COVID-19 is placing stress on Canada's public health system. Our clinic is starting to offer virtual care to make sure that we can continue to care for our patients safely and effectively. This means that we will be using video and audio technologies for some patient visits rather than asking all patients to come into our office. Some of these technologies are provided by the Province. Others have been provided by vendors like Google, or Apple to help make discussions with your care provider as easy as possible during these difficult times. Some health concerns can be addressed with virtual care alone, but in some cases your doctor may ask you to visit a hospital or other health care facility if necessary, for a physical examination.

We do our best to make sure that any information you give to us during virtual care visits is private and secure, but no video or audio tools are ever completely secure. There is an increased security risk that your health information may be intercepted or disclosed to third parties when using video or audio communications tools. To help us keep your information safe and secure, you can:

Understand that emails, calls, or texts you receive are not secure in the same way as a private appointment in an exam room.

Use a private computer/device (i.e., not an employer's or third party's computer/device), secure accounts, and a secure internet connection. For example, using a personal and encrypted email account is more secure than an unencrypted email account, and your access to the Internet on your home network will generally be more secure than an open guest Wi-Fi connection.

You should also understand that electronic communication is not a substitute for in-person communication or clinical examinations, where appropriate, or for attending the Emergency Department when needed (including for any urgent care that may be required).

If you are concerned about using video or audio tools for virtual care, you can ask our office to arrange for you to visit a different healthcare provider or other health care center where you can be seen in person. However, please note that visiting a health care provider in person comes with a higher risk of coming into contact with COVID-19 and the possibility of spreading the virus.

By providing your information, you agree to let us collect, use, or disclose your personal health information through video or audio communications (while following applicable privacy laws) in order to provide you with care. In particular, the following means of electronic communication may be used (identify all that apply): email, videoconferencing (including Skype, Facetime, etc.), text messaging (including instant messaging), website/portal, OnCall.

Update About Our Office During This Outbreak of Corona Virus : March 15, 2020

On the advice of the Ministry of Health we are changing our office protocols to ensure minimization of risk to our patients and our staff.

Starting the week of March 16, 2020 we will try to change as many patients visits as we can to virtual electronic visits. Initially most will be by phone. There are some patients who have already made arrangements to come to the office and, if they do, we will see them, once again minimizing risks by using frequent hand washing and minimized personal contact.

For the majority of scheduled patients we will set up visits through OnCall Health. One of the problems with phone visits is that each person requires individualized attention and some visits unexpectedly may take longer than others. We will make every effort to keep on schedule but at times we may be delayed.

Dr Lawrence Komer
Medical Director
The Komer Clinics

COVID-19 Annoucement | Office Updates

It’s Importance | Dr. Lawrence D. Komer Medical Professional Corporation

Dr. Lawrence D. Komer Medical Professional Corporation

The Importance of Testosterone

Simply being alive and living out a normal day causes some damage to the body.

Testosterone, along with growth hormone, is necessary so that the body can repair itself!

Testosterone is a hormone that has an effect on almost every aspect of a man’s body. Testosterone helps the body to build the various proteins that play key roles in virtually every bodily function. Testosterone is produced in the testes and in the adrenal glands. It is to males what estrogen is to females.

figure1

Starting at about age 30, testosterone levels drop by about 10 percent every decade. At the same time, another factor in the body called Sex Binding Hormone Globulin, or SHBG, is increasing. SHBG traps much of the testosterone that is still circulating and makes it unavailable to exert its effects in the body’s tissues. What’s left over does the beneficial work and is known as ‘bioavailable’ testosterone.

Andropause is associated with low (“bioavailable”) testosterone levels. Every man experiences a decline of bioavailable testosterone but some men’s levels dip lower than others. And when this happens these men can experience Andropausal symptoms.

chart2

Testosterone is essential for normal sexual behavior and giving rise to erections. It also affects many metabolic activities such as production of blood cells in the bone marrow, bone formation, cholesterol metabolism, carbohydrate metabolism, liver function and prostate gland growth. It also affects mood.

These symptoms can impact their quality of life and may expose them to other, longer-term risks of low testosterone. It is estimated that 30% of men in their 50s will have testosterone levels low enough to be causing symptoms.


 

The Importance of Testosterone

Simply being alive and living out a normal day causes some damage to the body.

Testosterone, along with growth hormone, is necessary so that the body can repair itself!

Testosterone is a hormone that has an effect on almost every aspect of a man’s body. Testosterone helps the body to build the various proteins that play key roles in virtually every bodily function. Testosterone is produced in the testes and in the adrenal glands. It is to males what estrogen is to females.

Starting at about age 30, testosterone levels drop by about 10 percent every decade. At the same time, another factor in the body called Sex Binding Hormone Globulin, or SHBG, is increasing. SHBG traps much of the testosterone that is still circulating and makes it unavailable to exert its effects in the body’s tissues. What’s left over does the beneficial work and is known as ‘bioavailable’ testosterone.

Andropause is associated with low (“bioavailable”) testosterone levels. Every man experiences a decline of bioavailable testosterone but some men’s levels dip lower than others. And when this happens these men can experience Andropausal symptoms.

Testosterone is essential for normal sexual behavior and giving rise to erections. It also affects many metabolic activities such as production of blood cells in the bone marrow, bone formation, cholesterol metabolism, carbohydrate metabolism, liver function and prostate gland growth. It also affects mood.
These symptoms can impact their quality of life and may expose them to other, longer-term risks of low testosterone. It is estimated that 30% of men in their 50s will have testosterone levels low enough to be causing symptoms.

Impact of Low Testosterone

Most parts of the body need testosterone to function optimally. Without enough active testosterone, many changes can occur throughout the body.

Among healthy men, there is a substantial variability in testosterone levels and so not all men will experience the same changes to the same extent.
Typical responses to low bioavailable testosterone levels include:

  • Excessive fatigue
  • Reduced interest in sex
  • Emotional, psychological and behavioural changes
  • Decreased muscle mass
  • Loss of muscle strength
  • Increased body fat
  • Weak bones/back pain or osteoporosis
  • Generalized aches and pains
  • Forgetfulness
  • Cardiovascular risks (See Below)
  • Sleep disturbances

 

Cardiovascular risks *

It is now well accepted that women’s risk of atherosclerosis (hardening of the arteries) increases after menopause. Estrogen replacement therapy seems to reverse this trend. New evidence suggests that a similar phenomenon occurs in men as their testosterone levels diminish with age. While research is not as complete as for women, the clinical findings point to an association between low testosterone levels and an increase in cardiovascular risk factors in men.

* A cause and effect relationship has not yet been established in large clinical trials. The current clinical work does support further research into this important area.