Relaxation Strategies

Admin 20 Jan , 2021

Information gathered and prepared by H. Wiens MSc., RP.
Registered Psychotherapist Portage Medical Family Health Team


Taking just a few moments each day to practice some deep breathing exercises, coupled with mantras and imagery, relaxes the mind and body in the following ways:

Increases energy level: As the body is being oxygenated, this provides additional energy and improves the function of every gland, muscle and organ.

Improves posture: As the lungs are filled to full capacity the spine is lengthened.

Activates the parasympathetic nervous system: Deep breathing signals to the nervous system that all is well, which decreases heart and respiration rate and stabilizes blood pressure, which rests and repairs the body and decreases anxiety and depression.

Improves concentration, memory and decision-making: In a state of calmness, the blood to the brain reaches its optimal supply, which improves concentration and the encoding of memory.

Natural painkiller: When you breathe deeply, the body releases endorphins, which relaxes muscles

Improves digestion: Breathing deeply increases the blood flow to the intestines to improve digestion.

Stimulates lymphatic and circulatory system: Deep breathing allows the lymphatic and circulatory system to work more efficiently in detoxifying the body.

Reduces inflammation: Deep breathing reduces the acidity in the body making it more alkaline thereby decreasing inflammation.

Oxygenates and detoxifies the body: Deep breathing detoxifies as the exhalation releases carbon dioxide, while the inhalation oxygenates glands and organs.

Websites for additional information:


Emotional Wellness Throughout the Holiday Season

Admin 10 Dec , 2020

Information gathered and prepared by A. Balind MSW, RSW
Clinical Social Worker, Portage Medical Family Health Team

Emotional Wellness Throughout the Holiday Season

There is so much to do at this time of year, that it’s easy for us to feel overwhelmed by it and let anger, frustration, and stress begin to build.  This season looking very different does not help. Making use of and practicing coping skills is essential at this time of year.  Here are a few suggestions that you may wish to try in the coming days and weeks in order to have a meaningful, joyous, and manageable holiday season.

1. Learn to say “No” to others and yourself

  • Prepare a budget for your holiday spending and do not go over it. You don’t have to overspend on gifts, trying to buy the perfect one for each person. Try a card with a special message or something homemade.
  • We often feel a lot of pressure to spend the holidays loved ones but, making sure everyone is healthy and safe. When it is time to attend gatherings and parties, set a definite number to attend and be sure to maintain social distancing and wear a mask when possible. Send out sincere apologies for any events that will have to be missed.
  • Listen and give empathy to each family/friend you speak to about their needs and concerns about the holidays. Everyone is in a different place right now and that is okay. Try and find solutions that everyone is comfortable with and validate how someone is feeling before you give suggestions or solutions.
  • Forget traditions and take a serious look at the holiday practices that you may struggle to maintain. Decide which are not worth the mental, emotional, and physical effort they require. Perhaps begin new and more manageable traditions that surround the most important things and people in your life.

2. Learn to say “Yes”- Do not hesitate to accept help

  • Lean on others for support. A network of close friends and family can help you keep things in perspective. Accept help as it is offered and do not be afraid to ask for help when you need it.
  • One good way to put things into perspective is to volunteer some of you time and energy into a worthy cause. It takes the focus off of you and any holiday anxieties. You can benefit from knowing you are making a difference and doing something that matters.

3. Assign one hour for yourself

  • Treat yourself to something special. It does not have to be anything that cost a great deal of money, but it should be something that includes relaxation and enjoyment. Schedule this time in your calendar and stick to it.  Your mind and body will thank you.

4. Think of different ways to safely spend time with family and friends

  • Connect over social media (Facebook, Zoom, FaceTime, etc.) and play games, decorate a tree or have an ugly sweater party.
  • Send/safely deliver packages to family/friends with cookies to decorate or a craft to make. This can also be done over a video chat together!

5. Talk with family and friends about delaying the holidays

  • It may not be traditional but, making the decision to delay get together and visits until it is safe to do so. It may be exciting and fun to have a summer Christmas! Warm weather is not something we get at Christmas in Canada!
  • Prepare family members of changes to traditions early. Give everyone time to understand their feelings and plan their holidays. This is very important for children so they can realize that it is not their fault that the holidays will be different this year and that they will still be fun!

Change your thoughts to transform your life!

Admin 24 Nov , 2020

Information gathered and prepared by H. Wiens, MSc., RP.
Registered Psychotherapist, Portage Medical Family Health Team

Change your thoughts to transform your life!

What are cognitive distortions and how can I change these thought patterns?

I just know I didn’t do well with my job interview, so no one will hire me”
I didn’t get invited. No one likes me.
I have a headache, it must be cancer.

These are all prime examples of cognitive distortions. Cognitive distortions are biased perspectives we may have about ourselves and the world around us. They are irrational thoughts and beliefs that we unknowingly reinforce over time. But if they’re reinforced often enough, they can increase anxiety, deepen depression, cause relationship difficulties, and lead to a host of other complications.

Research suggests that cognitive distortions originate as a means of the brain trying to make sense of stressful life events. In the distant past, when we resided within hunter and gather societies, it was adaptive at that time to be hypervigilant to threat. Thank goodness we no longer have to be on the lookout for predators but the brain may continue to have a negative bias. To alleviate this negative bias, it is helpful to become conscious of the thought process to identify the thought distortions. Thought distortions are tendencies of thinking or believing that are false or inaccurate and have the potential to cause psychological harm.

There are fourteen thought distortions that we can alter by first becoming conscious of the thought process to then find alternative explanations and counter evidence to the presenting scenario, worry or concern.

  • All or nothing: Viewing situations in extremes, as being all white or black.
  • Overgeneralization: Utilizing the words “always or never” to suggest a never ending pattern of defeat.
  • Mental filter: Dwelling on the negatives and ignoring the positives of the situation.
  • Disqualifying the positive: So focused upon the negative that we can no longer perceive positive qualities or accomplishments.
  • Jumping to conclusions: Making a negative assumption about a situation.
  • Magnifying and Minimizing: Blowing things out of proportion by magnifying the negatives of the situation and minimizing what is going well.
  • Emotional reasoning: Believing thoughts to be true based upon how one feels but feelings are not a fact.
  • Should and must statements: Statements that indicate an unrealistic expectation of ourselves or others.
  • Labeling: Labels occur when we fail to examine the context of a situation thereby believing that the label is a complete representation of the self or others.
  • Personalization: Assuming responsibility for others’ behaviours or circumstances outside of one’s control.
  • Catastrophizing: Imagining the worst case scenario.
  • Mind reading: Assuming that others are making negative evaluations of you.
  • Tunnel vision: Only focusing on the negative aspect of a situation instead of stepping back and looking at the bigger picture.
  • Fortune telling: Predicting doom and gloom in the future.

Steps to changing your thoughts:

  • Become conscious of the thought process to identify troubling situations in your life.
  • Identifying the thought distortions.
  • Identify rationale thoughts by examining alternative explanations. To illustrate, instead of believing the person is ignoring you, consider that instead they may not have seen you or are not feeling well.
  • Identify counter evidence. For example: “I am stupid” is replaced with counter evidence, “I am intelligent and creative.”
  • Counter evidence can become positive self-affirmations reviewed daily by writing down the names of those within your support system, achievements, compliments, and things that you are grateful for.
  • Writing three things that you are grateful for nightly amplifies the positive changes to brain chemistry and its neural circuitry.
  • For lasting results, get into the practice of monitoring and challenging your thoughts.

Helpful website links:





What is Mindfulness?

Admin 01 Sep , 2020

Information gathered and prepared by H. Wiens MSc., RP.
Registered Psychotherapist Portage Medical Family Health Team

What is Mindfulness?

Wheel of Awareness (Dr. Dan Siegel):



– Mindfulness began as a Buddhist tradition. Mindfulness is the state of being conscious by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations without judging them or believing that there is a “right” or “wrong” way to think or feel in a given moment.

– The mental benefits of mindfulness include the following: helps to regulate emotions, fights depression and anxiety, assists with memory, fights PTSD, and improves academic performance.

– The physical benefits of mindfulness include the following: reduces inflammation, fights chronic pain, reduces arthritis, and heart disease risk factors, helps with irritable bowel disease, assists with weight loss, improves sleep and the immune system.


Websites for additional information:

Medication Safety, Storage and Disposal

Admin 04 Aug , 2020

Information gathered and prepared by S. Bruni Registered
Pharmacist, Portage Medical Family Health Team


Medication Safety, Storage and Disposal

  • Medication safety is an on-going process from start to finish!
  • Importance of open communication at each stage between you and your prescriber and pharmacist.
  • Don’t hesitate to call with concerns about your medications.
  • Be sure to carry an up-to-date medication list with you. The option to also put a copy on your fridge if you live alone.
  • This can be obtained from your local pharmacy. They may advise you complete a MedsCheck visit to ensure your list is complete.
  • Medic-Alert bracelets for allergies, medical conditions and medications (e.g. blood thinners).

 What should I do with my unused medications?

  • Often expired/unused prescription and over-the-counter medications are left in medicine cabinets/cupboards.
  • This can lead to potential misuse if an individual mistakenly takes an expired or unused prescription medication that may no longer be effective.
  • Medications (prescribed/over-the-counter) that have been prescribed to treat a medical condition for one person, may not be safe for everyone (may interact negatively with other medications or their medical conditions).
  • Please safely dispose of expired/unused medications to ensure they are not taken by someone else in error!

When and how should I return expired medications/needles (sharps)?

Often your pharmacy will accept expired medications. If you’re unsure about returning expired medications at your pharmacy, check with your pharmacy first!

Prescription/Over-the-Counter Drug Disposal (Free of Charge)

Take medications to a household hazardous waste depot or a local pharmacy for proper disposal (free of charge).
Please do not put in the garbage, recycling boxes or pour them down the drain, as this can be harmful to people, animals and the environment!

Disposing of Needles/ Sharps

Place all syringes/sharps in a sealed container (eg. plastic coffee container) or a sharps container.

Contact your local pharmacy to see if they offer free sharps containers for disposal eg. Stericycle. Often the pharmacy requires any needles/sharps to be returned in a proper SHARPS disposal container.

Other options: bring the container to a Household Hazardous Waste Depot (see below for the Niagara Area).

 Waste Info Line: 905-356-4141

Humberstone Landfill
700 Humberstone Rd. Welland, ON
Bridge St. Drop-Off Depot 1300 Bridge St. Fort Erie, ON
Thorold Yard Household Hazardous Waste Drop-off Depot 3557 Thorold Townline Rd. Thorold, ON

What should I know about sun protection?

Admin 30 Jun , 2020

Information gathered and prepared by S. Bruni
Registered Pharmacist, Portage Medical Family Health Team

Come on Sunshine!

What should I know about sun protection?

  • Sunscreen can help prevent skin cancer that is caused by exposure to UV light and prevent premature skin aging.
  • UVB rays mostly cause sunburn. UVA rays can cause early skin aging and skin cancer. We recommend a sunscreen labelled “broad spectrum” to protect against both UVA and UVB rays and with an SPF of 30 or higher (some individuals require stronger SPF.
    • FUN FACT! SPF (sun protection factor): SPF describes the amount of UVB protection (i.e., protection against sunburn) that a sunscreen provides and is not related to the amount of time it provides protection.
  • Limit your time in the sun (especially between 10 AM and 2 PM when the sun’s rays are the strongest).
  • Don’t forget your sunglasses (ones that block UV rays) and that you can still get a burn even if it is cloudy outside!
  • Tightly woven dry clothes → reflect almost all UV rays.
  • If light passes through clothing held up to the sun → UV rays will pass through to skin.
  • Wet clothes → half of UV rays to pass through to skin.
  • Protect the skin → wear long-sleeved shirts, pants and wide brimmed hats.

Remember the importance of applying sunscreen properly!

  • Apply sunscreen 15 to 30 minutes before sun exposure for the best effectiveness.
  • Apply sunscreen every morning to face (don’t forget your ears and lips!), neck and hands.
  • To protect your lips, choose a lip balm with SPF 30 or higher.
  • Apply sunscreen generously to all exposed skin (most people apply only 1/4 to 1/2 of the recommended amount, putting their skin at risk!)
  • The average sized adult should apply a total of 1 to 3 tablespoons (about a handful) of sunscreen per full-body application.
  • This works out to about 1 teaspoon (per body part) to face/scalp and each arm, and 2 teaspoons (per body part) to torso and each leg.
  • REMINDER!! Reapply sunscreen at least every 2 hours.
  • Reapply even sooner if you are sweating or swimming.
  • Product labelling will read “water resistant,” and must indicate whether the sunscreen remains effective for 40 minutes or 80 minutes while a person is swimming or sweating.

Chemical Sunscreens
-Usually include combinations of ingredients avobenzone, homosalate, octinoxate, oxybenzone, mexoryl SX etc.
-Most common products
-Easier to apply

Physical Sunscreens
-Zinc oxide or titanium dioxide
-Can be thick and harder to apply but there are  formulations that may make application easier

Both chemical and physical sunscreens are effective.
Find a product that you like and be sure to apply it properly!

Medications: Some may make your skin more sensitive to the sun and cause reactions such as an itchy, red rash or exaggerated sunburns. You should be advised by your pharmacist to minimize sun exposure and to use broad-spectrum sunscreens when sun exposure cannot be avoided.

If you have any questions or concerns regarding sun protection or require individual recommendations, please contact the Portage Medical Family Health Team for an individual appointment with the team Pharmacist.







Seniors and Keeping Hydrated

Admin 11 Jun , 2020

Information gathered and prepared by A. DiLibero, Registered Dietitian, Portage Medical Family Health Team

Seniors and Keeping Hydrated

Hydration is important year round however during warmer weather staying well hydrated is essential.  Seniors are at increased risk for dehydration for many reasons including:

  • Decreased thirst sensation
  • Medications
  • Incontinence
  • Changes in functional ability
  • Cognitive impairment

Dehydration is a common cause of hospitalization among the elderly and symptoms of dehydration often go unrecognized.  Below are some of the signs of dehydration:

  • Dizziness, weakness and confusion
  • Dark strong smelling urine
  • Increase risk of falls
  • Constipation
  • Low blood pressure

Many follow the general rule of drinking 8 to 10 glasses of water daily however some people can tolerate less and some will need more, like in the summer months if you are sweating.  Also, some medical conditions like heart failure require more specific fluid needs.  When choosing beverages check for ingredients like sodium and sugar which can affect health conditions like high blood pressure and diabetes.

Facts on Fluids – How to Stay Hydrated –

Tips for Increasing Water Intake

  • Keep a variety of sources on hand – you don’t have to just drink water to stay hydrated. Coffee, tea, milk, sparkling water and foods like yogurt, custard, fruit and vegetables help keep us hydrated.
  • Keep a drink close by at all times. Sip something throughout the day. If you wait until you are thirsty to drink you are likely already dehydrated.  Keep a drink in a place where you can see it often like on the kitchen table or beside your favourite chair.  Use an insulated cup that regulates the temperature and is easy to take with you on the go.
  • Experiment with different temperatures and flavours. Try adding cucumbers, mint, berries or orange slices to make drinks more appealing.
  • Include smoothies and meal supplements for meals and snacks.

Making Smoothies with More Calories and Protein – Alberta …



Sleep Hygiene

Admin 13 May , 2020

Information gathered and prepared by H. Wiens MSc., RP.Registered Psychotherapist Portage Medical Family Health Team


A good night’s sleep that is 7-9 hours in duration has broad health benefits, such as improving the immune system, diminishing our risks for dementia, cancer, heart disease, diabetes, and even obesity. Sleep also has a profound effect upon our degree of concentration and ability to encode memory. Sleep increases the degree of serotonin and dopamine within the brain that has a direct impact upon mood, energy level and overall degree of happiness.

In these challenging times, we need restorative and restful sleep more than ever.  Here are some tips to consider.

10 Strategies to improve sleep:

  1. Go to sleep and wake up at the same time every day. This allows the pineal gland to produce enough melatonin so that you begin to feel sleepy and fall asleep much sooner, to acquire deeper quality sleep for a longer duration.
  2.  Set an alarm for bedtime. A regular night-time routine will signal to the body and brain that it is time to wind down.
  3. Engage in non-stimulating activities. Listen to relaxing music, nature sounds or podcasts such as Sleep with Me. Adult coloring books have the same effect as meditation to calm brain activity. Reading a magazine or calming book may also be soothing. Take some time to engage in relaxation strategies, such as deep belly breathing while saying a mantra and imagining a calming scene. Be sure to complete stimulating activities such as eating or doing chores at least 2 hours prior to bedtime. Limiting liquids will also minimize trips to the bathroom during the night.
  4. Shut off all electronics. A tablet, phone, PC or TV’s backlight reduces the amount of melatonin available for falling asleep in a timely manner to acquire deep and restful sleep.
  5. Cool off. Keep the bedroom at 18-20 Celsius, which allows the body to acquire restful REM sleep, which is restorative to cells and brain chemistry.
  6. Darken room and get morning light. Research indicates keeping the room dark or wearing a sleep mask results in deeper quality sleep. While getting sunlight during the day helps to set our circadian rhythm.
  7. Exercise. This allows the body to release body tensions and lactic acid that accumulates within muscle tissue. Be sure to complete your workout at least 3 hours prior to bedtime. Engaging with progressive muscle relaxation will also alleviate tension.
  8. Limit caffeine intake. Assess how many cups of coffee, pop, energy drinks and chocolate is ingested daily and try cutting back to improve your quality of sleep. Avoid caffeine 4-6 hours prior to bedtime.
  9. Deal with ruminations. Write a worry list, at least 2 hours prior to bedtime. Create a gratitude journal, in which you write three things that you are grateful for today. Engage in thought stopping by telling yourself that you will deal with the issue tomorrow and instead turn your attention to your relaxation strategies. You may also challenge your negative thought by replacing that thought with counter evidence.
  10.  Re-think your nap. Naps that are longer than 30 minutes in duration may disrupt the amount of melatonin required for a good night sleep.

Additional resources:

Health Benefits of Gardening

Admin 21 Apr , 2020

10 Tasks to Prepare Your Spring Garden

Adapted from

Inspect Raised Garden Beds
Check garden beds for any damage. Repair any bowed or split wood on the frames.

Check Your Garden Tools
Get your garden tools in tip-top shape before the planting season gets in full swing. Give them a good wipe down and inspect for rust on the tool heads.

Turn Your Compost
It’s time to turn your compost pile and check for any that is ready to use. Add compost to improve soil by scratching in finished compost into the top one inch of soil.

Top Dress Garden Beds
If you run short of home-grown compost, use well-seasoned manure to top-dress your garden beds in preparation for planting.

Divide Perennials
Spring is a great time to transplant divisions or move plants around. Share or trade some of your plants with neighbors and gardener friends, but be mindful of sharing pests, disease, and weeds.

Weed and Mulch
Eradicate those early spring weeds before they get too comfortable in your garden. Remove any young, sprouting weeds first and then put down a layer of cardboard or landscape fabric onto the bare ground before you add mulch

Seed Starting
Sow warm-weather vegetables and annuals indoors before the last frost date. To aid in germination, pre-soak larger seeds and seeds with thick coats such as beets and nasturtium the night before you sow them in starter pots.

Early Spring Vegetables
Direct sow any early spring vegetables once the soil is workable. Cool weather veggies like lettuce, cabbage, radishes and scallions will germinate in cooler soil.

Remove any dead branches from shrubs, trees and perennial foliage after new growth has begun. Prune the spring bloomers, like forsythia and rhododendrons, as needed soon after flowering is complete. Thin and shape hedges after the first flush of new spring growth.

Plan to Protect Seedlings
A late season frost or freeze can happen anytime in the spring. Make sure you have enough cloth and plastic to protect tender plants.


“Researchers have found daily gardening to represent the single biggest risk reduction for dementia, reducing incidence by 36%”

Gardening involves so many of our critical functions, including strength, endurance, dexterity, learning, problem solving and sensory awareness


Beating the Winter Blues

djadmin 06 Feb , 2020

Information gathered and prepared by W. Bulthuis MSW, RSW
Clinical Social Worker Portage Medical Family Health Team


  Beat the Winter Blues!

A Very Common Experience!
Research in Ontario suggests that 15 percent of the general population experience winter blues, which can include changes in appetite and lethargy. The winter blues differs from Seasonal Affective Disorder, or SAD, which affects about two percent of the population and is a serious form of depression.(Jan 15, 2018 CMHA)

Recognize the signs

Winter Blues:
•Difficulty sleeping
•Feeling less social than usual
•Difficulty taking initiative

Seasonal Affective Disorder:
•Mood that is down or depressed most of the day, nearly every day
•Loss of interest in activities you typically enjoy
•Withdrawing and isolating yourself from friends and family
•Struggling to focus and perform at work or home
•Feeling constantly fatigued and lethargic
•Feeling hopeless about the future
•Having suicidal thoughts

…………….Talk to your doctor!
(from:  More than Just the Winter Blues – Rush University Medical Centre (          

Treatments that work:
•Sunlight – Get outside whenever the sun is out during the darker days
•Light Therapy – See further explanation below
•Exercise – Moderate exercise of at least 30 minutes most days of the week may provide the biggest mood boost
•Cognitive Behavioural Therapy – what is this? (Self-Help:  Mind over Mood by Dennis Greenberger and Christine Padesky)
•Medication – Talk to your doctor

A Healthy Lifestyle:
•Sleep and wake time the same daily to regulate your circadian rhythms
•Structure eating – 3 meals a day around the same time every day
•Avoid the urge to overdo simple carbohydrates like starchy or sweet foods Eat a balanced diet of proteins, fruits, vegetables and whole grains
•Make and keep plans with friends and family to help you stay connected
•Take time for yourself and engage in activities you enjoy
(from:  More than Just the Winter Blues – Rush University Medical Centre (

Light Box:  The science of circadian rhythms shows how light activates a certain portion of our retina.  When blue light falls on receptors on the lower part of the retina, messages are transmitted to the suprachiasmatic nucleus in the hypothalamus.  This process, which is separate from vision, energizes us.


*Online survey to determine your Circadian Rhythm Type – to identify what time of day light therapy is effective for you:

(from:  How Seasonal Affective Disorder Can Endanger your Health, Dr. Elizabeth Saenger)
Image from:  James Madison University News (Online:  Jan 25, 2017 )