newsletter-issue 1 volume 7-web
- 1. RECENT EVENTS JUN Seminar: Genetics with Katherine Hodson (Vancouver) JUN Seminar: Genetics with Katherine Hodson (Calgary) JUL Seminar: Diabetes Management with Nina Hirvi UPCOMING EVENTS SEP Seminar: Cardiovascular Disease Review OCT Seminar: Breast Cancer NOV Seminar: Diabetes FEB Seminar: Heart Health MAR Seminar: Nutritional Health MAY Seminar: Hypertension Copeman Healthcare Centre • Volume VII Issue I Foods that help or hinder your sleep Sleep plays a key role in how well we function through- out the day, and nutrition plays a significant role in the quality of our sleep. Registered Dietitian, Nina Hirvi gives us the top best and worst foods for a restful sleep. Page 5 Your pathway to a better night’s sleep: teatment options for insomnia Most adults will experience an episode of poor sleep at some point in life. For many adults, difficulties naturally subside – but for others, this is the start of insomnia. Page 2 Yoga for a better night's sleep Since changing our culture and environment is not an option for most of us, another way to find some peace within the chaos can be through yoga. Page 3 10 bedtime tips to get your child to sleep Ten signs your child may have a sleep problem and ten healthy habits to help them get a good night's sleep. Page 4
- 2. 2 Medical Message With Dr. Amy Zwicker, Registered Psychologist, Reg. No. 2126 Your pathway to a better night’s sleep: Treatment options for insomnia Most adults will experience an episode of poor sleep at some point in life, which is often triggered by a stressor. For many adults, sleep difficulties naturally subside as the triggering circumstances resolve – but for others, this is the onset of insomnia. The amount of sleep you need varies widely based on multiple factors including your age, health, lifestyle (including physical and mental exertion), and genetic makeup. For most adults, the right amount falls between 4 to 10 hours/night. Meeting your personal sleep require- ments is important for many aspects of health including learning and memory, mood, immunity, cardiovascular health, metabolism and weight, and safety. What is Insomnia? Insomnia is a diagnosable disorder that exists when an individual has a significant sleep difficulty (non-restorative sleep or difficulty falling/ staying asleep) that persists for at least one month and causes signifi- cant daytime symptoms such as fatigue, poor concentration, mood disruption, or difficulty meeting social or occupational demands. Insomnia can be classified as either “primary” or “secondary.” Primary insomnia is diagnosed when sleeplessness cannot be attrib- uted to any other cause, whereas secondary insomnia is diagnosed when it is a symptom of another condition. Sleeplessness in secondary insomnia is often the result of an un- derlying difficulty with physical health (e.g., obstructive sleep apnea, arthritis or other pain conditions), psychological health (e.g., depres- sion, anxiety), or substances (e.g., prescription medications, alcohol, or recreational drug use). What treatment options are available? Key treatments for primary insomnia range from natural supplements such as melatonin and medications such as hypnotics and antidepres- sants, to psychological interventions such as Cognitive Behavioural Therapy for Insomnia (CBT-I). CBT-I is a structured therapy that involves monitoring and changing cognitive and behavioural factors that cause or maintain sleep difficulties. Significant improvements in sleep are often achieved after six to eight treatment sessions. Research has shown that CBT-I is as effective in treating insomnia as prescription medications, but the effects are longer lasting. Secondary insomnia is often best treated by treating the underlying cause. If sleeplessness persists after the contributing condition has been treated, additional sleep treatments may be appropriate. Which is the best treatment for you? If you are experiencing chronic sleep difficulties, the first step is to talk to your doctor or psychologist. A careful assessment can help to identify whether your sleep difficulty is a primary or secondary insomnia—this will determine the most effective treatment approach for your circumstances. It is also important to consider the pros and cons of pharmacologi- cal versus non-pharmacological approaches. While medications can have side effects and many are not intended for long-term use, sleep improvements are often achieved quickly. In contrast, CBT-I requires more effort and time to produce improvements; however, sleep im- provements are more durable and the side-effects of medications can be avoided. Selecting treatment options that fit your lifestyle is important—this helps to build motivation to follow through with treatment and achieve optimal results. Dr. Amy Zwicker is a registered psychologist who completed her doctoral degree in clinical psychology at the University of British Columbia and her clini- cal residency in neuropsychology at Vancouver Coastal Health. Although she is skilled in assessment and treatment of a broad range of psychological conditions, her primary interests lie in providing assessment and interventions for adults and older adults with cognitive changes. Further to her clinical experience, Dr. Zwicker has published multiple journal articles and book chapters pertaining to cognitive and clinical psychology. For more information on psychological treatment options for insomnia, please contact your nearest Copeman Healthcare Brain Health Department: CALGARY 403-270-2273 EDMONTON 780-455-2273 VANCOUVER 604-707-2273 Choose your path to a better night’s sleep
- 3. 3 Fitness Forum With Sukhi Kambo, Clinical Exercise Specialist Yoga for a better night's sleep In our fast-paced Western culture, it’s no surprise that so many Canadians have difficul- ty falling asleep. Since it is not often possible to change our culture and our environment, another way to find some peace within the chaos of the world is through yoga. Yoga is the salvation in a tornado of mental and physical exhaustion in which we can sometimes find ourselves. Regular practice calms the sympathetic nervous system that often keeps the body in a state of continu- ous stimulation, causing stress hormones to surge and our temperature, heart rate, and blood pressure to spike. Yoga has the ability to reverse these effects and quiet the mind, undoing the negative thought patterns that often accompany insomnia. TheYoga Journal recommends practicing yoga for an hour to an hour and a half, at least three times per week, to reduce stress hormones, heart rate, and blood pressure, which promotes better sleep. They also recommend that students suffering from insomnia breathe deeply both on and off the mat. If you can’t dedicate that much time to yoga, don’t worry - adding simple breathing tech- niques and a few minutes of yoga can also have an impact. Improved breathing starts with learning to breathe all the way down to our diaphragm. Deep breathing has the ability to turn up our parasympathetic tone in order to slow down our state of being (everything except our digestion, which has the tendency to speed up when we activate our parasympathetic nervous system). It’s also activated when we exhale. The Yoga Journal recommends students exhale twice as long as they inhale, which slows down the heartbeat and induces rest. So when you find that you are once again lying awake in bed, give your sheep a night off and become mindful of your breathing. A 2009 study at Northwestern Memorial Hospital in Chicago found that just two months of regular meditation can improve total sleep time and sleep quality. Remember, meditation does not mean we need to be sitting on a cushion in an incense-lit room; instead, it’s about becoming mindful of our reality. Breathing always brings us back to the present moment. There is no room to think about yesterday or tomorrow when we are concentrating on our next breath. Try the pattern of inhaling, holding, exhaling and holding your breath. You can do it for a count of 3, 4 or more—whatever feels comfortable. The technique is drawn from pranayama, an ancient Indian practice that basically means “regulation of breath.” Breathing is entirely controllable and thus one of the few things in life that we can actually control. Once tamed, it can influence heart rate, blood pressure, circulation, hormone production, stress levels and many other bodily functions. It can also settle you down enough to induce sleep. Try the following gentle yoga inversions to help you to relax and enjoy a peaceful sleep. Doing the poses shown above before bed will help to relax and calm the mind. Remember to breathe deep into the diaphragm when stretching and focus on the exhale! Sukhi Kambo is registered with the American College of Sports Medicine as a Clinical Exercise Specialist and is also registered with the Cardiology Technologist Association of British Columbia as a Registered Cardiology Technologist. After receiving her undergraduate degree in Human Kinetics in 2007, Sukhi started working with patients in the North Shore Cardiac Rehabilitation group and at the Saint Paul’s Healthy Heart Program. In 2010 she graduated with a technical diploma in Cardiac Sciences to further her understanding in cardiac pathophysiology and ECG interpretation. Plow Pose (Halasana) Meditation Child Pose (Shishuasana)
- 4. 4 Health Tips With Trish Stolle, Family Health Nurse Practitioner 10 bedtime tips to get your child to sleep Sleep is an essential part of daily life for people of all ages. For children, sleep helps them grow, combat illness, and recover from action-filled days of new experiences. Children grow rapidly and are learning a wealth of information on a daily basis; they need downtime to consolidate all of this information. Well rested children are better able to cope with daily tasks and regulate their emotions. How much sleep is required? The average hours of sleep required for children ranges between nine and ten per night. In addition to this noctural sleep, younger children also need one or two naps until the age of five, when they typically grow out of this phase. Adolescents require approximately nine hours of sleep; however, many are only getting seven to seven and a half due to extracur- ricular activities, homework, and social lives. Teenage circadian rhythms lead to a natural time-shift toward later bedtimes and awaken- ings, which can be difficult when they need to get up early for school or sports. Consequences of deprived sleep in children Impaired cognitive function Children require the appropriate amount of sleep to function well in school. Difficulty with comprehension, verbal fluency, abstract reasoning, planning, problem-solving, attentive- ness and memory are all common impairments in children who do not get enough sleep. Behavioral deregulation Overtired children have a paradoxical effect and often become hyper stimulated. Once they have reached that point it is much more difficult to get them to sleep a n d can lead to: hyperactivity, aggression, impul- sivity, and mood disorders such as anxiety and depression. Impaired health Obesity and immune system deficiencies can develop over time. Life-long sleep problems Like many other life-long habits, sleep is developed from a young age. If your child is having trouble now, it’s likely to stay with them long-term without proper intervention. 10bedtime tips to get your child to sleep 1. Routine! Children like routine because it gives them a sense of what is to come. They like consis- tency and repetition. Although we as parents may find it challenging to sing the same song or read the same book, children thrive on this. 2. Consistency Both regular bed times and wake times are important. 3. Calming activities Calming activities one hour prior to bed helps children wind down from their busy day. For example, reading, massage and warm baths are great options. Studies have shown that children who are read to before bed enjoy better and longer sleep. 4. Exercise and daytime activities During the day we need to make sure children are stimulated and have a variety of activities that nourish their senses—both physical and intellectual. Aim for at least 60 minutes of intense physical activity per day. 5. No electronic screens within one to two hours before bed. Ensure there are no TVs, video games, computers or cell phones in the bedroom. 6. Avoid large meals prior to bed; small snacks are OK. 7. Dark, comfortable bedroom Ensure bedrooms are dark and comfortable environments that are only used for sleep. Beds/cribs should never be used for play or punishment. 8. Put your children to bed when they’re drowsy but still awake This even includes the little ones. Feeding a baby to sleep after the age of 6 months can delay their opportunities to learn to self soothe - an important coping skill used to deal with future challenges and problem solving. 9. No caffeine after noon 10. Limit sugary foods 10signs that your child may have a sleep problem About 20 to 30 per cent of children have sleep problems, the signs for which include: • excessive daytime sleepiness • meltdowns later in the day • difficulty in school • frequent irritability or clumsiness • loud snoring or paused breathing at night • not achieving the recommended sleep needs • difficulty falling or staying asleep • taking more than 20 minutes to settle into sleep at night • waking more than two times per night • staying awake for longer than 20 minutes during the night Remember that as summer comes to an end, sleep times should be pulled back. Start a few weeks before school begins and reset their bedtime by 15 minutes every few nights until they are back on schedule and are able to get the required amount of sleep for their age. If you are concerned about your child’s sleep habits and would like further informa- tion or medical advice, please contact your Copeman Kids team. If your child is not enroled in Copeman Kids, please contact us for more information. Trish Stolle is a graduate of the Master of Nurs- ing/Nurse Practitioner program at UBC. She is passionate about her profession and enjoys working collaboratively within Copeman Health- care’s unique team based model. As a family nurse practitioner, Trish sees patients of all ages but has a particular passion for children and is the team lead for Copeman Kids. You will see Trish’s friendly smile when you visit the West Vancouver clinic.
- 5. 5 Food for Thought With Nina Hirvi, Registered Dietitian Foods that help or hinder your sleep Sleep plays a significant role in how well we all function throughout the day, and nutrition plays a key role in the quality of our sleep. Food relates directly to serotonin production - a key hormone that helps promote rest, so it's important to consume more of these foods and avoid those that tamper with your natural sleep patterns. Nina Hirvi is a Registered Dietitian and ClinicalTeam Lead at Copeman Healthcare Centre. She has provided realistic nutrition solutions to several thousand clients through both individual counseling and seminars throughout Canada. Nina obtained her Bachelor of Science Degree in Dietetics from the University of British Columbia and an accredited internship from Vancouver General Hospital. Nina is a Certified Diabetes Educator. Foods that hinder your sleep Caffeine This known stimulant can stay in your system for 6 hours (or more), so avoid consumption well before bedtime. Even moderate intake can affect you, so be aware of less obvious sources such as chocolate, colas, tea and decaffeinated coffee. Large, fatty meals Protein-rich, high-fat foods are harder to digest and can lead to tossing and turning. Alcohol Alcohol is a catch-22. While your evening indulgence helps you to fall asleep, it also leads to frequent awakenings. You may also experience headaches, night sweats and nightmares; none of which will help you get the restful sleep you desire. Spicy foods That spicy meatball can cause heartburn, and act as a stimulant, disrupt- ing sleep. Finish your spicy meal at least 4 hours before bedtime. Excess fluid If you find yourself up often to go to the bathroom, you may want to curb your fluid intake 4 hours prior to hitting the sack. Foods that help you rest soundly Soothing beverages Warm milk and honey will help you sleep, driving up tryptophan levels which promote serotonin and melatonin production to help you sleep like a baby. Complex Carbohydrates & Healthy Fats Unsaturated fats will not only boost your heart health but also improve your serotonin levels. Whole grains are rich with magnesium to help you fall asleep faster. Oatmeal with flaxseed is a great combination. Dairy Products Dairy products, which contain both tryptophan and calcium, are one of the top sleep-inducing foods. Combine a complex carb with dairy and you have a match made in slumber - heaven. Whole grain toast and soft cheese is a helpful snack. Magnesium & Niacin Rich Foods Packed with potassium and magnesium for natural muscle relaxation, bananas help promote sleep. They are complex carbohydrates, which also assists with sleep. Combine half a banana with a tablespoon of niacin-rich natural peanut butter for a good night's sleep. Rich sources of trytophan Hummus is another great source of tryptophan. Combine this middle eastern spread with a few whole grain crackers for a healthy snack during the day. Turkey is also a well known tryptophan-rich food, and thus a great option for sleep. A great option for kids!
- 6. 6 Live Well With Ashley Weissberg, Family Health Nurse Turn it off to tuck in: sleep tips for tech junkies Our modern lifestyles leave little time for relaxation. Due to our ex- haustion, many of us expect to fall asleep as soon as we hit the pillow – but that is often not the case. Our eveningTV, movies or other electronic habits that we use to quiet our brains may actually be working against us when it comes to a restful sleep. Exposure to light at night time can offset our circadian rhythms. As a result, we lose out on the powerful health benefits of quality sleep. Melatonin production is higher in individuals exposed to the full spectrum of light throughout the day; however, it decreases with increased exposure to light at night. While light of any kind can suppress the secretion of melatonin, blue light is the most powerful suppressor. Blue wavelengths emitted from our electronic screens as well as energy efficient light bulbs are shown to shorten or disrupt sleep. Researchers at Harvard University have linked short sleep and exposure to light after dark to an increased risk for certain cancers, cardiovascular disease, depression, obesity, and diabetes. While the research remains inconclusive, we know melatonin secretion stops very quickly upon exposure to even a small amount of light. For your health and the health of your loved ones, avoid or dim electronic screens to improve your sleep and daytime wakefulness. If manually dimming your screen as night approaches is not an attrac- tive option, download F.lux software. F.lux automatically programs your computer to tone down the blue light emitted from your screen in order to preserve your natural melatonin levels. Depending on your device’s operating system, you may also be able to download the software for use on cell phones, tablets or PDAs at justgetflux.com Try these bonus tips to preserveyour melatonin and sleep smarter: • Dim your lights and unwind from electronics and bright lights one to two hours before bedtime. Enjoy a bath, read, or listen to audio- books, guided meditations or relaxing music on a timer. • Sleep in the darkest room you can, or get an eye mask. • Use dim red lights as night lights. Red light has the least power to shift circadian rhythm and suppress melatonin. • Soak up plenty of natural light throughout the day. Sweet dreams. Ashley has a great passion for health coaching, acute care, chronic disease prevention and management. Ashley’s background includes Acute Perina- tal, Community, Mental Health, Surgical, and Pediatric nursing. She also has experience facilitating health service programs in diabetes self-care, immunization clinics for high school students, smoking cessation, and nutri- tional counselling. She completed her Nursing Degree at British Columbia Institute of Technology. Fitness Tips With Stephanie Schlaak, Certified Exercise Specialist Why you should be sleeping like an athlete Whether you’re training for a competition or involved with recreational sports, you can expect to see a decrease in exercise per- formance if you are selling yourself short on sleep. The National Sleep Foundation recom- mends sleeping an average of seven to nine hours a night, but statistics show that adults get less than seven hours, on average. Our lack of sleep is impacting our sports perfor- mance in the following ways: Slowed reaction time Sleep-deprived individuals are at a greater risk of accidents and potential injury due to a reduced ability to respond quickly to stimuli. Lack of sleep can also impair visual reaction time, which can be the difference between success and failure during a competition. Delays in auditory reaction, such as a delay in hearing a coach or teammate during play or training, can affect tactical and decision- making capabilities, taking away from potential successes. Lower cognitive performance Sleep deprivation causes a decrease in alertness and attention, negatively impacting our decision-making capabilities on the field. Mood disturbances Depression has also been linked to sleep defi- ciency. Repeated moderate-intensity exercise may improve mood shortly afterwards, but without proper sleep can cause negative mood disturbances, lower energy levels and fatigue in the long run. Longer recovery time Day–to-day recovery is adversely impacted by sleep deprivation. In particular, the storage, conversion, and metabolism of glucose to a useful energy source is decreased. Reduced ability to effectively recover can potentially lead to overtraining syndrome with a small exercise volume or lower exercise intensities, increasing risk of injury or accidents. Overall, sleep deprivation acts as an additional stress on our body, leading to a negative impact on our sports performance. Be aware of how your sleep levels are impacting you and make adjustments if you are not reaching the necessary seven to nine hours per night. Contact your Copeman Healthcare kinesiolo- gist asyou start buildingyour training program, for ideas on a successful exercise routine. Stephanie Schlaak is a Certified Exercise Spe- cialist. She graduated with a Bachelor of Physi- cal Education from the University of Alberta in 2008. She obtained her ACSM Certified Clinical Exercise Specialist® certification the same year. Stephanie started her career in cardiac rehabilita- tion, performing fitness tests and counseling pa- tients to minimize their risk factors, improve their level of fitness, and help achieve a healthy life- style. She has experience working with clients in group settings and one-on-one to counsel and ed- ucate them on exercise programs, adherence to exercise, and progression through their program.
- 7. 7 Health Tips With Amra Dizdarevic, Family Health Nurse Practitioner Got jet lag? Seven helpful tricks to reset your body clock We've all suffered from it. After taking a flight across two or more time zones, you might find yourself craving an omelette in the middle of the night or ready for a good night’s sleep…at 9 a.m. It’s called jet lag, and it’s caused by the temporary difference between the sleep and wake cycle generated by our internal body clock at home, and the environmental rhythms of our destination time zone. Our sleep/activity cycle becomes affected, leading to disruptions in our physical and mental functioning. You might recognize jet lag through the following signs: Sleep disturbances (difficulty falling or staying asleep) and sleep fragmentation You could be at high alert in the middle of the night at your destination, which further disrupts your ability to sleep at the desired local time. Sleep deprivation then ensues. Excessive daytime sleepiness You might feel drowsy during periods of the day when you most want to be awake. Reduced performance Having trouble thinking, concentrating, reasoning or doing normal activities are common. Loss of attention and vigilance play a role in many motor vehicle accidents, so it’s important to be aware of your impaired perfor- mance at your new destination. Gastrointestinal problems Conditions on the plane may contribute to abdominal discomfort and constipation.The lowered cabin pressure makes gas in the gut expand, potentially leading to feeling bloated. Generalized malaise It’s common to feel sick, weak, fatigued or have less energy than normal. Headaches and irritability are also known to occur. Not all these symptoms are present in every case, and people may vary in their susceptibility to them.The more times zones you cross, the more likely you are to get jet lag; and the further you are from home, the longer it takes to get over it. While jet lag affects all age groups, older adults may have less pronounced symptoms and recover more slowly compared with younger individuals. Once you’re home, expect it to take several days to adjust to the new time zone. Readjustment and re- synchronization occur at a rate of about one hour per day after eastward travel and 1.5 hours per day after westward travel. Pre-existing sleep deprivation, stress, poor sleep habits, and the flight conditions may predis- pose you to more severe jet lag. Try the following seven tricks to help mitigate and reduce the effects: • When possible, choose daytime flights to minimize loss of sleep and fatigue. • Avoid large fatty meals, caffeine and alcohol during the flight. • Drink lots of water. • Stay up until it’s dark once you arrive to your destina- tion. Exposure to bright morning light can also help your body adjust to the new time zone. Bright light is more effective than ordinary indoor light. Resist the temptation to sleep during daytime hours for the first few days at destination, as this will decrease the ability to sleep at night and prolong the adjustment cycle. • Eat meals at mealtime in the new time zone. For example, if you normally eat lunch at noon, eat at noon in the new time zone (not noon at home). • Get some exercise, but not right before you are supposed to go to sleep. While there is no evidence of the usefulness of ho- meopathic remedies or diet in treatment/prevention of jet lag, taking melatonin can help your body adjust to a new time zone. As a hormone that is naturally made by a gland in the brain, melatonin aligns sleep cycles and other physiological functions. The usual dose is two or three milligrams after dark each night, about half an hour before bedtime in the new time zone. It can be taken for up to four nights in the new time zone; after that, it likely won’t be needed. Ensure that you check with your doctor, nurse practitioner or pharmacist that it is safe for you to take melatonin. There are other prescription medications that may help with sleep issues associated with travel. A WORD OF CAUTION: Melatonin can produce sleepi- ness and reduced alertness. Persons taking melatonin should not drive, operate heavy machinery, or perform tasks requiring alertness for four to five hours after taking melatonin. The timing of the dose of melatonin needs to be precise to avoid worsening the jet lag symptoms. The body normally has a cycle in which melatonin is secreted during the hours of darkness and inhibited during the hours of light; it reaches peak blood levels at around 2:00 am. When crossing time zones, this peak needs to be adjusted (shifted) so that it always peaks at this time of the night. Amra graduated from UBC with a Bachelor of Science in Cell Biology & Genetics, a Bachelor of Science in Nursing and a Masters of Science in Nursing – Nurse Practitioner. Amra maintains a special interest in travel medicine and immunizations. She also has a keen interest in education and is an Adjunct Professor at the UBC School of Nursing teaching in the Master’s program.
- 8. BENEFITS: Automatic transition from your current Health Management System (HMS) to carebook.com Actively monitors the information in your medical record Provides reminders for important immunizations, tests or exams Offers practical guidance to keep you and your family on the path to optimal wellness Integrates with Withings wireless scale & blood pressure monitor Community Involvement Keep Vancouver Spectacular In July, the staff at Copeman Healthcare in Vancouver participated in a city initiative called: Keep Vancouver Spectacular. Armed with gloves, bags and trash pickers, the crew walked the neighbourhood, collecting garbage from the sidewalks in order to help Keep Vancouver Spectacular. Visit www.vancouver.ca to learn about this and other city initiatives. Lions Gate Golf Tournament Lions Gate Hospital Foundation Golf Classic raised an outstanding $562,885 net, a record to date for the Classic, and helped complete the Foundation’s current $2.5 million campaign to purchase a new CT Scanner for Lions Gate Hospital. Copeman was pleased to have sponsored this event once again this year with a donation to their silent auction. Denim Days for the Highbank Society Don't be surprised when you see your Copeman Calgary team in their favourite denim on your next Friday visit. Starting August 1st, staff will donate $5 each Friday to wear jeans. All proceeds go to the Highbank Society to help provide safe, affordable housing and other necessities to vulnerable, young families. Summer Vancouver Food Bank Drive Copeman Healthcare is 'Craving to Curb Hunger' through donations to the Vancouver Food Bank. Since the summer is not a popular time for food bank donations, the Vancouver team has decided to run a food drive from August 1st until September 26th in order to help boost the summer food stocks and Curb Hunger! Copeman clients are also welcome to bring any non-perishable food donations to the Centre at their next visit. Visit www.carebook.com for more information or contact support@carebook.com CAREBOOK mobile app coming soon! CALGARY 4th Floor, 628 12 Ave SW Calgary, AB, T2R 0H6 403-270-CARE (2273) EDMONTON Suite 700, 10216 124 St. Edmonton, AB, T5N 4A3 780-455-CARE (2273) VANCOUVER 4th Floor, 1128 Hornby St. Vancouver, BC, V6Z 2L4 604-707-CARE (2273) WEST VANCOUVER Suite 200, 545 Clyde Avenue West Vancouver, BC, V7T 1C5 604-699-CARE (2273) www.copemanhealthcare.com @CopemanClinic facebook.com/copemanhealthcare linkedin.com Announcements CALGARY Welcome Family Physician, Dr. Lachelle Botha and Client Services Coordinator, Amandella Joseph, to the team. EDMONTON Welcome to the team, Family Physician Dr. Misagh Ziaei, Family Health Nurse, Patricia Wig and Kinesiologist, Kylie Morrison. VANCOUVER Welcome Family Physician, Dr. Alireza Sameny to the team. Carebook coming to all Vancouver clients this fall. Contact support@ carebook.com for more information. WEST VANCOUVER Carebook coming to all West Vancouver clients this fall. Contact support@ carebook.com for more information. Health management, simplified. Coming this fall to all Copeman Healthcare Clients