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Creating a Butterfly Garden in your backyard…not all that tough to do!

Butterfly Garden

Frequently asked questions

How do I start a butterfly garden?

This task seemed a little overwhelming at first. But a friend of mine told me to buy the butterfly garden kits from Home Depot. It is the CWF Butterfly Plant pack. I felt it was value for money. Four small plants came with the pack. I bought a pack, dug a small garden in the back yard and planted.

Is it a lot of work to have a butterfly garden?

The work is in the digging and the planting. After the starter plants were in the ground, all I worried about was watering. I have had the garden in place for 3 years.

Have you seen any pollinators?

Yes. Bees, monarch butterflies as well as other butterflies visit the plants.

Did you expland the garden?

Yes, this year, I expanded the garden and purchased a couple of bird baths as well. It is not considered professional landscaping but it is a space that I worked on and am proud of.

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When Cancer Strikes the Young

Celebrating milestones is important to many of us as we age. Birthdays and anniversaries take on more meaning as we age. As many of our friends and family start to pass away, we often think of our own mortality.

Many of us can accept the death of our peers as we get older. Accepting the illness and death of a person in their twenties is much tougher to handle.

As a parent, I was at a loss for words when my friend told me that her adult child had cancer. There isn’t a play book to follow at times like this. I didn’t know what to say without the words sounding like the “thoughts and prayers” of so many politicians…anything that I said sounded like empty words.

I welled up after hearing my friend’s news. The tears said far more than any of my words could.

When young and seemingly healthy people develop cancer, things seem grossly unfair.

For many of us, turning to faith is helpful. Hoping to find clear direction and bring some light into a dark situation is not an easy thing to do.

Watching a friend grieve the loss of child is painful. Listening and being as supportive as I can be is something that I have cleaved to in the last few weeks. I can’t shake this feeling of a life being snatched away very cruelly.

Having friends and family to speak to during times of grief is important. The bonds and tough conversations weave a thread of humanity and bind us together. Mental health professionals and primary health care providers are excellent resources when you feel that you need to speak with a trained professional.

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The Empty Nest…bad or good? It depends

Many seniors have to deal with the empty nest. It can be difficult for parents to let go psychologically from their children especially if their lives as parents revolved around their children and their activities.

For some people, the empty nest is a relief and a chance to find new hobbies and pursue new dreams. How somebody copes with the empty nest depends upon a lot of factors.

If you are retired and your last child has moved out of the house, there could be a feeling of loneliness and you could be wondering about how you should spend all this new free time that you have. Maybe, you were the one doing all the cooking and the meal prep while your adult child was working or going to university. All of a sudden, there could be a lot of time on your hands.

One strategy that some people find helpful is to create a vision board. Pictures of your children, grandchildren, gardens you might like to create, places you might like to travel to….anything that you are interested in. Focusing on what interests you, where you might like to live if you downsize, and hobbies that matter to you can be helpful to ease the transition into accepting the empty nest and learning how to thrive in your new environment.

It’s not always easy to get used to the change. But being patient with yourself and giving yourself time to figure out how you would like to spend your time in retirement is certainly worth it.

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Mental health and aging

Aging brings about many life changes. Many of us see declines in our physical health. Children may move away to start their lives. Retirement often results in a loss of social networks that defined us in our younger years.


Isolation and physical limitations often cause us to ruminate about the past. Did we do everything we could have or should have for our children? Were we honest with our loved ones? Did we give our life partner the respect that he or she deserved? What about lost friendships? Betrayals?

Unresolved issues from our past can lead to anxiety and/or depression.

Many of us are from a generation where we don’t talk about our emotional pain. And, this way of managing our struggles can lead to more isolation and depression.

If you are struggling mentally, please speak to your family doctor about what is going on. There are many treatments available today which were not available 50 or 60 years ago.

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Turning 60 and starting an exercise program

Turning 60 is big milestone. When I turned sixty. I took a long look at my fitness and quality of life.

I started training for a marathon this past year and that was probably one of the best decisions that I could have made for my health and overall sense of well being.

From a psychological stand point, it has been very healthy for my overall sense of well being. Like many other health care providers, I was feeling stress and burnout after the pandemic. Focusing on something for me was key to improving my health.

If you are thinking of starting an exercise program, speak to your doctor first for an assessment. Find a program that is going to work for you and ease into it.

Depending on the type of exercise program that you start out with, getting a good pair of shoes is important. I found the Brooks shoe to be an excellent running shoe. It feels very comfortable and accommodates orthotics.

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Sulfonylureas and Meglitinides and Apha-glucosidase Inhibitors

Sulfonylureas have been around for a long time. They work by getting the pancreas to secrete more insulin. The second-generation sulfonylureas are less likely to cause low blood sugar when compared to the first-generation Sulfonylureas. When sulfonylureas are started in the elderly, the dose is started low and slowly increased.

Meglitinides are a class of medications that cause insulin to be secreted when there is glucose in the blood. These drugs target the blood glucose increases that happen after you eat. They are not prescribed for people with liver disease.

Alpha-glucosidase inhibitors slow down the absorption of glucose in the gut after a meal. This causes the blood glucose levels to be lower after a meal. They may cause gastrointestinal side-effects such as diarrhea and cramps and gas. If you are taking an alpha-glucosidase inhibitor, make sure to have dextrose tablets on hand in the event you experience low blood sugar.

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What will adding SGLT2 inhibitor do to lowering my blood glucose levels and A1C?

SGLT2 stands for Sodium Glucose Co-transporter 2 which are proteins that help filter glucose back into our bloodstream.

Our kidneys filter out the glucose from our bodies every day. Most of this glucose is filtered back into circulation.

The SGLT2 inhibitors stop the glucose from being reabsorbed into your bloodstream.

So what happens when you take a medication that is in the SGLT2 class?

  1. There is a lower amount of blood glucose in your blood.
  2. Weight loss
  3. Decrease in blood pressure

Your A1C should decrease (up to a 0.7% reduction).

There is a low risk of hypoglycemia (low blood sugar) with this class of drugs.

This class of medication will cause you to urinate more frequently. Some people experience yeast infections when taking SGLT2 inhibitors.

Individual drugs within this class of medications have specific prescribing precautions. As always, discuss your diabetes management with your doctor to determine which medications are right for you.

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I have kidney disease. Can I take a DPP-4 inhibitor?

Sitagliptin is a DPP 4-inhibitor. It is dosed once daily and can be taken with food or on an empty stomach. Your doctor will check your kidney function and prescribe an appropriate dose for you.

Saxagliptin is taken once daily. It is not recommended if your kidneys are functioning with an estimated glomerular filtration rate of less than 15mL/min.

Linagliptin is dosed once a day. It should be taken in the morning with or without food. It is ok to take if your estimated glomerular filtration rate is greater than 15mL/min. Your doctor will check your liver function before prescribing.

Alogliptin is dosed once daily in the morning. It can be taken with food or on an empty stomach. If you have congestive heart failure or severe liver impairment, then this drug is not recommended. Dosages need to be adjusted for renal impairment.

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Incretin Mimetics and what is their role in Diabetes treatment?

Incretin hormones are released by cells in your get after you eat carbs. The incretins cause insulin to be produced by your pancreas. This is called the incretin effect.

When people have Type 2 diabetes, the incretin effect is decreased.

So what are the main incretin hormones?

1)Glucagon -like peptide-1 (GLP-1)

This hormone gets your body to secrete more insulin. It reduces the amount of glucagon that is produced. It slows down how fast food leaves your gut. It increases the feeling of “being full” after eating.

2)Dipeptidyl peptidase-4 (DPP-4)

This is an enzyme that breaks down GLP-1

Medications are available that impact how the above hormones work.

GLP-1 Analogues increase the levels of GLP 1 after they are administered. They are given by subcutaneous injection. This class of drugs helps with weight loss. They do not cause low blood glucose (hypoglycemia). Using this class of medication can result in an A1C lowering of 1%.

DPP-4 inhibitors “inhibit” the enzyme that breaks down GLP-1. They are available in tablet form. This class of drug does not result in a reduced appetite or filling full after eating. Taking this class of drugs can result in an A1C lowering of 0.5 to 0.7%.

Who should not take DPP-4 inhibitors?

People with Type 1 diabetes.

Pregnant women or for women who are breast feeding.

People under the age of 18.

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Metformin

Metformin is a first-line agent for Type 2 diabetes. It is usually dosed at 500mg twice a day and should be given with food. Your doctor may tell you to increase the dose by 500mg once a week if your blood sugars are not where they should be. The usual dose of metformin is 500mg three times daily. For the elderly, the starting dose may be 500mg and the dose may be increased more slowly. The reason for this is that metformin can cause side effects such as bloating, gas, diarrhea and nausea. These side-effects tend to go away over time (in about one or two weeks).

Once you start metformin you should see a drop in your fasting blood sugars anywhere from 3 to 5 days.

Metformin is not prescribed for patients with poor kidney function where the estimated glomerular filtration rate is less than 30ml/min or if there is liver failure. If you are currently taking metformin and your estimate glomerular filtration rate drops to the range of 30 to 45 ml/min, your doctor may decrease the dose a maximum of 1000mg per day.