Active Living • Health News • Healthy Mind • Nutrition • Prevention • Women's Health

WHAT'S NEW

Fixing health follies

Sex, drugs, rock 'n' roll -- most of us have taken health risks of one kind or another. You can't go back, but you can (in most cases) act now to neutralize your youthful indiscretions.

By Paul Benedetti

5. Rap sheet: Sunburn
Fort Lauderdale, Fla. Spring break, 1985. You are in a new bikini. You pour on the coconut oil and fall asleep in the sun. That night, you're not tanned, you're medium rare.

Regrets: Welcome to Wrinkle City. Exposure to sunlight creates a photoaging effect dermatologists commonly call Miami Beach Syndrome. "That's 90-year-old skin on a 40-year-old," says Dr. David McLean, a dermatologist in Vancouver. "It is caused by the collagen in the skin being functionally destroyed by ultraviolet light over time." Want proof? Look at the bottom of your arm. It's soft, smooth and unblemished. Now look at the top of your arm. See the freckles, brown spots and roughened texture? "That's the benefit of sunshine," says McLean sarcastically. "Childhood exposure causes the wrinkles at age 40."

Wrinkles are a worry, but more serious is the risk of skin cancer. McLean says it's not possible to quantify the risk of a single sunburn, but then few people get just one. And "one in eight Canadians develops a skin cancer in the course of a lifetime," he says. "It is almost 100 per cent preventable."

What to do now: In terms of cancer prevention, the best thing to do is visit your doctor once a year after age 40.

"That's really important," says McLean, who is also the head of cancer prevention for the B.C. Cancer Agency. Many skin cancers have a precancerous phase and can be diagnosed very early and treated simply and effectively.

Avoid getting more sun. Never use tanning salons. Wear a hat in the sun to protect your head and face. Whether you are light-skinned or have a dark complexion, use a high-number sunscreen (at least SPF 60) generously. Most people use a quarter of the amount of sunscreen used in testing.

As for the wrinkles, you have three choices. You can get a laser treatment or a face-lift from a cosmetic surgeon, both costly options. For much less money, you can use tretinoin, a vitamin A acid that's also known as Stieva A or Retin A. You put on a tiny amount at night. After a year, you'll notice a difference. Fine lines fade and blotchiness improves.

Finally, limit your sun exposure. "What you do now will affect the way you look when you are 60," says McLean. "That may seem a long time off, but 40 looked to be a long time off when you were 20."

6. Rap sheet: Sports injuries
When Patti Flaherty was young she played high school volleyball, field hockey, basketball, track-and-field and a bit of soccer. She won athlete of the year in Grade 12 -- and she has the trophy to prove it.

Regrets: Of course, that was 1984. Today, Flaherty also has sore shoulders, sore wrists and sore fingers. "I didn't have any significant long-term injuries, but I never really allowed things to heal very well," says Flaherty. "It was stupid, but I just wanted to play."

That's not news to Glen Bergeron, an associate professor in the department of kinesiology and applied health at the University of Winnipeg. He's seeing dozens of athletes coming back as early as their 40s to get their knees and hips done. "It's alarming," says Bergeron, who specializes in athletic therapy. "The majority of what we see is knee and hip arthritis. But we also see significant ankle and shoulder deteriorative changes." Old cartilage tears result in serious osteoarthritis and eventually, for some people, the need for total joint replacement surgery. In the meantime, there's pain, reduced mobility and the need for medication.

What to do now: You can't fix the damage, but you can minimize the symptoms. That usually means doing strength and flexibility exercises, such as lifting weights and stretching, says Bergeron. Also, find an activity, such as cycling or swimming, that is easier on your joints and will not continue to aggravate the problem.

7. Rap sheet: Unprotected sex
In your mid-20s, you did a bit of recreational sleeping around. It was fun for a while. You got chlamydia once, but your family doctor gave you antibiotics and it cleared up completely.

Regrets: In today's safe sex world, you're worried that an STD you got years ago may be a problem. The good news is that while getting chlamydia may be embarrassing, knowing you had it -- and having it treated -- means you were cured and will suffer no long-term effects. The same goes for gonorrhea and even the relatively rare syphilis, both of which can be cured with antibiotics.

The problem is having an STD without knowing it. You can have chlamydia for years and not have any symptoms: up to 90 per cent of women with chlamydia have no symptoms at all. That means not only are you passing the infection along to your partners, but you may also be doing long-term damage to yourself. Untreated chlamydia can lead to pelvic inflammatory disease, which can scar the fallopian tubes and result in ectopic pregnancies or infertility. And it increases the risk of contracting HIV, says Dr. Cheryl Main, director of Hamilton's STD and Sexual Health Clinics for Public Health.

Similarly, it's possible to have herpes for years and not know it. Some people break out in painful blisters, but some women only get burning and itching, which they often mistake for a yeast or bladder infection.

Also very common is human papillomavirus (HPV). There are two kinds: low-risk HPV, which causes genital warts, and high-risk HPV, which can cause cervical cancer in some people. Many people will not have any symptoms, and while the majority of people's immune systems will clear HPV, not everyone's does. "We don't know why," says Main, who is an infectious disease specialist. "Within that small percentage who do not clear it, they are at risk to develop cancer."

Finally, people who contract human immunodeficiency virus (HIV) can remain symptomless for years, but the virus still attacks the immune system. Within 10 years, most people with HIV contract an opportunistic infection, which means they have acquired immune deficiency syndrome (AIDS).

What to do now: Get tested. "It's not too late," says Main. "I think when women get their regular Pap smears, they should get a swab done as well to look for gonorrhea and chlamydia -- because they are curable."

Testing is important for other STDs, too. Though herpes is not yet curable, medications can reduce outbreaks and reduce spread. Cervical cancer can develop 20 years after HPV infection, but regular Pap smears can detect precancerous lesions, which can be effectively treated. Currently there is no cure for HIV-AIDS, but antiretroviral drugs can delay the deterioration of the immune system in most patients.

If you are embarrassed to visit your family doctor, find the nearest walk-in STD clinic. They are completely hassle-free: no names, no health card and no trip to the pharmacy. Most medication is provided on the spot free of charge. "Come in and get tested," says Main. "That is the responsible thing to do."

Page 2 of 2