example, because of an allergy to an mRNA vaccine or its components.
4) AstraZeneca and Johnson&Johnson vaccine safety
What is Vaccine-induced Immune Thrombotic Thrombocytopenia (VITT)?
VITT is a very rare syndrome of low platelets with unusual clots. Rare instances of VITT have been observed following vaccination with the AstraZeneca vaccine in Europe and with the Janssen (Johnson & Johnson) vaccine in the United States, with associated high case fatality and related serious outcomes (PHAC, March 29, 2021; EMA, April 20, 2021). VITT appears to mimic Heparin-induced Thrombocytopenia (HIT), but does not require heparin as a trigger (Ontario COVID-19 Science Advisory Table, May 7, 2021).
These blood clots have two important features:
- they occur within 4 – 28 days after vaccination
- they are associated with low platelets (tiny blood cells that help form blood clots to stop bleeding)
VITT can cause blood clots in different parts of the body, resulting in syndromes such as Cerebral Venous Sinus Thrombosis (CVST) or other arterial or venous clots (Ontario COVID-19 Science Advisory Table, May 7, 2021). If diagnosed early, VITT can be treated and the risk of serious outcomes reduced (PHAC, March 29, 2021).
What is the incidence rate?
The rate of VITT internationally is difficult to confirm, as there is no central data source. While the rate of incidence for this condition is difficult to determine at this time, published estimates range from 1 case per 26,000 to 1 case per 127,000 doses of AstraZeneca administered (Ontario COVID-19 Science Advisory Table, May 7, 2021). The incidence of VITT in the Janssen vaccine is estimated to be approximately 1 per 500,000 at this time (Ontario COVID-19 Science Advisory Table, May 7, 2021). NACI estimates the case fatality of VITT as approximately 25 – 40%, but notes that widespread awareness and early treatment may decrease this rate (NACI, April 22, 2021).
Any evaluation of risks and benefits of vaccine-induced blood clots must include acknowledgement of the well-established high risk of blood clots caused by COVID-19 itself. Several studies have suggested that 30-70% of people who are admitted into intensive care units with COVID-19 will develop blood clots in the deep veins of their legs or in the lungs, while approximately 25% will develop a blockage in one of the arteries supplying blood to the lungs (GAVI, March 16, 2021).
What about patients who’ve already received the AstraZeneca or Janssen (Johnson & Johnson) vaccines?
For those who have already been vaccinated with AstraZeneca or Janssen:
- More than 28 days ago: there is no cause for concern.
- Less than 28 days ago, or those vaccinated moving forward: self-monitor for 28 days, and seek immediate medical attention if you develop any of these symptoms:
- shortness of breath
- difficulty speaking
- severe chest, back or abdominal pain
- new severe swelling, pain or colour change in an arm or leg
- sudden onset of severe or persistent worsening headaches or blurred or double vision
- unusual bleeding or bruising (other than at the site of vaccination)
- new reddish or purplish spots or blood blisters
- seizure
- difficulty moving part of your body
- Second doses:
- For second doses, NACI recommends that:
- An mRNA vaccine is now preferred as the second dose for individuals who received a first dose of the AstraZeneca/COVISHIELD vaccine, based on emerging evidence of a potentially better immune response from this mixed vaccine schedule and to mitigate the potential risk of VITT associated with viral vector vaccines.
- People who received two doses of AstraZeneca/COVISHIELD vaccine can rest assured that the vaccine provides good protection against infection and very good protection against severe disease and hospitalization.
Receiving a second vaccine dose for a two-dose schedule is essential to provide better and longer-term protection against COVID-19 for individuals and for the entire community.
- For second doses, NACI recommends that:
(Taken from Centre of Effective Practise, NACI statement on June 17, 2021)
USEFUL LINKS
Diabetes, Prediabetes
Having diabetes is not the end of the world! Please understand – the “diabetic diet” is really just healthy eating – that is, ALL of us should eat this way. It is not a special diet. ALL of us should exercise. Check out this website from the Canadian Diabetes Association for more tips and information on diabetes, healthy lifestyle and community resources.
Hypertension
Want to know more about what your blood pressure mean to you? Wondering what you can do to lower your blood pressure through lifestyle changes? Check out this website.
Flu Vaccine
Get the facts on the seasonal flu, flu shot safety, and who are most at risk for the flu (young children, 65 years or older, pregnant women, and those with underlying health conditions). Be informed and get vaccinated!
Women’s Health and Pregnancy
Get the facts on pap test, cervical cancer screening, and colposcopy. This is a Manitoba website, but the information on pap test, results, and colposcopy is the same across the provinces. The follow up procedure for abnormal pap results can vary by province. Please speak with your health care provider about the recommended follow up for your pap test result.
Please also check out the Ontario cervical cancer screening website
https://www.cancercareontario.ca/en/types-of-cancer/cervical/screening
Pregnant or has kids in the Peel health region? Check out the above websites for health info and community resources.
Health Canada’s recommendations on proper nutrition during pregnancy and breastfeeding
Information regarding sexual health, including contraception information.
Feeling the flashes? Trouble dealing with all your menopausal symptoms? Look no further than this trusted website by the Society of Obstetricians & Gynecologists of Canada.
Ontario’s new funded Fertility Program information
Kids Health
Want some tips on how to deal with your picky eater, disciplining your child, or reducing vaccination pain? Check out this website created by the Canadian Pediatric Society. This website is designed for the general public.
Great website developed by Sick Kids Hospital for the general public. Highly recommend.
18 month routine well child visit is one of the most important appointment in the first 2 years of your baby’s life. This is the time to identify any problems in development and behaviours, as early interventions lead to better outcomes. Please check out this website to help you better prepare for your child’s 18 month visit.
Canadian Pediatric Society website
Lifestyle, Nutrition
- The new Canada Food guide is EXCELLENT! It’s based on the latest evidence !
This website contains very good information about nutrition, proper eating, weight loss, exercising etc.
- http://www.csep.ca/en/guidelines/guidelines-for-other-age-groups
This website contains current guidelines on recommended physical activities for all age groups.
This can help you choose healthy foods on your plate!
Colon Cancer Screening – Everyone over age 50, or earlier if you are at risk. Get screened – do not delay!
Liver Disease
Get the facts on liver disease and prevention.
Osteoporosis
Wondering how to get enough calcium and vitamin D for health bones? Want to know what type of exercises can strengthen your bones? Check out this excellent website.