As the weather gets colder, we tend to spend more time indoors and closer to other people, making it easier for respiratory infections to spread. In addition to catching coughs and colds, we also face the possibility of getting a more serious infection such as the flu, COVID, or RSV.

Even though the risk is higher as we approach winter, getting sick is not inevitable. There are ways we can protect ourselves. The most important step we can take is to get the proper vaccinations. While there is no vaccine against the common cold, there are vaccines that provide protection against other respiratory diseases. One very important vaccine is the flu shot.

It is best to get your flu shot each year as soon as possible after the new influenza vaccine becomes available–usually in October. It takes about two weeks after being vaccinated for your body to produce the antibodies that will protect you from the flu. Unless there are medical reasons why a person should not receive the vaccine, the Canadian National Advisory Committee on Immunization (NACI) recommends that everyone six months of age and older should be vaccinated.

Since the outbreak of COVID-19 several years ago, new strains of the COVID virus have appeared, and new vaccines have been developed in response. Another new COVID vaccine will become available this fall. Make sure your COVID shots are up to date.

Other vaccines commonly recommended for adults include pneumococcal and RSV vaccines. Pneumococcal vaccine protects against bacteria that can cause pneumonia, a lung infection characterized by severe cough and chest pain. Vulnerable people can get so sick from pneumonia that it can lead to hospitalization or even death.

RSV (respiratory syncytial virus) is a viral infection affecting the lungs and respiratory tract and causes mild to severe cold-like symptoms such as cough and fever. New single dose vaccines are now available to protect vulnerable groups.

There are guidelines indicating who should receive each vaccine, but the recommendations are general, and they can vary depending on the person’s age and other health factors. Your doctor and London Drugs pharmacist can explain your vaccine options and explain which ones would be right for you. Your London Drugs pharmacist can also administer the vaccines conveniently right in the pharmacy.

Do you really have a cold?

Because a number of respiratory infections spread during the same time of the year as colds, how do you know if what you have is actually a cold? While symptoms and warning signs tend to vary from person to person and from one disease to another, the following are typical signs of a cold:

• Symptoms come on gradually.
• Fever is rare.
• Body aches are mild.
• Chills are uncommon.
• Fatigue and weakness may occur.
• Sneezing, stuffy nose, and sore throat are common.
• Cough and chest congestion are mild to moderate.
• Headaches are rare.

When to see a doctor

Because cold symptoms can be similar to those of more serious illnesses, you should speak with your doctor if:

• Your cold symptoms are severe or unusual.
• You have a fever that lasts for more than four days.
• You have difficulty breathing or are breathing fast.
• Your cold symptoms worsen any chronic medical condition you may have.

If you have any questions about colds or other respiratory illnesses, your London Drugs pharmacists are available to answer them. Ask us. We’re here for you.

These common infections can involve any part of your urinary system.

The urinary tract consists of several parts including a pair of kidneys and ureters, a bladder, and a urethra. Your kidneys filter water and waste products from your blood, and this becomes your urine (pee). Your ureters are tubes that carry the urine from your kidneys to your bladder. Your bladder stores the urine before it leaves your body through your urethra.

Most urinary tract infections (UTIs) affect the bladder. As long as you get prompt treatment for a bladder infection, it generally won’t be a serious problem, and most can be cured with antibiotics in less than a week. However, if treatment is delayed, the infection can spread to your kidneys and may cause lasting damage.

Who gets UTIs?

UTIs can affect anyone, at any age. Male babies tend to have more UTIs than female babies, but once past infancy, more females are affected than males. The chance of a male getting a UTI rises after age 65, when the prostate is more likely to be enlarged.

Someone who develops one UTI is more likely to get another one. About 20% to 30% of people who get one UTI will experience a recurrence.

Starting treatment early is very important to prevent complications, so it is vital to be able to recognize the warning signs. UTIs don’t always cause symptoms, but when they do, they may include:

• A burning feeling when you urinate
• Pain or pressure in the pelvic area
• Frequent urges to urinate
• Awakening two or more times during the night needing to urinate
• Inability to fully empty your bladder
• Blood in your urine, making it look bright pink or red
• Urine that looks cloudy
• Strong smelling urine

When a UTI spreads beyond the bladder, it requires immediate medical attention. See a doctor if you develop symptoms such as:

• Chills
• Fever
• Nausea or vomiting
• Pain in the abdomen, sides, or lower back

It can be difficult to know when children get a urinary tract infection, because they may not be able to explain clearly what they are experiencing, or they may be too young to tell you anything about the problem. If you suspect that something may be wrong, watch to see if they cry when urinating, if they suddenly need to go to the bathroom more often but little urine comes out, or if their urine or diapers have a bad odour.

Treating UTIs

On the bright side, UTIs usually respond well to treatment and can often be cured within a few days.

The usual treatment for a UTI in the bladder is an oral antibiotic that will kill the bacteria causing the infection. Pharmacists can often prescribe antibiotics to treat uncomplicated UTIs. Your doctor or pharmacist can also recommend prescription or over-the-counter pain relievers if needed. It is important to take all of the prescribed antibiotic, even if you start to feel better in a day or two. If the infection has progressed to the kidneys, a doctor may prescribe stronger oral or intravenously (IV) antibiotics.

To reduce the risk of UTI infections and repeated infections:

• Drink more water to help flush bacteria out of your urinary tract.
• Empty your bladder as much as possible when you urinate.
• Women: When you wipe yourself after using the toilet, wipe from the front to the back to
• avoid spreading bacteria from your anus to your urinary tract.
• Women: Urinate immediately following sexual intercourse. Use of spermicide or
• diaphragms may increase your risk of repeat UTIs. Ask your pharmacist or doctor for
• alternative birth control recommendations if you get recurrent UTIs.
• Men: Keep the tip of your penis clean, especially if you aren’t circumcised, because the
• foreskin can trap bacteria that can get into your urinary tract.

Your London Drugs pharmacists are here to help you. If you have more questions about urinary tract infections, your risks of complications, or about the medication that has been prescribed for you, ask us.

What’s behind the exotic name?

Chikungunya is a virus that can be found in many regions of the world, including Asia, Africa, and the Americas. While we are quite safe from this virus in Canada, people who are travelling to other countries should be aware of this disease. Like Malaria and West Nile virus, it is usually spread to humans through mosquito bites. The name “Chikungunya” means “to become contorted” in a Tanzanian language, where it was first identified in 1952.

Chikungunya often occurs in warm and rainy regions, as these provide good conditions for the type of mosquitoes that spread the disease. These mosquitoes typically bite during the day and near water sources. Chikungunya first appeared in the Caribbean in late 2013. By the end of 2017, there had been more than 2.9 million cases. During outbreaks, the virus can spread very quickly, affecting up to 75% of the local population. Many countries have also experienced outbreaks in the past five years, including popular destinations such as Mexico, Thailand, The Maldives, and Nigeria.

People who are sick from the Chikungunya virus do not usually die from the disease, but it can often leave some long-term issues. Up to 30% of infected people show no symptoms, but those who do often experience high fever and severe joint pain in the hands and feet. Rash and eye problems can also occur. Babies, older adults, and people with certain medical conditions may be at higher risk for developing severe disease. Although most people recover in seven to ten days, joint pain and tiredness can last for years. People suffering from long-term effects of Chikungunya infections are often unable to stand upright without difficulty and pain, frequently adopting a “contorted” posture that gives rise to the disease’s name.

There is no treatment for the Chikungunya virus aside from rest, fluids, and pain relievers; therefore, prevention is the best approach. Proper use of mosquito protection measures—such as mosquito repellant sprays, long-sleeved clothing, and mosquito nets—is important to provide protection against Chikungunya. These measures can also prevent other mosquito-borne diseases such as Malaria, Dengue Fever, and Zika virus. Recently, a new Chikungunya vaccine that provides excellent protection against the virus has been approved in Canada for people who are at risk of exposure to the disease. It will be available in late 2024.

If you’re planning a trip, talk to a physician or schedule an appointment with a healthcare provider who specializes in travel medicine. It is best to schedule an appointment at least four to six weeks before your travel, because some vaccines require multiple doses for full protection. Travellers with shorter timelines should also seek advice. All of our Travel Clinic pharmacists are certified by the International Society of Travel Medicine (ISTM). They can provide you with comprehensive travel advice, plus vaccines and medicines to help keep you safe on your trip. Visit ldtravelclinics.ca for more information about our London Drugs Travel Clinics and for a list of locations.

As summer turns to fall and fall to winter, it is important to protect ourselves from the flu.

Influenza (the flu) is an illness that affects the whole world and reaches Canada every fall, making many people sick. While most cases of the flu occur in January and February, flu season can begin as early as November and stretch into April. While it doesn’t usually last more than a couple of weeks in most people, it can cause serious complications for some.

PREVENTION

The best way to prevent the flu is through vaccination. The virus that causes the flu is called influenza, and it changes from year to year, so the vaccines must change as well. Scientists around the world study the new strains of the virus, and they work to develop new vaccines that are effective against these new strains. There are a number of different flu vaccines available in Canada, and some are designed especially for people in certain age groups. Your healthcare provider will determine which vaccine you should receive.

It is best to get your flu shot each year as soon as possible after the new influenza vaccine becomes available–usually in October. It takes about two weeks after being vaccinated for your body to produce the antibodies that will protect you from the flu. Unless there are medical reasons why a person should not receive the vaccine, the Canadian National Advisory Committee on Immunization (NACI) recommends that everyone six months of age and older should be vaccinated. Vaccination is particularly important in people who have a higher risk of developing serious complications. Among the groups that are considered to be at high risk are people with chronic health conditions, adults over age 65, anyone living in a long-term care facility, Indigenous peoples, and pregnant women.

Not only will being vaccinated help keep you healthy, it will also help others, because if you don’t catch the flu, you can’t pass the flu virus along to others. Some people cannot receive the vaccine due to health issues, and some of them have a high risk of developing serious complications from the flu. If everyone who could get a flu shot did get one, there would be fewer people in the community spreading the virus. By taking this step to prevent your own suffering from the flu, you could be saving someone else from a serious health problem.

In addition to getting vaccinated, other precautions you can take include:

• Avoid close contact with anyone who appears to be sick.
• Wash your hands frequently with soap and warm water or use an alcohol-based cleanser.
• Cough or sneeze into a tissue or into your sleeve, dispose of the tissue properly, and wash
• your hands as soon as possible.
• Don’t touch your eyes, nose, or mouth.
• Don’t share food, utensils, or personal items.
• Disinfect commonly touched surfaces such as doorknobs and light switches.
• Practice healthy habits: eat nutritious foods, be physically active, drink plenty of fluids, get
• enough sleep, and manage your stress.

NOT JUST THE FLU

Since the outbreak of COVID-19 several years ago, new strains of the COVID virus have appeared, and new vaccines have been developed in response. Another new COVID vaccine will become available this fall. Make sure your COVID shots are up to date.

Other vaccines commonly recommended for adults are:

• Shingles vaccine: Shingles is a viral infection caused by re-activation of the varicella-zoster virus, the same virus that causes chickenpox. After exposure to chickenpox, the virus lays dormant in the body and can be reactivated later in life due to a stimulus such as stress or illness. Shingles often causes a painful blistering rash that appears in a line on one side of the body and is often accompanied by nerve pain. The pain can last for several months after the rash disappears. Some people can even experience a loss of hearing or vision or other complications. The shingles vaccine is recommended for adults 50 years and older and for immunocompromised individuals 18 years and older. The vaccine series requires a total of two doses spread over two to six months, and it is important to get both doses.
• Pneumococcal vaccines: Pneumococcal vaccines protect against bacteria that can cause pneumonia, a lung infection characterized by severe cough and chest pain. Vulnerable people including older adults can get so sick that it can lead to hospitalization or even death. Pneumococcal vaccines are recommended for all adults 65 years and older, for adults 50 to 64 years of age with chronic medical conditions or other risk factors, and for adults 18 to 49 years of age with risk factors. Long-lasting protection is usually achieved with a single dose of vaccine.
• MMR vaccine: Measles, mumps, and rubella (MMR) are conditions caused by highly contagious viruses. Measles can result in symptoms of fever, red eyes, cough, and a rash. Mumps often causes painful swollen glands, and rubella can cause a fever and a rash as well. Individuals born before 1970 are assumed immune because of widespread disease before an effective vaccine was widely available in 1971. If you were exposed to someone who had measles or if you had measles yourself, you likely have natural immunity now. MMR vaccine is now part of routine childhood immunization programs, and it is less common for kids to get these illnesses. For adults, a single dose of the vaccine is recommended for people born after 1970, healthcare workers, travelers, and for other individuals at risk.
• HPV vaccine: Human papillomavirus (HPV), is a virus that can cause genital and common warts. It is also the most common sexually transmitted infection in Canada, infecting over 70% of sexually active adults in their lifetime. HPV is responsible for almost all cases of cervical cancer as well as head and neck cancers and other genital cancers. Not all HPV infections lead to cancer, but the there is an effective vaccine that can help prevent HPV infections and reduce your risk of developing these cancers. School age children are offered this vaccine as part of routine vaccination programs. It is also recommended for unimmunized adults up to age 45 and sometimes for older adults who are at continued risk, such as having new or multiple sexual partners. Speak to a healthcare professional about whether HPV vaccine would be appropriate you. For adults, the vaccine series requires a total of three doses spread over a six-month timeframe.
• Tetanus vaccine: Tetanus is a disease of the nervous system caused by a bacteria called Clostridium tetani and results in painful tightening of muscles over the body. People can be exposed to this bacterium through cuts, scrapes, and puncture wounds. Tetanus vaccines are provided as part of routine childhood vaccine programs. A single booster dose of the vaccine is recommended for all adults over the age of 18 and for pregnant women between 27 and 32 weeks of each pregnancy to protect their babies. Additionally, everyone should get booster doses every ten years for ongoing protection and after certain injuries or animal bites. The vaccine is available in two formulations, tetanus-diphtheria (Td) or tetanus-diphtheria-pertussis (Tdap).

Take our quick one-minute quiz to see which vaccines are recommended for you. The quiz is available at londondrugs.com/vaccine-screening. Then speak to your pharmacist for more information about each vaccine and to learn about public (free) vaccine programs or insurance coverage.

Have you ever wondered if you are getting the most out of your medications? Do you ever feel frustrated with managing your medications from morning to night?  Are you concerned about whether your medications are right for you? If so, consider making an appointment for a medication review or a personalized one-on-one consultation with your local London Drugs pharmacist, where a plan can be made to address all your medication, lifestyle and health concerns.

Did you know that 1 in 30 patients have a drug-related problem that may cause a current or future health issue?  Pharmacists are experts in managing all aspects of your medication regimen and how they impact your everyday life. A medication review is a great way to detect and resolve any drug-related concerns before they become a problem to your health.

Patients often wonder how medication reviews differ from the consultations provided when picking-up medication.  Consultations provided during prescription pick-up are focused on ensuring you can take the prescribed medication(s) correctly, as well as knowing when to expect benefits and what side effects to monitor for.  Consultations provided during medication reviews are thorough discussions about all your medications, and how they relate to your lifestyle and overall health goals.

During a medication review, your pharmacist will go over every medication that you take, including prescription drugs, over-the-counter medications, natural health products, and vitamins/supplements, to ensure that they are appropriate, effective and safe.  Your pharmacist will also ask questions about your health conditions and lifestyle, in order to tailor advice and information, especially for you. Based on the information collected, your pharmacist will develop a plan to address any problems and/or concerns identified during the medication review. These plans can help you simplify your medication regimen, eliminate unnecessary medications, reduce drug costs, address drug-related side effects, and remove barriers to taking medication through blister-packing, delivery and medication synchronisation services.

At the end of the medication review, your pharmacist will provide you with a document summarising everything that was discussed during the consultation.  It will contain an up-to-date medication list and any recommendations that were discussed during the meeting.  If necessary, the pharmacist can also communicate any findings to other members of your healthcare team.

Medication reviews are helpful for most patients.  However, medication reviews are especially helpful for those who were recently discharged from hospital, receive care from multiple healthcare providers, and/or take prescription medication for chronic diseases such as high blood pressure, heart disease, diabetes, asthma, COPD or mental health.  This is because these patients are often at a higher risk of experiencing drug-related problems, and can benefit from increased check-ups to detect and resolve issues before they negatively impact their health.  Appointments typically last 30 to 45 minutes and should occur every 6 to 12 months. Follow-ups can be arranged upon request, or if any changes are made to your medications.

Medication reviews are confidential in-person discussions with the patient at the pharmacy, conducted at one of the pharmacy booths or in a consultation room.  Some patients also like to have a caregiver or family member present.  In some cases, caregivers may be able to come on-behalf of a patient, if they have legal consent or power-of-attorney and sufficient knowledge of the patient’s health concerns.  Bring all of your medications, both prescription and over-the-counter, plus any natural health products, and vitamins, and supplements that you take. Some patients have also found it useful to bring a list of questions and concerns to the appointment, as well as laboratory and medical reports that they want to discuss. You are also encouraged to bring any expired medications or drugs that you no longer take so we can safely dispose of them for you.

Book your medication review today!  Appointments can be made by calling or visiting your local London Drugs pharmacy, or by requesting an appointment through the London Drugs Pharmacy App. If you have questions about medication reviews or any other pharmacy service, speak to one of our pharmacists anytime.

Medication Reviews in Brief

What is a medication review:

• Thorough consultation with a pharmacist to discuss all medication and health concerns.

Who should have a medication review:

• Patients who take multiple prescription medications
• Patients who were recently discharged from hospital
• Patients who receive care from multiple healthcare providers
• Patients who take over-the-counter medications and/or natural health products
• Patients with chronic diseases

Additional reasons for a medication review:

• You want to simplify your medication regimen
• You want to reduce the amount of money you spend on medication
• You want to feel less overwhelmed by your medicines
• You want to make sure that your medicines are working for you and not causing side effects or other interactions.

Where and when are medication reviews are held:

• They are in-person appointments held at the pharmacy in a semi-private consultation booth or in a private consultation room.
• Appointments typically last 30 to 45 minutes and occur every 6 to 12 months.
• Follow-up appointments are available to check on any changes made at the initial appointment, if there is a change in patient’s medication or health status, or whenever a patient requests.

Menopause marks the end of the transitional phase women go through as their bodies pass out of the childbearing stage of life. Even though all women experience “the change of life,” as it is often called, there is still a lot of confusion surrounding the stages of menopause and how to make the transition more comfortable. Put simply, menopause is the point 12 months after a woman’s final menstrual period. The transition leading up to that point is referred to as perimenopause.

Perimenopause:

Perimenopause generally begins between the ages of 45 and 55 and usually lasts about seven years, although it can last up to 14 years in some women. During this phase, a woman may experience a variety of changes, both physical and emotional. Emotional changes can range from feeling depressed about getting older to being happy about no longer having to worry about the possibility of becoming pregnant. Health professionals generally counsel women to focus on the positive aspects of the change and how it is the beginning of a new stage of life, one without the pain and inconvenience of menstruation. Think about it—no more cramps, no more having to stock up on sanitary products such as pads and tampons, and no more worrying about unexpected periods. Some women go through the perimenopausal years without experiencing any significant symptoms, but most women will notice some symptoms as their bodies’ production of the hormones estrogen and progesterone change. You may find that mild symptoms are manageable with lifestyle adjustments (such as dressing in layers so they can adapt to changes in body temperature), while others may require the help of your healthcare team.

Common symptoms:

The symptoms can vary greatly from woman to woman, but among the most common symptoms a woman may experience are:

• Changes to period
• Hot flashes
• Loss of bladder control
• Sleep difficulties
• Vaginal dryness
• Changes in libido
• Mood disturbances
• Memory problems
• Weight gain
• Night Sweats

Because changes to hormone levels can be triggering these symptoms, it is impossible to predict which women will get which symptoms, how severe they will be, or how often they will occur.

Treatments:

For vaginal dryness

• Non-medicated vaginal moisturizers and lubricants: daily use, a few days per week, or specifically during intercourse
• Prescription vaginal estrogen tablets or cream

For hot flashes and night sweats

• Hormone replacement therapies: estrogen and progesterone
• Other prescription medications: antidepressants, clonidine, gabapentin, pregabalin

Although hot flashes and vaginal dryness are the most common concerns, there are many treatments, prescription and non-prescription, available to help treat other menopausal symptoms you may be experiencing. Speak with your healthcare team, including your pharmacist, to help you choose what types of therapies may be right for you.

Herbal remedies:

Among the natural, non hormonal products used to treat menopausal symptoms are black cohosh, red clover, and evening primrose oil, which may reduce hot flashes in some women. Another option is ginseng, which may help with moods, a sense of well-being, and sleep disturbances.

In Canada there are regulations in place to ensure that natural health products are safe, effective for their intended use, and of high quality. However, more studies are necessary to demonstrate a high level of effectiveness, and just because a product is natural does not mean that is it without harm. Some herbal medications can interact with other medications or can cause harmful side effects for some people. Check with your pharmacist before starting any new natural remedy and inform your doctor as well. Your healthcare team can help you find the right products that will be safe for you to try.