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Wednesday, October 18, 2017

Dr. Lee's Self-help exercise class

For the 24 Move Tai Chi Chuan video we talked about during the class; here is the link

Tuesday, October 17, 2017

FLU SHOTS ARE IN!!  THIS FIRST BATCH IS FOR HIGH RISK PATIENTS ONLY. If you are high risk, flu shots are available on a drop in basis.  We highly recommend that all our patients get the flu shots.   

The flu vaccine is really important for:

People at higher risk of having complications from the getting the flu:
  • Adults and children with chronic health conditions
  • Pregnant women
  • Aboriginal peoples
  • All children 6-59 months of age and people age 65 and older
  • All residents of long-term care homes and other chronic care facilities
People capable of transmitting flu to those at high risk:
  • Health care providers and those who provide services to those at high risk
  • Household contacts of people at high risk
  • Members of a household expecting a newborn during flu season
  • Those providing regular child care to children under 5 years of age
Other recommended groups:
  • People who provide essential community services
  • People in direct contact with avian-flu infected poultry

Misconceptions about Flu Vaccines

Can a flu shot give you the flu?

No, a flu shot cannot cause flu illness. Flu vaccines given with a needle are currently made in two ways: the vaccine is made either with a) flu vaccine viruses that have been ‘inactivated’ and are therefore not infectious, or b) with no flu vaccine viruses at all (which is the case for recombinant influenza vaccine). The most common side effects from the influenza shot are soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur.
In randomized, blinded studies, where some people get inactivated flu shots and others get salt-water shots, the only differences in symptoms was increased soreness in the arm and redness at the injection site among people who got the flu shot. There were no differences in terms of body aches, fever, cough, runny nose or sore throat.

Is it better to get the flu than the flu vaccine?

No. Flu can be a serious disease, particularly among young children, older adults, and people with certain chronic health conditions, such as asthma, heart disease or diabetes. Any flu infection can carry a risk of serious complications, hospitalization or death, even among otherwise healthy children and adults. Therefore, getting vaccinated is a safer choice than risking illness to obtain immune protection.

Do I really need a flu vaccine every year?

Yes. CDC recommends a yearly flu vaccine for just about everyone 6 months and older, even when the viruses the vaccine protects against have not changed from the previous season. The reason for this is that a person’s immune protection from vaccination declines over time, so an annual vaccination is needed to get the “optimal” or best protection against the flu.

Why do some people not feel well after getting the seasonal flu vaccine?

Some people report having mild reactions to flu vaccination. The most common reaction to the flu shot in adults has been soreness, redness or swelling at the spot where the shot was given. This usually lasts less than two days. This initial soreness is most likely the result of the body’s early immune response reacting to a foreign substance entering the body. Other reactions following the flu shot are usually mild and can include a low grade fever and aches. If these reactions occur, they usually begin soon after the shot and last 1-2 days. The most common reactions people have to flu vaccine are considerably less severe than the symptoms caused by actual flu illness.

What about serious reactions to flu vaccine?

Serious allergic reactions to flu vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the vaccination. While these reactions can be life-threatening, effective treatments are available.

What about people who get a seasonal flu vaccine and still get sick with flu symptoms?

There are several reasons why someone might get a flu symptoms, even after they have been vaccinated against flu.
  1. One reason is that some people can become ill from other respiratory viruses besides flu such as rhinoviruses, which are associated with the common cold, cause symptoms similar to flu, and also spread and cause illness during the flu season. The flu vaccine only protects against influenza, not other illnesses.
  2. Another explanation is that it is possible to be exposed to influenza viruses, which cause the flu, shortly before getting vaccinated or during the two-week period after vaccination that it takes the body to develop immune protection. This exposure may result in a person becoming ill with flu before protection from the vaccine takes effect.
  3. A third reason why some people may experience flu like symptoms despite getting vaccinated is that they may have been exposed to a flu virus that is very different from the viruses the vaccine is designed to protect against. The ability of a flu vaccine to protect a person depends largely on the similarity or “match” between the viruses selected to make the vaccine and those spreading and causing illness. There are many different flu viruses that spread and cause illness among people. For more information, see Influenza (Flu) Viruses.
  4. The final explanation for experiencing flu symptoms after vaccination is that the flu vaccine can vary in how well it works and some people who get vaccinated may still get sick.

Can vaccinating someone twice provide added immunity?

In adults, studies have not shown a benefit from getting more than one dose of vaccine during the same influenza season, even among elderly persons with weakened immune systems. Except for some children, only one dose of flu vaccine is recommended each season.

Is it true that getting a flu vaccine can make you more susceptible to other respiratory viruses?

There was one study (published in 2012) that suggested that influenza vaccination might make people more susceptible to other respiratory infections. After that study was published, many experts looked into this issue further and conducted additional studies to see if the findings could be replicated. No other studies have found this effect. For example, this article [99 KB, 5 pages] in Clinical Infectious Diseases (published in 2013). It’s not clear why this finding was detected in the one study, but the preponderance of evidence suggests that this is not a common or regular occurrence and that influenza vaccination does not, in fact, make people more susceptible to other respiratory infections.

Misconceptions about Flu Vaccine Effectiveness

Influenza vaccine effectiveness (VE) can vary from year to year and among different age and risk groups. For more information about vaccine effectiveness, visit How Well Does the Seasonal Flu Vaccine Work. For information specific to this season, visit About the Current Flu Season.
While how well the flu vaccine works can vary, there are many reasons to get a flu vaccine each year.
  • Flu vaccination can keep you from getting sick with flu.
  • Flu vaccination can reduce the risk of flu-associated hospitalization, including among children and older adults.
    • Vaccine effectiveness for the prevention of flu-associated hospitalizations was similar to vaccine effectiveness against flu illness resulting in doctor’s visits in a comparative study published in 2016.
  • Flu vaccination is an important preventive tool for people with chronic health conditions.
    • Flu vaccination has been associated with lower rates of some cardiac (heart) events among people with heart disease, especially among those who experienced a cardiac event in the past year.
    • Flu vaccination also has been associated with reduced hospitalizations among people with diabetes (79%) and chronic lung disease (52%).
  • Vaccination helps protect women during and after pregnancy. Getting vaccinated can also protect a baby after birth from flu. (Mom passes antibodies onto the developing baby during her pregnancy.)
    • A study that looked at flu vaccine effectiveness in pregnant women found that vaccination reduced the risk of flu-associated acute respiratory infection by about one half.
    • There are studies that show that flu vaccine in a pregnant woman can reduce the risk of flu illness in her baby by up to half. This protective benefit was observed for several months after birth.
  • And a 2017 study was the first of its kind to show that flu vaccination can significantly reduce a child’s risk of dying from influenza.
  • Flu vaccination also may make your illness milder if you do get sick. (For example a 2017 study showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized flu patients.)
  • Getting vaccinated yourself also protects people around you, including those who are more vulnerable to serious flu illness, like babies and young children, older people, and people with certain chronic health conditions.
*References for the studies listed above can be found at Publications on Influenza Vaccine Benefits. Also see the Why get a flu vaccine[224 KB, 2 Pages] fact sheet.

Misconceptions about the Timing of Seasonal Influenza Vaccination

Should I wait to get vaccinated so that my immunity lasts through the end of the season?

CDC and the Advisory Committee on Immunization Practices (ACIP) recommend that flu vaccinations begin by the end of October, if possible. However, as long as flu viruses are circulating, it is not too late to get vaccinated, even in January or later. While seasonal flu outbreaks can happen as early as October, most of the time flu activity peaks between December and February, although activity can last as late as May. Since it takes about two weeks after vaccination for antibodies to develop in the body that protect against flu virus infection, it is best that people get vaccinated in time to be protected before flu viruses begin spreading in their community. Although immunity obtained from flu vaccination can vary by person, previously published studies suggest that immunity lasts through a full flu season for most people.
There is some evidence, however, that immunity may decline more quickly in older people. For older adults, two vaccine options are available. One of these options is a “high-dose” vaccine, which is designed specifically for people 65 and older. This vaccine contains a higher dose of antigen (the part of the vaccine that prompts the body to make antibody), which is intended to create a stronger immune response in this age group. For more information, see Fluzone® High-Dose Seasonal Influenza Vaccine Questions and Answers. Another option licensed is an adjuvanted flu vaccine (FLUAD™). FLUAD™ is a trivalent vaccine made with MF59 adjuvant for use in persons aged 65 years and older. (FLUAD™ is the first adjuvanted influenza vaccine marketed in the United States.) For more information, see FLUAD™ Flu Vaccine with Adjuvant.
How long you are immune or your “duration of immunity” is discussed in the ACIP recommendations. While delaying getting of vaccine until later in the fall may lead to higher levels of immunity during winter months, this should be balanced against possible risks, such as missed opportunities to receive vaccine and difficulties associated with vaccinating a large number of people within a shorter time period.

Is it too late to get vaccinated after Thanksgiving (or the end of November)?

No. Vaccination can still be beneficial as long as flu viruses are circulating. CDC recommends that providers begin to offer flu vaccination by the end of October, if possible, but if you have not been vaccinated by Thanksgiving (or the end of November), it can still be protective to get vaccinated in December or later. Flu is unpredictable and seasons can vary. Seasonal flu disease usually peaks between December and March most years, but disease can occur as late as May.

Misconceptions about Physician Consent for Vaccination

Do pregnant women or people with pre-existing medical conditions need special permission or written consent from their doctor to receive the flu vaccine?

No. There is no recommendation for pregnant women or people with pre-existing medical conditions to seek special permission or secure written consent from their doctor for vaccination if they get vaccinated at a worksite clinic, pharmacy or other location outside of their physician’s office. With rare exception, CDC recommends an annual flu vaccine for everyone 6 months and older, including pregnant women and people with medical conditions.
A variety of influenza vaccine products are available (Table 1). Vaccine providers should be aware of the approved age indications of the vaccine they are using and of any contraindications or precautions. Providers also should appropriately screen all people getting vaccinated for allergies to vaccine components or other contraindications. People who have previously had a severe allergic reaction to influenza vaccine or any of its ingredients should generally not be vaccinated.
There are some people who should not get a flu vaccine without first speaking with their doctor.
These include:
  • People who have a moderate-to-severe illness with or without a fever (they should wait until they recover to get vaccinated), and
  • People with a history of Guillain-Barré Syndrome (a severe paralytic illness, also called GBS) that occurred after receiving influenza vaccine and who are not at risk for severe illness from influenza should generally not receive vaccine. Tell your doctor if you ever had Guillain-Barré Syndrome. Your doctor will help you decide whether the vaccine is recommended for you.
Pregnant women or people with pre-existing medical conditions who get vaccinated should get the flu shot.
If a person is vaccinated by someone other than their primary health care provider, the vaccinating provider should ensure that the patient and, if possible, the patient’s medical provider have documentation of vaccination.
For a complete list of people who should not get the vaccine before speaking with their doctor, please review the influenza Vaccine Information Statement for the flu shot.

Misconceptions about “Stomach Flu”

Is the “stomach flu” really the flu?

No. Many people use the term “stomach flu” to describe illnesses with nausea, vomiting or diarrhea. These symptoms can be caused by many different viruses, bacteria or even parasites. While vomiting, diarrhea, and being nauseous or “sick to your stomach” can sometimes be related to the flu — more commonly in children than adults — these problems are rarely the main symptoms of influenza. The flu is a respiratory disease and not a stomach or intestinal disease.

Friday, October 13, 2017

Children's Mental Health

The following resources provided by the Canadian Mental Health Association may be of interest to you.

Joint Consortium for School Health Positive Mental Health Toolkit:

Monday, September 18, 2017

Self Help Exercise Workshop with Dr. Edward Lee

1-2 pm Main conference room at Ajax Harwood Clinic for Tai Chi Class

Please come join us and discover together:
Let’s discover together how your body works.
Can we overcome our problems without the aid of others or medication?
Let’s work together and share techniques that help us manage our pain.

Thursday, September 14, 2017

Back Massage on Demand - self-administered

describes exercise I’d like to promote: a self-administered back decompression exercise that utilizes abdominal musculature:
1. Sit up straight, shoulders back and down, take 3 stacked inspiration to ensure lung is in maximal inflation; abdomen should protruded to allow more room for full inspiration.
2. hold the breath in
3. compress abdominal muscles and feel the spinal decompression from internal pressure - a person with 40” abd girth, at 2 PSI intra-abdominal pressure can generate 250lb of decompression force along the spine.

This is a manoeuvre that can relieve nerve compression from degenerative disc disease of the lumbar spine.
I have some left leg numbness and pain which I can relieve instantly using this technique; it can be used any time and in any body position.
Other virtues of this exercise are as follows:
Breathing exercise: "triple breathing exercise" (ie. three inspiration followed by 3 expiration... in contrast to the conventional one inspiration followed by 1 expiration)
1. mental meditation, self regulation, self-calming; relieve trapped mind
2. improve thoracic posture
3. improve ventilation; tidal volume; vital capacity; respiratory musculature (scalenes, intercostals and diaphragmatic)
4. improve respiration; better oxygenation and pCO2
5. improve abdominal musculature
6. decompress lumbar spine
7. improve pelvic musculature and improve bladder and sphincter control
8. improve CM (centre of mass) awareness; and improve balance

Thursday, August 24, 2017

Attention Smokers!

Lakeridge Health is one of three hospitals in Ontario that is participating in a pilot project to determine the feasibility of a province-wide lung cancer screening project.

They will accept referrals for those between the ages of 55 and 74 and have smoked cigarettes daily for at least 20 years (not necessarily consecutively).

If you are interested talk to your doctor to see if you are eligible.

If you have any of the following, you are NOT eligible:
  • Have previously been diagnosed with lung cancer
  • Are under surveillance for lung nodules
  • You are being investigated for coughing up blood
  • You are being investigated for unexplained weight loss


Your friendly Ajax Harwood Clinic Staff

Monday, June 19, 2017

We are Excited to Announce Three New Workshops

Do you want to get the most out of your healthcare appointment?

Do you live with challenges and complications as a result of chronic pain?

Do you live with challenges and complications as a result of a chronic condition?

If you answered yes to any of these questions we have the workshop for you!!

Getting the Most from your Healthcare Appointment

When:  Thursday, September 7, 2017

Where: At your favourite medical clinic. 88 Harwood Ave S, Ajax, On

Registration is required: To register, please call 905-683-0690 or register in person at our clinic

Living a Healthy Life with Chronic Pain Workshop

When:  Every Tuesday, September 12 - October 17, 2017

Where: At your favourite medical clinic. 88 Harwood Ave S, Ajax, On

Registration is required: To register, please call 905-683-0690 or register in person at our clinic

Living a Healthy Life with Chronic Conditions Workshop

When:  Every Thursday, September 14 - October 19, 2017

Where: At your favourite medical clinic. 88 Harwood Ave S, Ajax, On

Registration is required: To register, please call 905-683-0690 or register in person at our clinic

Sunday, June 18, 2017


I love to see travel patients!  I get to share their excitement and get travel virtually with them.  Patients can make this visit more fruitful by bringing in any and all immunizations you have received in the past.  Also since it is a travel consult, a copy of detailed itinerary is most helpful.  Please print this off so I don't have to squint into your phone.  If you are being treated for any chronic illness or are taking any medications, I need to know this to decide on what your health needs may come up when you travel.

Once you know you are travelling, book your travel consult as soon as you can.  Travel appointments fill up quickly during busy travel seasons and some vaccinations require multiple boosters.   

My list of helpful hints for travellers:

I used to tell patients to photocopy their travel documents and leave a copy with friends or family at home.  My new advice is to have patients scan important documents and email it to themselves and their emergency contact person.  

It is always helpful to have a reuse able water bottle.  This will allow you to fill it up once you pass security and have water on the plane without having to balance the cup on that tiny table placed in front of your leg.  I find those tables to be equivalent to restraints while flying and defies any leg movement!  Water that has been boiled at your destination is generally safe.  This is handy to have for your day out and will allow you to avoid any counterfeit bottled water.  In a pinch, when you are not sure of the water source, beer and soda may be safer.   This is the ONLY time I will tell you to drink beer or soda instead of water💧!!!

Meds kit:   
Prescription drugs - I advise my patients to take all their prescription drugs in their original bottle.  You can use an older bottle if you don't want to take to many with you on your trip.  Border guards frown on little pills in ziplock bags! 
Fever and pain control - I also recommend that you travel with some Tylenol or Advil (whatever is your preference) for fever and pain. 
Cough and cold - your favourite cough and cold med.   This is not the time for you to try something new.  I also recommend some throat lozenges.  For some reason I always feel a cough when I'm at the border with a sign warning me to disclose if I have a cough.  
Nausea and vomiting - take some Gravol with you. 
Diarrhea- almost everyone who travels experiences a little diarrhea.  If it is mild you will want some Imodium, Kaopectate or whatever you are used to taking for diarrhea.  Ask your doctor about Dukoral, the traveler's diarrhea or antibiotics to carry in case you get sick during travel.  
Electrolytes -   If you are prone to diarrhea, you may want to carry some electrolyte crystals with you for rehydration.  

This list is by no means exhaustive.  It is important that you seek individual medical advice for your travel.   I wish all my patients many safe and enjoyable travels in your future!  Bon voyage!

Dr.  Maria Yu

Tuesday, April 18, 2017

Thursday night Walking/Running Club

On one of my walks/runs last week, it occurred to me that I would like to share this with my patients.
Walking helps to maintain a health weight and prevents and manages hypertension and diabetes.  It will strengthen your bones and muscles and improve your balance and co-ordination.  My favourite reason is that it improves my mood!  I just feel better when I am walking or running!

I will be leading a walk/run (depending on who shows up) every Thursday night between 4-5 pm.  Please join me!  You can either sign up by calling 905-683-0690 ( you can just leave a message so I know you are coming)  If you don't get to call you can just drop in at 4 pm on Thursdays.  No experience required!!  Just wear comfy clothes and good shoes.   Bring your own reusable water bottle! 

I will commit to walking/running all Thursdays.  When I am away at conferences or meetings I will post and let you know ahead of time.  ( I know I will be away on Thursday May 11, 2017)

Eventually, those that are interested can sign up for the Ajax run/walk on Oct 1, 2017.  They have a 5k walk/run to raise money for Grandview.  I will be there to cheer you on and also run the 15k

I hope to see you there!

Dr. Maria

Day 1: Trying out the routes around the clinic!

Thursday, April 13, 2017



Wednesday May 31, 2017

I will be in clinic to catch up on pap smear screening.  If you are between the age of 21- 70 and have not had a pap in the past 3 years. Please let us know so that we can book you in for a pap. 
Since I will only see you for a pap that day, you will only be here 5 minutes with minimum wait!
Your health is worth it!

I have added Wednesday May 17 and June 1 to the schedule.  I am aiming to have at least 90% of my patients screened!

                                    Dr. Maria Yu

Tuesday, February 28, 2017

Call Volume to Ajax Harwood Clinic

Presently we receive nearly 600 calls on a Monday; Please expect delay in answering your queries on the high call volume days.

Call  Volume Chart below indicates that a better time to call the clinic would be towards end of the week.