Health and wellness
Written by Laura King
Editor Laura King interviewed Ontario Labour Minister Kevin Flynn in April, a year after the Supporting First Responders Act made PTSD a presumptive illness, and in the lead up to PTSD Awareness Month in June.
Written by Keith Stecko
Making a conscious effort to build your personal resilience is one of the most important things you can do for yourself as a firefighter. Being a firefighter is physically and emotionally demanding. Having a tailored personal resilience program can produce positive results and help to maintain work-life balance.
Written by Wayne Jasper
Mental-health programs teach us that the effects of trauma can be cumulative. As a chief officer, do you know how much exposure your crews have had to traumatic incidents such as fatalities or calls involving children?
Written by David Moseley
Not all critical incident stress management (CISM) programs are equal. Having had the privilege to work on four CISM teams, it is clear that certain practices and protocols enhance the program for both facilitators and participants. If your department is looking to adopt a CISM program, here are some considerations.
Written by David Moseley
Dead children, severe mutilation, homicide, known victims, aircraft crashes, injured and dead firefighters: sadly, I don’t think my experiences of fire fighting are unusual. Who could deny this takes an emotional toll on us? Who would argue that as an organization, a profession, we don’t have an obligation to address the emotional cost?
Written by Mike Vilneff
Life is too short; we have all heard this cliché many times, but it seems that the older you get the more you hear and use it. So, if life is too short, what are you doing to make the most of it?
Written by Rob Grimwood
For many years, firefighters took pride in the soot that covered their bunker gear, helmets and gloves; it was a sign that they had been to a good job, and evidence that they had been on the front lines of fire attack. As fire prevention efforts paid off and the number of structure fires decreased, fewer firefighters engaged in fire attack; when they did, they were sure to leave all the evidence in place.
Written by Maria Church

June 2016 - Fire Chief Colin Shewell and Deputy Chief Roree Payment are the only full-time members of Clearview Fire and Emergency Services in Ontario. The department heads were naturally nervous when they decided to introduce a mandatory annual physical-abilities test for all paid-on-call firefighters.

Written by Gord Schreiner
Much has been written about cancer and its relationship to the fire service. The bottom line is that if you are a firefighter you have a higher chance of getting cancer than a non-firefighter. Rather than argue about how many times more likely we are to get cancer, I would rather discuss some ways chief officers and firefighters can help reduce these odds.
Written by Mike Vilneff
Hernia: the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it.
Written by Elias Markou
Electrolyte deficiencies and dehydration are the most common preventable occupational hazards faced by firefighters. Firefighters, similar to high-level athletes, lose water rapidly during physical exertion. Water is the carrier of electrolytes, so dehydration leads to electrolyte depletion. Almost all firefighters have experienced an intense fire with searing, radiant heat, hours of physical activity in heavy bunker gear and quick changes in core body temperatures. The body depends on sweat to cool itself, so an extreme fire situation can quickly empty its water reserve.

There are a number of risk factors that affect depletion of water and minerals in a firefighter. Firefighters, wearing layers of non-breathable clothing to protect themselves, often deal with high temperatures inside a structure or outside on a hot summer day. Extreme sweating in these conditions depletes the body of all its water and good minerals.

Research conducted by the University of Cumbria in England, in collaboration with Cumbria Fire and Rescue Service, highlights how vital proper hydration is to a firefighter’s performance. The study identified that a high percentage of firefighters arrived to a training exercise or a real fire incident already significantly or severely dehydrated.

Electrolytes are minerals that are essential for the body to function. When water with electrolytes is consumed, the minerals are dissolved in the water and they enter the blood system. These minerals have ionic electrical charges that drive the function of every cell in the body. So imagine the importance minerals such as potassium, sodium, calcium and magnesium play in holding water in the body, making your cardiovascular system function and allowing energy production in muscle, brain and vital organs. Water and electrolytes are critical for peak performance, but are by far the most important health issue often overlooked. Dehydration, in extreme cases, can cause death.

 Potassium is probably the most important mineral in the body. Potassium helps maintain electrical activity in the brain and the heart. Potassium deficiency, for firefighters in extreme occupational situations, can be life threatening.  

The second most important and the second most abundant mineral in the body is phosphorus. Phosphorus is used for protein, fat and carbohydrate synthesis in the body; these key nutrients are integrated into DNA and cellular membranes. For firefighters, this mineral is mostly used in recovery after intense firefighting activity.

Sodium is known to regulate the level of water in the body. The more water you drink, the more sodium will be removed from your body via the kidneys. Sodium is used in transmitting important but subtle information from cell to cell in the body. Finding a good balance between sodium and water intake is critical.

Magnesium is responsible for more than 400 biochemical interactions in the body; about half the magnesium is found in critical organs such as the heart, nerves, muscles and the immune system. When firefighters experience muscle cramping during or after an intense fire, they should reach for large dosages of magnesium to reverse the effects. Depleted magnesium stores in the body prevent the muscles from physiologically performing. If a muscle does not slide properly, sudden movements can damage the tissue. A muscle pull is the most common fire-scene injury for firefighters.

There are many signs associated with electrolyte and water deficiency and imbalance. In the rush of life and especially fire fighting, we often overlook the simple act of rehydration. Examples of symptoms associated with water and electrolyte deficiencies include muscle spasms, restlessness, insomnia, dizziness, headaches, fever, heart activity, heart palpitations and blood pressure issues. If ignored and not treated, these symptoms become chronic and sometimes life threatening.

Finding electrolytes and water in whole, complete foods is a great way to increase minerals in the body. Vegetables are an excellent source of electrolytes, especially when combined in a soup. Consider adding kale, artichoke, spinach, parsley and Swiss chard into your diet. Another way to boost mineral intake is to use salts that contain more minerals, such as Himalayan, Celtic or sea salt. Fruits can also be a great source of minerals and water, including bananas, coconuts and avocados.

As a firefighter, make sure you are properly hydrated and balanced with electrolytes to maintain an optimum performing body.

Elias Markou is in private practice in Mississauga, Ont., and is the chief medical officer for the Halton Hills Fire Department. Markou was a volunteer firefighter for six years and is now a firefighter health expert and blogger who is regularly featured on television and radio and in print. Contact him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Written by Laura King
May 2016 - There’s one in every station – the ticking-time-bomb firefighter whose demeanour slips Jekyll-and-Hyde-like between everyone’s best friend and look-at-him-sideways and he’ll snap.
Written by Maria Church
May 2016 - Last summer, Luanne Donahoe was worried about her son, Josh. The 17-year-old’s father, a firefighter, died in the line of duty when Josh was nine, and he has had a rough time dealing with his absence.
Written by Maria Church, Ruth Lamb and David Gillis
March 2016 - A college in British Columbia has developed a program to help first responders learn to be more resilient.
Written by Elias Markou
In the past few months I have conducted many firefighter physical exams for a number of fire departments. As I was going through the medical assessments, I observed an interesting trend: a significant number of firefighters still smoke.
Written by Bernie Van Tighem
There is a sort of cliché that Americans and many Canadians say to returning military: “Thank you for your service.” Some soldiers appreciate it; many hate it because they figure that it’s easy to say but doesn’t begin to reflect an understanding of what they’ve been through.
Written by Matthew Johnston
September 2015 - Have you ever found yourself at a social event and sparked up a conversation with a random person that went something like this:

Random person: “So what do you do for work?”

You: “I am a firefighter.”

Random person: “I could never do that . . . to see what you must see.”

You probably brushed this comment aside and moved along with your evening. But this conversation is an important reminder that in order to deal with the duties of professional fire fighting, at some point in your life, your mind was forced to alter the way you interpret a traumatic experience. As with the formation of a callous on your hand, your mind had to blister first in order to thicken and harden.

This psychological process meant that you had to let the analytical aspect of your mind – getting the job done – suppress nearly all of your natural emotional responses. This shift, through training and experience, changed the way your brain organizes information to the point that what was once considered traumatic became a normal part of your daily reality.

Recent events have made it clear that witnessing trauma can affect firefighters to the point that they become victims of their own professions. In the summer of 2014, Global News reported that 13 Canadian first responders had committed suicide over the spring of that year. In the 10 weeks that followed, the number rose to 23, and by publication, according to the organization Tema Contour, the number was at least 29. (The actual number of first responder suicides is likely significantly higher than media reports suggest as many suicide completions are often masked by lethal methods that appear accidental.) The spike in numbers indicates a firm systemic mental-health crisis is now gripping first responders across Canada. Media articles often point to post-traumatic stress and other mental illness as the root causes of first responder suicides, which paints a bleak picture for the struggling individual who may be apprehensive to reach out for mental-health support.

Adding to the stigma, the suicide of a colleague often leaves many co-workers in shaken, introspective states, filled with questions and uncertainties of how effective they are at assessing their own personal mental health and wellbeing. For these reasons, first responders, employers and mental-health professionals across Canada have the common interest of finding new ways to assist first responders in recovering from the trauma they regularly experience.

Current challenges
Global News reported last year that some of the Toronto police officers who had taken their own lives were getting various forms of psychological services and supports. First responders that may be struggling with symptoms consistent with post-traumatic stress disorder (PTSD), often have the daunting task of undoing many years of trauma in the face of time-limited therapy.

Well-intentioned therapists commonly implement a variety of short-term, solution-focused interventions in the hope of temporarily alleviating the layered effects of longstanding trauma. These deeply seeded traumatic memories continue to resonate within the individual’s being well beyond the clinician’s office, and are often camouflaged by more recognizable and, oddly, more acceptable personal crises, such as divorce, interpersonal conflict and substance use. This therapeutic complexity makes traditional employee-assistance programs (EAPs) inadequate in addressing the often multiple, traumatic work-related events that underlie many of the personal crises faced by struggling first responders.

There is a unique subculture in a paramilitary workplace that extends into the lived emotional reality of first responders. Police, firefighters, paramedics and prison staff work under a command structure in which personal decision-making is restricted by industry protocols and department guidelines. This paradigm of training creates dependable, logic-based behaviour that dominates personal thoughts and actions in the face of extremely stressful situations. These protocols serve to reassure first responders that they did everything they could during a potentially traumatic situation. However, many first responders struggle the most when they physically leave work, yet remain emotionally handcuffed to the memory of a troubling call. In order to understand the power of a traumatic memory, first responders may benefit from exploring how their workplace duties and subcultures impact their everyday functioning.

Building a wall
Our limbic system consists of brain structures that largely govern emotions, behaviours and long-term memory. During a potentially traumatic encounter, first responders are trained to remain calm so that emotional and behavioural patterns follow predictable paths, reflecting industry best practices. This consistency requires first responders to place personal feelings, beliefs and sensations on hold as the analytical mind overrides the emotional challenges of the circumstances.

In order to achieve a calm state, the limbic system is suppressed to cope with the demands of a situation that would either paralyze or cause most humans to flee the given situation. The traditional fight, flight or freeze reaction to stress and anxiety – responses that have been integral to human evolution – are simply not behavioural options for first responders attending emergency situations.

Over time, first responders attending calls of a traumatic nature, typically develop a strong dissociative barrier between risk and action. This allows first responders to run into a burning building, confront a robbery suspect or quell the bleeding of a young child. In these moments, the needs of civilians supersede the physical and emotional harm that first responders may experience. While such actions may be well-suited for risk-taking personality types, it also shows the power that a well-trained analytical mind can have in overriding the natural emotional and behavioural reactions to a dangerous situation.

Without a variety of techniques to release the effects of witnessed traumas, the analytical minds of first responders can build up like dams and create barriers that interrupt natural flows and ranges of emotions. A restricted emotional energy leaves a struggling first responder to experience a fast-flowing, albeit limited range of thoughts and feelings. These buoyant thoughts and feelings have a tendency to fuel a hyper-aroused state of mind that can produce raw, unprocessed emotional reactions. As unresolved trauma continues to build, the integrity of an emotional and cognitive dam is often breached, which releases uncontrollable images that prevent healthy recovery from taking place. A lost sense of internal control can ultimately progress towards the debilitating state of mind known as PTSD.

If a struggling first responder chooses to ignore certain signs and symptoms, traumatic imagery has the power to dominate attention and is intensified by the thoughts and feelings that accompany emotional pain. This type of imagery can become so powerful that the mind misinterprets or ignores important social cues to the point that it can drive friends, co-workers and loved ones away without any awareness on behalf of the struggling individual.

A closed loop of traumatic thinking and feeling fuels a hyper-aroused state that leads a first responder to having difficulty unwinding from work and experiencing sleep disturbances that exacerbate anxiety-based symptoms. Therefore, it is important for first responders to identify activities that cultivate a peaceful state of mind and quell restlessness. It is only during these moments that traumatic material will have adequate time to aerate, leading to effective stress recovery.

You should seek the help of a professional mental health clinician when you have:
  • Difficulty sleeping including frequent nightmares and night terrors
  • Unwanted thoughts and feelings that affect concentration
  • Flashbacks and powerful, troubling imagery
Chronic fatigue and loss of interest in usually enjoyable activities
  • Irritability towards others including co-workers, strangers and loved ones
  • Addictions including alcohol, drugs and body enhancement supplements
  • Self-isolating behaviours, including a lack of interest in social connectedness
  • Frequent feelings of hopelessness, shame and/or guilt
  • Compulsion to work excessively at the expense of important relationships
Invest in your mental health
One of the advantages that some first responders have is the opportunity to achieve adequate work-life balance. Shift-work rotations combined with holidays throughout the year enable members to have sufficient time off to engage in healthy self-care activities. These opportunities allow firefighters to experience both physical and emotional recovery from work-related duties – but only if the first responder is open to actively engaging in healing practices. While hobbies and interests should not be viewed as an alternative to accessing mental-health services, engaging in regular, healthy activities can lead to many of the same outcomes as effective talk therapy.

Tip: The more resistance you have to engaging in a healthy activity, the more you should push yourself to do it. Limbic memory steals a lot of healthy energy and taking an active approach to quell its powerful impact is one of the few ways to accelerate recovery from work-related stress.

During difficult times, first responders, as with all humans, have a tendency to turn away from many of the activities that can bring them greater work-life balances. Immersing in healthy activities fosters a state of mindfulness – where the first responder’s full attention is in the present without conscious awareness or judgement. This state of mind is a universal stress-recovery practice that reduces the dissociative barrier between the analytical and emotional mind.

During mindfulness-based activities, emotional pain is allowed to aerate spontaneously and naturally. We simply feel better after spending time in nature, finishing a hobby-based project or helping others. Keeping up with a variety of mindfulness-based activities is especially important for first responders who are resistant to accessing professional mental-health services.

Common activities that cultivate mindfulness:
  • Breathing exercises and cardiovascular activities including sports and hiking
  • Creativity woodworking and restoration activities
  • Healing imagery, music, photography and cooking
  • Compassion – volunteering and helping others
  • Connectedness – spending time with loved ones and friends
  • Nature engagement camping, fishing and hunting
  • Physical healing massage therapy and yoga
  • Spiritual religious practices and setting time aside to experience silence
Engaging in mindful self-care measures along with talk therapy allows firefighters to not only digest the effects of work-related trauma, but also reclaim a healthy emotional life. A life filled with positive relationships, an improved outlook and ultimately greater
life expectancy are goals that everyone should strive for, and deserves. Mindfulness activities can reduce symptoms consistent with PTSD, while also counteracting other related psychological issues including depression and anxiety.

Moving forward, the test for all first responders is finding ways to actively engage in healthy activities during the most challenging points in their careers and lives. While this process will involve a level of vulnerability that may be unfamiliar to most, the emotional crises faced by first responders across Canada warrant the need to embrace and expand on additional ways to recover and heal from witnessed trauma.

Dedicated to #287, #318 and #445; rest in peace, brothers.

Matthew Johnston is a full-time firefighter in British Columbia and a trained mental health clinician. He is certified in critical incident stress management and operates a mental health clinic that specializes in treating first responder trauma. Email him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Written by Keith Stecko
In June I attended the BC Fire Expo and Fire Chiefs Association of BC conference in Penticton. During the conference, I sat in on one session in particular that stirred powerful emotions not only within me but also in every fire officer in the entire room. The energy was raw, and, at times, the silence was deafening. It was a story told by firefighter Nathalie Michaud about her post-traumatic stress disorder (PTSD).

This was the first time that Michaud stood in front of a packed room and bared it all: the dark thoughts and feelings of suicide and hyper vigilance; waking up in the middle of the night in a sweat-soaked bed; flashbacks; self medicating with alcohol; anger and helplessness. She relived the horrific images, smells, and sounds that have haunted her.

On Jan. 30, 2010, Michaud reported to her station in Otterburn Park, Que., for duty and found Fire Chief Richard Stringer hanging in the fire hall. Not only was Stringer her chief, he was also her husband.

As I looked around the room packed with fire officers, it was as if all the air had been sucked out of it.

Three years later, Michaud was one of the responders to Lac-Megantic and explained that she was often referred to as the rock by her peers and the people who know her well. They saw her, she said, as steady and strong, but, as she pointed out in her talk, “It turned out to be the very thing that also hurt me.” How else was she expected to act when something traumatic happened?

I sat still in my seat and listened to Michaud tell her story of finding her husband. I watched her, standing tall in her uniform, stoic and steadfast, occasionally trembling, sometimes squeezing her stress ball. It was obvious to me that every word she uttered came at a great emotional cost as she summoned strength to tell her story.

When Michaud stepped back from the lectern to signal that she was done, the audience stood and erupted with applause. It was a clear demonstration to Michaud of the support from her fire-service family.

Michaud is no doubt one of the bravest and most courageous people I have had the pleasure to meet. She stands a beacon of light for those who are suffering from PTSD in silence. She described the effect of the disorder with perfect clarity: “I’ve learned that there are two ways PTSD can kill you. First, you’re still alive, but you’re slowly dying inside. Second, suicide.”

Later at the conference I connected with two of my colleagues; both confided in me that they were struggling with PTSD. One colleague had just starting to talk to someone about his experience. As we talked, I could see by the look on his face that it weighed heavily on him.

My other colleague has been off work and has been receiving help, however, insurance coverage is limited and he is desperately seeking all avenues of assistance, including worker compensation. The situation has been emotionally draining and stressful for him; the process includes recounting his many years of responding to various traumatic calls in order to determine if he actually is suffering from PTSD.

In both of these circumstances, I mentioned to my colleagues that suffering in silence needs to stop. Coming forward and opening up is the most important step to take. Keeping the poison of PTSD inside will only continue to erode a person and can become very destructive. I was grateful that they felt they could talk to me openly about how they feel.

I believe that PTSD treatment needs to be a national strategic priority for all fire-service associations. That means pursuing and having clear discussions with provincial and territorial governments to have PTSD recognized under presumptive legislation. If a first responder is diagnosed with PTSD, the condition should be presumed to have risen out of and in the course of employment, unless the contrary is proven.

Members of the fire service respond in their communities with pride. The first word in their vocabulary is action, and they do so by putting both their physical and emotional safety at risk.

We need to talk about PTSD openly, and support and educate one another without fear of being seen as damaged goods, marginalized or cast aside. Maybe the most important action you can take is to check in with one of your fire-service colleagues and ask, “Is everything OK?”

Keith Stecko is the fire chief and emergency program co-ordinator in Smithers, B.C. He joined the fire service in 1986 as a firefighter/paramedic level 2 advanced life support, served in the Canadian Armed Forces, and is a graduate of the Lakeland College bachelor of business in emergency services program and the public administration program from Camosun College. Contact Keith at This e-mail address is being protected from spambots. You need JavaScript enabled to view it and follow him on Twitter at @KeithStecko

Written by Nathalie Michaud and Wayne Jasper
September 2015 - Editor’s note: It’s not often a conference speaker silences a room and brings delegates to tears. That’s what happened in June in Penticton, B.C., and in July in Summerside, P.E.I., when firefighter Nathalie Michaud told fire officers her story about post-traumatic stress. The story is remarkable, ugly, even shocking. Wayne Jasper’s story is equally as compelling, that of a friend and fellow firefighter, connected by compassion but geographically more than half a country away. Here is their story.

I have learned what PTSD can do and how it can start. The simplest way I have found to describe it is this: PTSD is like the imprint of the emotion that stems from an event but your brain blocks it and locks it away because it’s too much to process. And, even though as time goes by, your brain knows the difference between what is real and what isn’t; it’s the emotional imprint that silently grows inside, just like a tumour.

On Jan. 30, 2010, Fire Chief Richard Stringer saw no way out. Depression, desperation and the presence of unrecognized PTSD got the best of him. That morning, Chief Stringer left his home while his wife slept and went to the fire department to face his last battle, his last demon – and hanged himself.

Chief Stringer had been my fire chief for the previous five years.

Richard Stringer was also my husband.

My world got turned upside down and changed forever the moment I found him. I shut down and no one saw it.

No one ever warned me of what was waiting for me in the future. When I closed my eyes at night, all I saw was the image of him hanging between the two fire trucks, the images and sounds of me running around in the hospital from department to department so I could officially identify his body; no one could really direct me as to where he was, so I had to ask at least five people in different departments. “Can you tell me where the body of my husband Richard Stringer is? I have to ID his body.”

The small town speculated; I was blamed. His suicide was in the media; there was nowhere for me to hide to grieve privately, to deal with rumours, wait for the official police report.

During this time, I felt nothing but shame and incredible guilt, and I had so many unanswered questions.

The day of his funeral, when the casket was carried out, two salutes took place: the first was a general salute by all firefighters, followed shortly after by a salute called by members of Chief Stringer’s Otterburn Park Fire Department. Even though I wasn’t in uniform, as his firefighter, by reflex, I saluted along with the rest of my department, clinging to my husband’s helmet. I was also his wife saluting my husband for the very last time.

This was followed by the wail of the Federal Q siren. To this day, that siren is a trigger and every time I hear it, I’m thrown back to that moment and I must deal with it.

Richard’s suicide and all that followed created PTSD that was finally diagnosed five years later. For those five years, I suffered in silence, not knowing that PTSD was slowly growing inside me ever so quietly and robbing me of who I was.

I can tell you what it feels like to follow the coffin of your husband clinging to the last thing you will ever have of him – his helmet; to never again hear his voice, his laughter, his touch, his comfort, his friendship. It rips you apart and all the million tiny pieces are scattered in such a violent way that even magic can’t glue you back together.

The guilt, the questions, the shame, the loss of who you are . . . they can kill you and it never really goes away. Richard’s suicide caused PTSD in me. His suicide, his death, also stripped me of my identity. I’m changed forever.

In my fire community, I’m forever Nathalie the widow of the chief who committed suicide. So to cope with all of it, I learned how to live dead inside. According to the police report, I missed him by maybe 30 minutes. I live with that every single day. Could I have stopped him?

In July 2013 in Lac-Megantic, I was prepared to do the job for which I had been trained.

As I got closer to the site, my heart sank, but my heart rate went up and so did my blood pressure; this was a feeling I recognized but chose to ignore. I kept pushing forward to get the job done.

That’s what’s expected right?

I felt OK until it was time to head back to the fire department for a break. Walking ahead of a group of firefighters, I kept looking back at the disaster site, wondering how it could be that a nearby church survived intact and how those streets and buildings, just on the other side of the railroad tracks, were reduced to dust.

My brain just could not compute the scene.

Then I realized that familiar crunching sound that I had been hearing all along was coming from under my boots. I stopped dead in my tracks, looked at my feet and got thrown back to 9-11, which had changed me forever. I could no longer tell where I was – in the situation from the past or in the present moment in Lac-Megantic.

I consider myself fortunate to have met Nathalie several years ago while our respective organizations worked to honour Canada’s fallen firefighters in Ottawa. We had become friends over the years and in the fall of 2014, after a meeting, we had the chance to talk about presumptive legislations governing workplace illnesses for firefighters, and the subject of PTSD came up. After a brief conversation, Nathalie indicated to me she had been recently diagnosed as suffering from PTSD. This caught me a little by surprise initially as I wasn’t sure what to say next. I wondered if it was even OK to ask her about it or if some of the things I would say or ask would make it worse.

I have to admit, I was one of those people who didn’t realize what it means to try to deal with PTSD on a day-to-day basis, but after Nathalie talked about it for a while, I felt she was reaching out hoping that maybe I would talk about it with her more. The more she said, the more I realized I had to ask her.

I wanted to know how PTSD affected her job, how it affected her life off the job. Will it ever go away or even get better? How do you get PTSD? How does PTSD get you? Is there anything I can do to help? That’s a ton of stuff; would all these questions overwhelm her?

What did I really know about PTSD as it affects emergency-services workers other than what most of us have heard, which is that people with it are prone to severe depression and in the worst cases, committing suicide? Even tougher to digest were the next questions: had suicide crossed her mind? And how in the world do I even approach discussing that with her?

I decided to take that chance and ask her if she wanted to talk about her story. I was willing to listen and I really wanted know what she was going through.

And then I listened . . .

And I have to say that some of what I heard, including several incidents to which Nathalie had responded, hit me very hard, especially the affects the PTSD was having on her. Little did I know I was one of very few people who crossed the line and spoke with Nathalie about her PTSD. I also didn’t know it at that time, but the conversation we were having about PTSD that evening would eventually help to save Nathalie’s life.

The conversation wasn’t about just the events that caused Nathalie to develop PTSD, but also what was happening to her mentally and physically because of it. I was not expecting to hear how much PTSD disrupted her life or the extent to which it had changed her abilities to do what would appear on the outside to be normal, easy, everyday tasks that most of us take for granted.

I remember on one occasion I chatted on the phone with Nathalie while she grocery shopped so I could provide a distraction from others who might encroach on her “bubble” at the checkout, so she would know there was someone with her whom she trusted. I remember thinking how horrible it must be to live that way, wondering if you are going to get through the day. Surely there must be some coverage and help available, I thought. It quickly became clear that it wasn’t that easy.

Wayne was one of the few people who dared ask or talk to me about PTSD and I felt that 100 pounds lifted off my shoulders because finally I could talk to someone.

Being asked questions and talking made me lose some sense of loneliness and isolation.

I’ve learned that there are two ways PTSD can kill you: the first way, you’re alive, slowly dying inside as PTSD controls the every essence of you; the second is suicide.

Living with PTSD and not knowing or understanding what was happening to me was extremely difficult and frightening. However, once I was diagnosed by qualified medical personnel, my life became easier to manage.

When I got the diagnosis I didn’t do a happy dance in the doctor’s office, but the diagnosis gave me hope.

I have PTSD.

PTSD does not have me.

PTSD does not define me.

PTSD is not about what’s wrong with me, it’s about what happened to me.

After proper diagnosis in summer of 2014, I went in November to a private therapy centre called La Vigile. It was also there, that because of a trigger, I discovered I had PTSD from Lac-Megantic. One of the biggest things I learned was that with each traumatic event in my life, I was stripped of the feeling of safety; this changed how I see the world and I now constantly watch over my shoulder, which is known as hyper arousal.

The following is my day-to-day life, before and after diagnosis.

My first battle is realizing that my eyes are open and I have to get up and face the day. I’m always scared of what the day will bring – or do – to me.

  • I have insomnia, but when I do sleep, I get cold sweats so badly I need to change my clothes and sheets.
  • I keep lights on all over the house; darkness is now frightening.
  • I self-medicate with prescription drugs but when this was not enough, my best friend became tequila and then more alcohol took over.
  • I had little or no appetite because of my high level of anxiety.
  • I rarely dine in restaurants because I can’t stand crowds and noises. If I go, my back needs to be against the wall so I can see all around me at all times. I have to have at least one direct route to an exit and I always have two exit plans that I go over and over and over in my head during the dinner. You think I enjoy dinner like this?
Hyper arousal
  • Anxiety.
  • Outbursts, anger, irritability, lashing out, over reacting, guilt, shame, insecurities about my own mind and actions.
  • am constantly watching over my shoulder and am jumpy.
  • They can come up and bite me in the behind and there is never ever a way to prepare.
  • On a daily basis.
  • This starts with a trigger, then a flashback and then, something happens and brings me back so deep inside that I’m disconnected from reality. During that time I’m reliving the event all over again and I have no control. There is a window of about 10 seconds to get me out of that state, if I’m lucky. Sometimes it can be so strong that I spiral down very quickly and don’t even have time to realize what’s happening and then, well, the outcome is not good.
  • Due to hyper arousal, I get very impatient and can be aggressive when there is too much noise.
  • I avoid public places and or crowds or any kind, clothing stores, malls, restaurants and even grocery stores.
  • I have short-term memory loss and my cognitive abilities are reduced. Thankfully, they are returning due to continuous therapy.
Other symptoms that appeared as PTSD and got worse before diagnosis
  • Lack of concentration.
  • Lack of interest in anything.
  • Detached from surroundings and avoiding people, including friends and family.
  • Depression hit. This led me to think about suicide and the “how.”
  • Suicide became more and more present in all thought process and a plan took form.
  • Suicide became a beautiful “life.”
On that one night, I was intoxicated, got in my truck and drove to a specific train crossing. I sat there in my truck, waiting for the train to end it for me.

Today, I know why the train tracks were the best way for me:
  1. I saw and know the destruction a train can do and the chances of survival are slim.
  2. I didn’t want my parents to have to identify my body like I had to ID Richard’s body. I needed to ensure there would be nothing to ID.
Coming out in public and talking about PTSD openly, I had to fight my fears of being judged by my peers, never getting a promotion and not getting hired elsewhere within my fire community because I am labeled.

Darkness and silence are the two killers that wait for PTSD sufferers.

If you feel anyone may be showing signs of PTSD, it’s extremely important that you do not wait for him or her to come to you but instead go to your friend or colleague as soon as possible and be ready to listen without judgment.

Most of all, follow up. Never leave that person’s side, because if they trust you enough to share their darkest fears, they need you there throughout the healing process too.

As emergency workers, we always work as a team. In a fire, it’s always two in and two out, and this is no different.

In July 2014 when I was told by my doctor and psychologist that I needed to enter a detox or therapy program, my response to them was, “F--- off! I don’t have a problem!”

In mid-October, while having a dinner meeting with a trusted and respected friend, he asked me how I was and waited for an actual answer. Then he asked, “How’s my favourite firefighter really doing?” I collapsed.

He had noticed signs back in April, but I was closed when he approach me. He strongly suggested a centre that helps only emergency first responders, a 30-day closed therapy program that also deals with PTSD. I told him, “Call now before I change my mind.”

He called La Vigile. A staff person stayed on the phone with me for two hours and there was a follow-up call every day until I went in on Sunday, Nov. 2 – the day my new life started.

As I took the time as a friend to be there for Nathalie, something else became very apparent to me about PTSD – it doesn’t just affect the person suffering from it. In fact, someone suffering from PTSD can bring on much mental pain and anxiety to those who are close to them as they try to figure out what that person is going through. Inevitably, their friends, loved ones and co-workers can be affected by the actions of the person suffering from PTSD and may need assistance dealing with that aspect of it – they may start to struggle just as much while caring for someone suffering from PTSD.

Through our conversations, I know firsthand how hard it was to listen to Nathalie talk about what she was going through and not know if I had the ability to help her get through a triggered emotion, or even whether I might say the wrong things and make it worse.

It was heart-wrenching for me to process Nathalie explaining to me how the nightmares and depression brought on by PTSD were getting the best of her, that she couldn’t see any other way to make the pain stop other than the worst-case scenario we were trying to prevent.

As Nathalie underwent her 30-day closed therapy session at La Vigile, she was able to communicate only briefly with friends and loved ones on the outside. Through these very brief periods of contact, it felt like I was drowning and I was only able to break the surface long enough to get a taste of how she was doing, but not long enough to get the full breadth of how her therapy was progressing. This made it extremely hard for me as Nathalie’s friend to make it through to the next phone call, not having a full understanding of how she was doing until the next time we talked. It was very difficult to determine at what level the therapy was helping Nathalie.

As Nathalie went through her therapy, I found it extremely difficult to stand by her throughout all the changes she was experiencing, but I refused to turn my back on her. There was no way I was going to let her down when she needed the support of a friend she trusted as she went through this learning process.

Inevitably though, realizing the PTSD sufferer is being given the necessary support and treatment can lift a great burden off the shoulders of family, friends and loved ones, which makes it much easier for them to cope as well.

What I have learned in talking with Nathalie about PTSD is how important it is to stand beside a person through the darkest moments just by listening without judging; it may be the single most important thing you can do for that person. And be prepared to listen a lot, because once a PTSD sufferer finds that comfort level and trust in talking with you, he or she can sometimes talk for hours as everything comes to the surface. Allow the person space but always be aware that someone suffering from PTSD may spiral downward unexpectedly and sometimes just being there without saying anything can do the most for that person. Do not put any pressure on someone to get over it or suck it up, but instead be there while he or she makes adjustments to come through a triggered emotion; doing so can make the world of difference.

I am very fortunate to have some good friends on my department with whom I have been able to share a lot of this; one of them asked me a question that I did not expect. Surprisingly, several days later with no knowledge that I had been asked this question already, Nathalie asked me the same question. I’m sure I had a deer-in-the-headlights look as I fumbled for an answer.

It was clear to both Nathalie and my colleague that I made a very serious commitment to help her get through the hardest moments in dealing with PTSD, and to be that trusted friend she could call on and talk to at any time of day or night, to help her get through the crippling moments. So far so good.

The question: What did I think would happen to me if all the efforts to help Nathalie failed and she took her own life anyway?

The question haunts me. I had thought about it but never really accepted the fact that it might happen, and I still don’t want to. But the question made me think, and with what I know today about how PTSD can affect friends and families, it made me wonder how her PTSD was now affecting me.

PTSD is a horrible illness that can take its toll on more than just the person suffering from it.

Since my therapy at La Vigile I’ve learned to better understand my symptoms and what causes them.

The hardest part of the therapy was Nov. 29, 2014, the day I came out and had to live my new normal in a world that had not changed.

I constantly have the haunting thoughts, “Will I get triggered? Will I be able to control it? Do I tell? Will they judge me?”

Another question is how and when do I tell someone I just started to date that I have an illness, an injury that is so taboo and judged? Will he run with his feet glued to his behind?

The man who chose to not run after I told him I suffered from PTSD asked why I wanted to speak out. Why put myself out there and risk it all – my reputation, my career, the goal, the big picture?

It’s time to talk, to change things. My voice will be heard.

But our voices together will be louder.

Nathalie Michaud has been a paramedic, firefighter, fire-prevention officer and fire investigator during her 15-year career in emergency services in Quebec. She is on the board of the Canadian Volunteer Fire Services Association and has been its Quebec director since 2012. She is also on the board of the Federation quebecois des intervenants en securite incendie since April. Nathalie is a master instructor for St. John’s Ambulance. Contact her at This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Wayne Jasper has served more than 32 years in the fire service, 30 as a career firefighter with CFB Esquimalt Fire Rescue in Victoria. He has also served nine years on the board of directors for the Canadian Fallen Firefighters Foundation as LODD application-committee chair. Contact him at  This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Written by Elias Markou
In the past 200 years there have been tremendous advancements in science, technology and industry. But our dependence on chemicals to make our lives easy and convenient has left a lasting footprint on the natural world and on humans – an illness price, if you will. Academic literature and research continue to make connections between chemicals and their cancer-causing properties.

As the first on scene to hazmat calls and structure fires, firefighters are exposed to a higher-than-average volume and variety of cancer-causing chemicals. Firefighters have a vested interest in understanding detoxification and why it’s important to help the body eliminate toxins through a science-based, effective detox program.

We know from many of our own experiences that the body is very resilient and can adapt to many situations, both positive and negative. However, unmanageable volumes of chemicals are accumulating in the body faster than the body can remove them. In many individuals, the total toxic load often leads to cellular dysfunction, hormonal imbalances, metabolic syndromes, full-body inflammation, nutritional deficits and extreme health issues such as cancer.

It is important to remember that one chemical-exposing agent does not create an out-of-control health issue. We know that most chemicals are fat soluble and so they love the fatty tissues in our body. Toxins enter the body and travel through the bloodstream to their eventual resting place. All organs in the body are supplied by the blood, which means they are continually exposed to low levels of toxins. A firefighter’s greatest risk of chemical exposure occurs during fires or hazmat calls.

The liver plays an important role in detoxification; it detoxifies or inactivates and excretes toxic chemicals, drugs and hormones, those made by the body and those that come from outside sources. After the liver inactivates the toxic substances, the bowels, lungs, kidneys, or skin eventually excrete them. The liver is also a major blood reservoir; it filters more than 1.4 litres of blood per minute and removes bacteria, toxins and various other unwanted substances from circulation. Too much pressure on the liver from overeating, rich or poor-quality food, environmental stresses, overwork or emotional stress can cause liver overload. Overload leads to a decreased ability to clear toxins and hormones, and the manufacture of bile. An overloaded liver allows toxic and waste material to pass into the blood and accumulate in the body instead of being eliminated.

A good detoxification program aims to improve bowel and liver health. Such a program also moves toxins out of their storage sites in the fatty tissue, supports the liver’s ability to break them down, and supports the functioning of the other major organs of elimination: the skin, the lungs, the kidneys and the gastrointestinal tract.

To help firefighters detoxify their bodies, I created a program that combines nutritional modifications, functional detox supplementations, herbal medicines, water therapy, and infrared sauna therapies.

A diet high in vegetables is the key to a comprehensive detox program. Most notable are the cruciferous vegetables – broccoli, cabbage, cauliflower, Brussels sprouts, kale and rapini. Cruciferous vegetables are packed with glucosinolates phytonutrients that can help heal the liver and allow it to eliminate toxins.

Studies that show herbal medicines such as curcumin, which is found in turmeric root, can increase the production of liver enzyme detoxification pathways.

Why an infrared sauna? Infrared heat penetrates the body tissues to a depth of more than 3.8 centimetres (1.5 inches), deeper than a conventional sauna, which relies on convection rather then conduction to produce heating. The infrared sauna uses heat stress and increased circulation to facilitate lipid mobilization and excretion of fat-stored toxins through various excretion pathways, including perspiration. The functional food is a rice protein-based nutritional supplement designed for use in detoxification protocols, as an adjunct to liver and bowel detoxification, and for systemic inflammatory control and allergy relief.

The program takes 28 days to complete, and firefighters who have gone the distance tell me it was difficult but very rewarding. Patients often experience health improvements such as mental clarity, restored energy levels, weight loss, decreased allergies, improved sleeping patterns and lowered blood pressure. Most importantly you will be one step closer to a healthy liver and a cleaner body.

Read part 1 of this series on firefighter detoxification.

Elias Markou is in private practice in Mississauga, Ont., and is the chief medical officer for the Halton Hills Fire Department. Markou was a volunteer firefighter for six years and is now a firefighter health expert and blogger. Contact him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

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