Over the past ten years I have helped many people THRIVE! I can do the same for you and your loved ones.

How do I help people THRIVE

THRIVING means experiencing deep health. Deep health is feeling the way you want to feel physically, mentally and emotionally, even relationally. People who experience deep health say things like "I feel on top of the world", "I feel like I have come alive", "I feel energized and happy!" My name is Mathilda Prinsloo. I am a medical professional with expertise in Medication Management and Deprescribing, Diabetes Management, Cognitive Behavioural Therapy and Lifestyle Coaching. Read my story in About Mathilda. My clients are:
  • Older adults taking multiple medications.
  • People with diabetes or pre-diabetes who seek help to control their blood sugar, put diabetes in remission or reverse pre-diabetes.
  • Poor sleepers who want to have the sleep of their dreams.
  • People with food cravings and concerns about their weight.
Older adults, take less medications and have more life!
As we age our bodies undergo physiological changes that can affect the safety of medications and even how they work. Some medications become unsafe or less effective. Others become unnecessary. And not only that, as our knowledge of illnesses and medications evolves, therapies and best practices often change and safer and more effective medications become available.
In other words, “What was good earlier in life, may not be good for ever.” We all know that medications are prescribed for good reasons and necessary to relief symptoms, reduce suffering, prevent disease complications, disability and even death. But sometimes medications are continued when they are no longer needed or helpful or even harmful. Having said that, a large body of evidence shows that in the later years of life, “LESS IS MORE!” This expression means older people need fewer medications to manage chronic illnesses that rewards them with more satisfaction with life. The question is, how does one find the balance between medications that are needed, safe and effective and ones that are unnecessary or perhaps do more harm that good. Scroll down and discover how you can benefit from booking an appointment for Medication Assessment and Deprescribing.
Take control of diabetes instead of diabetes controlling you!
Diabetes is a common metabolic disease and chronic condition that affects many people worldwide. Almost 9% of Canadians have diabetes and an estimated 6% of adults have pre-diabetes. That means many people with pre-diabetes are unaware of having elevated blood sugar. If you are fourty years or older and or have a family member with diabetes ask your doctor to check your blood sugar routinely. Knowledge and practical skills of diabetes friendly lifestyle including food choices and portions are powerful tools that have stood the test of time. Diabetes friendly lifestyle has shown to reverse pre-diabetes and put type 2 diabetes in remission in many people. Medications also play an important role in controlling blood sugar in people with diabetes. Newer, safer and more potent blood sugar lowering agents make it easier for people with diabetes to control their blood sugar with fewer medications while experiencing less or no side-effects. Most importantly newer blood sugar lowering agents are designed to prevent and or treat diabetes complications such as heart attack and stroke, kidney disease and heart failure compared tomedications that only lower blood sugar. Scroll down to Blood Sugar Management and discover how booking an appointment for a consultation will change your LIFE!
Poor sleepers have the sleep of your dreams.
Poor sleep can be caused by bad sleeping habits, emotions and thoughts, misbeliefs, your sleep environment or just a noisy mind. Did you know sleep is a behaviour regulated by neurochemicals in the body and factors in the environment that are coordinated by the brain. Behaviours are formed by patterns and patterns can be good or problematic. Fortunately the brain is plastic. That means patterns that are problematic can be unlearned and new patterns which foster better sleep can be learned. That is amazing! Changing the brain's patterns is called cognitive behavioural therapy. Cognitive Behavioural Therapy (CBT) is drug free and first line treatment for problems with sleep. First line therapy is a treatment that is recommended to be implemented before others are tried. CBT for insomnia is called CBT-i and works for most people with sleeping problems. Studies have proven that CBT-i is as effective as sleeping aids luckily without typical side effects like brain fog, daytime drowsiness, dizziness and grogginess upon awakening. The best part is CBT-i does not only address the underlying problems of sleeping, the effects of CBT-i are long lasting. Cognitive Behavioural Therapy for insomnia equips people with strategies and cognitive tools that address interferences with sleep called sleep distruptors while producing adequate and refreshing sleep. Understanding the basic principles of systems in the body which regulate sleep and factors that interfere with sleep will help you identify why you have difficulty with sleeping. You will master tools to sleep better, stop tossing and turning in bed, worry about sleep and poor performance the next day. Poor sleepers scroll down to Sleep-O-Thrive and discover how booking an appointment for CBT-i will let you have sweet dreams!
Take control of food cravings and weight gain. Feel on top of the world!
You may have tried diet after diet or a myriad of other strategies to lose weight that left you disappointed with their short-lived weight loss and subsequent regain effects. Maybe you are frustrated with cravings or concerned about where your weight is heading. The good news is modern science has proven that WILL power is over-rated and NOT the answer to controlling food cravings, losing pounds, keeping them off and improving body composition! Factors like genetic predisposition, lifestyle, the environment, our thought processes and associations related to eating have profound effects on our eating habits and appetite control. Interventions that target modifyable factors like lifestyle, environment, thought processes and associations form the backbone of successful weight loss and weight management. Most people are surprised to learn that eating is a behaviour. Behaviours are formed by habits. And habits can be good or problematic. Luckily there is an effective scientifically proven intervention model that explores and addresses thought processes, emotions and habits that are at the root of problems with appetite control and weight management. It is called Cognitive Behavioural Therapy for problematic eating. (CBT-e). If you are concerned about your relationship with food and having problems with weight gain scroll down to Crave-A-Thrive and discover how booking an appointment for CBT-e will help you cultivate a healthy relationship with yourself, food and weight management.

Our philosophy

At Patient Care and Thrive Practice we take a client-centered approach. Our interventions and care are focussed on the needs of our clients. Needs mean acknowledging your beliefs, preferences and values while guiding treatment decisions in a collaborative and respectful manner. Needs also mean meeting you where you are on our journey of change and aim for doing better. Our mandate is to empower you and inspire you, guide you step- by- step, equip you with evidence based scientific knowledge and trusted tools while helping you to create a vision of your potential and ability to succeed in your goals.
Medication Assessment and Deprescribing
A Medication Assessment is the most effective tool to assess the health and medication needs of older adults. Recent data shows that one in four Canadians are taking ten or more classes of drugs per day and studies show that 15-20% of drugs used by seniors are considered unnecessary and or unsafe. Even one medication that can cause more harm that good, can be one too many. Experts blame the high use of medications on our medicalized society.We have adopted the perception that there is a “pill” for every problem and every problem has a "pill" that can fix it. And this cannot be further from the truth.
Fortunately, medication experts developed a scientific framework to find the balance between necessary, safe and effective medications and those which are not, called deprescribing. Deprescribing is the opposite of prescribing and means to safely and systematically reduce the number of prescribed and over-the-counter medications a person takes or lower the doses of medications when lower doses are safer or as effective as a higher ones. Deprescribing simplifies complex medication regimens, replaces unsafe or ineffective medications with better alternatives and stops medications that have poor evidence of supposed benefits. Deprescribing is good medicine from all sides of the gurney! The goal of Medication Assessment and Deprescribing is to ensure that older people are not treated with medications they no longer need or medications that are no longer effective or safe for them. Click on CONTACT in the top to book an appointment and discover how Medication Management and Deprescribing can help you take LESS medications and have MORE life!
Blood Sugar Management
A higher than normal blood sugar is called hyperglycemia. Hyperglycemia is classified as gestational, type 1, type 2 or pre-diabetes. The latter is formerly known as borderline diabetes. The main concern with pre-diabetes is becoming diabetes usually in five years unless diabetes friendly lifestyle behaviours are implemented. A major concern with uncontrolled diabetes is the worsening of diabetes and the onset of debilitating longterm complications. Complications refers to damage to other parts of the body that leads to health problems like kidney disease, heart disease, blindness, heart attack and stroke, liver disease, nerve damage, memory loss to name a few. The good news is that diabetes friendly lifestyle behaviours tailored to your needs and preferences will help you reach your blood sugar goals. Take the work and worry out of diabetes and pre-diabetes with a personalized plan. Moreover, aim to put diabetes in remission and reverse pre-diabetes. Reversal of pre-diabetes means having no diagnosis of diabetes and taking no medications.Remission of diabetes means your blood sugar is normal without taking medications. When people are not able to achieve remission they tend to take fewer medications. Click on CONTACT in the top to book an appointment and discover how a Diabetes Management consultation can help you take the work and worry out of blood sugar control. You will be rewarded with MORE energy, LESS stress and BETTER sleep.
Sleep-O-Thrive
Sleep-O-Thrive is a CBT-i program based on research and clinical expertise of local and global sleep experts. You may be tossing and turning every night, be frustrated with poor sleep and not knowing why. Or you may have tried various strategies to sleep including prescription and over-the-counter drugs only to find they don’t produce adequate and restorative sleep. Moreover, their sedative effects wane over time. That often results in the need for taking higher doses and experiencing side-effects. Therefore the adage, ’Natural sleep cannot be bottled.’ Did you know sleeping pills have not been tested for safety when taken longterm. In fact, they have recently been associated with risks of memory impairment, daytime sedation, falls and traffic accidents particularly in older adults. A person may be impaired and not even notice. Adequate refreshing sleep is an important element of overall health and wellness. Sleep allows our bodies and minds to rest and recharge, leaving us refreshed and alert when we wake up.In other words, during sleep the immune, nervous and musculoskeletal systems are in a state of repair, regeneration and rejuvenation.
Evidence shows that chronic poor sleep is associated with the onset and or worsening of chronic diseases like heart disease, high blood pressure and blood sugar, stroke, problems with weight management, anxiety, depression and chronic pain. Not only that, without regular, adequate and refreshing sleep the brain has difficulty to function properly and that can affect mental health. In other words, sleep plays a central role in every aspect of human life. Adequate good quality sleep is key to regulating mood, reducing stress, worry and irritability, consolidating and recalling memories, improving cognitive performance, reducing pain, reducing daytime fatigue and sleepiness. Click on CONTACT in the top to book an appointment and discover how Sleep-O-Thrive will let you have sweet dreams!
Crave-A-Thrive
Crave-A-Thrive is a skills-based psycho-educational intervention tool, modelled after reknown and popular Cognitive Behavioural Therapy for problematic eating (CBT-e) programs. CBT-e is globally and in Canada recognized as one of the four pillars of effective weight loss and longterm weight management strategies and an essential ingredient of deep health. Deep health is a multi-faceted, whole-life experience of thriving in all domains: physical, mental, emotional, social and even financial.A healthy relationship with eating and food makes people feel satisfied with self and cultivates a sense of thriving! You will learn that the body’s physiology, your environment, personal circumstances, personality types, culture, associations, beliefs and emotions have a lot more to do with your eating habits than food, alone. We can compare eating problems with an iceberg. On the surface appears ‘WHAT’ bothers you about your eating. Like an iceberg, the area below the surface is much bigger than the one above. Crave-A-Thrive targets the area below the surface that reveals the ‘WHY’ factors which affect the way you eat.Understanding the ‘WHY’ of eating behaviours will help you address influences that affect ‘WHAT’ bothers you about your eating. Crave-A-Thrive aims to equip you with understanding of the principles of healthy eating, your body’s normal physiology and how your thinking patterns affect your eating. Once you gained insights of these factors you will learn how to use cognitive tools to help you change your relationship with eating and food. Click on CONTACT in the top to book an appointment and discover how Crave -A-Thrive rewards you with less distressed over your relationship with food and weight. You will gain control of your eating habits and feel satisfied with the best version of YOU!
  • I have had diabetes for many years that has been worsening over the last year. My family doctor referred me to an endocrinologist. The waiting time was three months or I had the option to see Mathilda, a diabetes practitioner. I was desperate and willing to take any help I could get.

    I had an appointment with Mathilda in three weeks. She got to the bottom of my blood sugar problem in one visit and changed my medications. It was an incredibly satisfying experience to see my blood sugar readings lowering steadily until it was in target range over such short period of time. I felt relieved, less stressed and even had better sleep.

    Mathilda’s professionalism and enthusiastic support are additional gifts to her patients. Patients who have her as their diabetes care provider are indeed fortunate.

    Brenda C Winnipeg October 2022
  • I was referred to Mathilda at a time of crisis in my life. I had developed debilitating insomnia within a few months of the Covid-19 pandemic. My daily thoughts revolved around how to get more sleep. No matter how many things I tried on my own, my insomnia and quality of life felt like it was spiraling out of control.

    Within three to four weeks of my first CBT-i session with Mathilda, I went from feeling almost entirely helpless, ruled by sleepless anxiety-ridden nights to having a sense of calm and control over my sleep. My bed went from being a place where I tossed and turned (and sometimes cried in anguish) over my insomnia to a place that I now celebrate for bringing me deeply refreshing sleep.

    To say that the sessions with Mathilda exceeded my expectations is an understatement. She was an absolute pleasure to meet with, always making me feel respected, valued, and understood. Her approach was indescribably valuable, helping me live a happy, healthy, and fulfilling life again. I am so grateful to her for helping set me up for a successful future.

    Thank you, Mathilda!
    Bronwen Winnipeg January 2022
  • My dad is 86 years old and has multiple health conditions. Since a few months ago his health started to deteriorate alarmingly fast. He was hospialized three times for stomach bleeding and received blood transfusions all three times. He complained constantly of feeling lethargic, dizzy and out of energy. This situation with our dad concerned all three our children. I felt hopless and mentioned to a friend who is married to a physicain who works with Mathilda. She suggested to contact Mathilda. I was impressed with her insights and professionalism from the start. She was able to identify my dad's bleeding problem immediatly, collaborated with his family physician and within a week the bleeding problem had been resolved. I felt relieved. She moved on to resolving other issues. In three months my dad showed signs of having more energy, he started to walk in the hallways and complained less of back pain. The part he appreciated most of Mathilda's interventions was having more energy and taking less medications. She was able to reduced his medications from 16 pills a day to eight, switched one medication to once a week and switched his medications for back pain to an injection every six months. My family will always be greatful for Mathilda's involvement in the care of our parents.
    Lorraine B Hamilton ON March 2020
  • I am a physician and had the privilege of working with Mathilda for a number of years in a senior care setting. She is one of the most knowledgeable pharmacists I have ever worked with. The depth of her medical knowledge, wealth of her clinical understanding, and her ability to work as a team member were invaluable in the provision of care to our patients. Mathilda’s expertise in Diabetes Management was an additional benefit in providing the best possible care to our residents. I wish her just the best in her future endeavours!
    Dr. D. C. Winnipeg October 2019
  • "I am fortunate to have Mathilda work with me and my patients. She makes a significant positive difference to the diabetes care we offer patients in my practice.

    Mathilda is extremely knowledgeable and thorough. She understands the challenges of living with diabetes and knows how to guide and motivate her patients. My patients, staff and I enjoy her passion for patient care and we hope to continue working with her."
    Dr. H L, Winnipeg March 2017

Frequently Asked Questions

  • I am concerned about the reaction of my physician if I would seek help from Mathilda to reduce my medications.
    In my experience most family physicians appreciate patients becoming engaged in their health. Most welcome respectful interactions with other health experts when the goal is benefitting their patients. After my initial meeting with patients I contact their other relevant health providers to introduce myself and outline my role as an allied health professional with expertise in geriatrics, medication management and deprescribing. So far my experiences have been positive and many physicians in the city are familiar with the work that I do. Apart from that, everyone in the medical world knows that a team approach to patient care offers patients higher quality of care, improved results and greater satisfaction with the health care system.
  • What are examples of deprescribing?
    Some medications may be deprescribed because they do not have benefit. Examples are stool softeners, certain supplements and vitamins. Other medications may be deprescried because they can have harmful adverse effects like longterm use of benzodiazepines for anxiety, over-the-counter sleeping aids, prescription sleeping aids called z-drugs and longterm use of non-steroidal anti-inflammatory drugs like ibuprofen. Some chronic conditions don not need to be as tightly controlled with age. For example blood sugar, cholesterol and high blood pressure. Some medications may have been prescribed for symptoms or an illness which are no longer present. Examples are acid reflux medications and hormone replacemement therapy for symptoms of menopause in woman. Certain chronic illnesses like high blood sugar and blood pressure, even chronic pain can effectively be managed or co-managed with dietary changes and physical activity that may suggest deprescribing some of medications and lower the number of medications needed. More information on deprescribing is available on the websites of Canadian Medication Appropriateness and Deprescribing Network: https://www.deprescribingnetwork.ca/deprescribing and US Deprescribing Research Network: https://deprescribingresearch.org/for-patients/
  • Is it safe to deprescribe medications?
    Deprescribing is safe under the supervision of a healthcare professional. Some medications can safely be stopped immediatly like vitamins. The dose of others need to be slowly decreased bit by bit over time, called tapering. Tapering indicates if the medication is really needed at that particular dose and if a lower dose is effective or the medication is even needed. In cases where the body typically gets used to a drug, tapering helps the body to gradually gets used to less of the drug until it can be stopped without rebound or withdrawal effects. Examples are medications for high blood pressure and blood sugar, sleeping aids, drugs for acid reflux and hormone replacement therapy. . More information on deprescribing is available on the websites of Canadian Medication Appropriateness and Deprescribing Network: https://www.deprescribingnetwork.ca/deprescribing and US Deprescribing Research Network: https://deprescribingresearch.org/for-patients/
  • What are the benefits of deprescribing?
    Taking less medications make older adults feel better for several reasons. Deprescribing lowers the number of medications needed to take every day. Not only does it safe money spend on prescription as well as over-the-counter medications, taking less medications is more convenient and ensures that people take medications that actually benefit them. Deprescribing lowers the risk of drug interactions that may cause harmful reactions, the prescribing cascade, polypharmacy (read about this in other FQA pages) and lowers the risk of unnecessary hospitalizations, loss of independence and functionality. Survey participants who have had their medications assessed and safely deprescribed report feeling less ill and more able to manage their health problems. Most participants report having more mental energy and satisfaction with where they are in life. More information on deprescribing is available on the websites of Canadian Medication Appropriateness and Deprescribing Network: https://www.deprescribingnetwork.ca/deprescribing and US Deprescribing Research Network: https://deprescribingresearch.org/for-patients/
  • What will my doctor say if you change my diabetes medications?
    Before considering to change patients' medications I build a relationship with patients. Together we explore the results of diabetes friendly lifestyle and therapeutic nutrition. If it becomes evident that my patient will benefit from changing their medication/s, we discuss the reasons for change, various alternatives, respective benefits and side-effects, practicalities and costs. Once we agreed on the most appropriate plan moving forward and my patient has given consent I contact their physician. I send a letter by fax to the physician to introduce myself and outline my role as a member of the team taking care of the patient's diabetes management needs as well as my credentials and the plan moving forward. The letter requests feedback, input and approval from the physician. Once approval is received my patient and I go ahead with the plan that includes timely follow up to ensue that the change we made produces expected benefits. Throughout my interactions with patients I keep their physicians updated. This format is similar to when patients are referred to specialists and other health care providers. The difference is that patients are self-referred instead of being referred by their physician. I've been doing this work for more than ten years and to date have not had any negative reponse from physicians. On the contrary, many physicians refer their patients with diabetes and pre-diabetes to me once they become familiar with the work I do. Moreover, they appreciate their patients being engaged in their diabetes care.
  • What happens if a medication is deprescribed and my symptoms return?
    The short answer is, we re-start the medication. Keep in mind that only certain types of medications are candidates for deprescribing. Life-sustaining and medications that control life-threatening symptoms are not candidates for deprescribing although sometimes tapering the dose is an option to lower side-effects or pill burden. Tapering means to gradually lower the dose and measure the outcome every step of the way before stopping completely and the best way to determine the needs and benefits of medications or particular doses of medications. There is really nothing to lose.
  • What is the prescribing cascade?
    Prescribing cascade occurs when unwanted effects of existing medications are misinterpreted as new medical conditions that lead to the addition of another medication that is totally avoidable. Here is an example of what could happen: A patient develops a cough caused by his blood pressure medication.His health provider treats the cough with a cough syrup and that is not helping. Unfortuntely the health provider percieves the cough as being pneumonia and prescribes an antibiotic. The antibiotic causes diarrhea and dehydration. Dehydration led to delirium and hospitalization.
  • What happens during a 10 minute assessment call?
    I use this opportunity to meet and greet my clients and determine if the service they are interested in is a fit for them. This is also an opportunity to answer questions and book an appointment.
  • Is deprescribing not the responsibility of my doctor?
    Hypothetically yes. However, there are reasons why medication assessment and deprescribing are not routinely done in many primary care offices. The most common reason is time restriction. Medication assessment and deprescribing is a process that involves careful review of numerous pieces of information and often research of evidence prior to formulating a treatment and follow up plan. It can be time consuming. We all know that most clinics alot 10-15 minutes per patient visit. In addition many clinics allow discussing only one problem per visit. Another reason is that patients often see multiple health providers and accummulate medications as they go through health and life. Physicians are typically hesitant to change medications that were prescribed by other health providers in particular specialists although sometimes many years ago. Lastly, changing medications or medication doses requires timely follow- up. Many family physicians are already overwhelmed by their patient loads. Adding more patient visits may be challenging to manage. Most physicians who I have worked with expressed their gratitude for my involvement as a medication expert.
  • Is deprescribing not the responsibility of my pharmacist?
    Medication assessment and deprescribing is a process that involves careful review of numerous pieces of information and often research of evidence prior to formulating a treatment and follow up plan. It can take up to one to two hours. Unfortunately pharmacists in Manitoba are not compensated for medication assessments, doctor communication and follow-up visits. In addition, pharmacists typically don't have access to laboratory and medical history information that are paramount to the accuracy and relevance of a medication assessment and deprescibing plan.
  • What is a diabetes practitioner?
    A diabetes practitioner is a medical professional with advanced training and clinical expertise in diabetes management. I am a pharmacist by profession and have been a Certified Diabetes Educator for more than 10 years. My clinical expertise afforded me prescribing priviledges.
  • How do people end up taking too many medications?
    Taking too many medications is called polypharmacy and the consequence of the prescribing cascade. There are a number of reasons for polypharmacy. The most common reason is that over time as we age we tend to experience more and more health problems that are usually treated with medications. Some problems are short-lived and unless medications are timely reviewed people continue to take medications for problems they no longer have. Another reason is that physicians usually don't feel confident to challenge stopping a medication that was prescribed by another physcian. Sometimes the reason for a treatment may no longer be needed. Another reason is that the side effect of a drug can be percieved as a new problem and therefore treated with a new medication that adds to the list. These are good reasons for people who take more than five medications to have their medications assessed for relevance and appropriateness.
  • Does the government pay for your services?
    Unfortunately there is no funding for my services from the current government. Clients pay out of pocket and use their receipts to deduct the cost from their taxes. Others have health insurance spending accounts that cover the cost.
  • Why do some people need more than two appointments for Diabetes Management?
    People with pre-diabetes usually benefit from attending one appointment. People with diabetes may need two or more appointments. The number of appointments depends on the complexity of the case, the person's level of health literacy, their ability to implement diabetes friendly lifestyle concepts and whether medication changes is an objective..