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Category "Health"

15Jun

Bone-marrow transplant lets sun shine on Langley toddler for Father’s Day

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Kelsey Lock’s ideal Father’s Day involves eating ice cream in the park with his daughter — a simple plan, but one bordering on miraculous.

Lock’s daughter, Charlie, was born with erythropoietic protoporphyria or EPP, a disease sometimes described as an allergy to the sun. Since she was a baby, ultraviolet light, even in minuscule amounts, would cause the little girl’s skin to burn, blister and swell. More insidious, it would also begin to destroy her liver.

As a result, Charlie’s life was lived inside. The world beyond the tinted glass of her Langley home was largely unknown to the toddler, now 3.

“Any time we’d see a playground, it was rough,” recalled Lock. “To see other kids playing outside and know that Charlie could never do that was really hard.”

Late last year, Charlie’s liver began to fail. It is impossible to prevent all exposure to ultraviolet light. Unseen, porphyrins had been accumulating in the toddler’s liver, causing it to swell to three times its normal size.

People with EPP have a shortage of an enzyme that metabolizes porphyrins, which help with the production of hemoglobin. Without the enzyme, porphyrins accumulate in the blood, reacting with sunlight to cause burns. In a small percentage of people with EPP, including Charlie, they also accumulate in the liver.

To save his daughter’s life, Lock was asked to donate part of his liver. The family travelled to the Hospital for Sick Children in Toronto for the procedure. Working in a darkened operating room, a surgeon removed Charlie’s damaged liver and gave her a piece of her dad’s liver.

“I don’t think about it too much,” said Lock, “but every now and then, it hits me. I can say that I’ll always be there for her, and it’s literally true. I will.”

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But Charlie’s journey — from the family apartment with tinted windows in Langley to a park in Toronto on Father’s Day — was only beginning.


Charlie Lock, 2, during her first severe reaction to the Sun.

Submitted photo – Bekah Lock /

PNG

Doctors told the family they were essentially rewriting the playbook with Charlie’s case. Porphyria is rare, and EPP rarer still. Charlie’s form, which destroys the liver, hasn’t been the subject of much research. But because the toddler still had porphyria, the cause of her liver failure hadn’t been addressed by the transplant. The cycle would begin again.

So Lock was tapped to donate his bone marrow. A perfect match would give Charlie’s body the ability to create the enzyme that breaks down porphyrins, essentially curing both her liver problems and sun allergy. But no one in Charlie’s family was a perfect match. Because the girl has two exceptionally rare genetic markers, there were no matches on the international bone marrow registry either.

Still, doctors believed there was a good chance Lock’s bone marrow could at least prevent the destruction of Charlie’s new liver.

“The idea is that the bone marrow reprograms your entire blood-making system, but how well that would work was unclear,” explained Charlie’s mom, Bekah Lock.

In February, Kelsey Lock watched as blood was drawn from his body and passed through a sophisticated machine that looked like a “crazy water clock” to filter the stem cells from the rest. A few days before the procedure, he’d been given a medication that caused his bone marrow cells to leach into his blood, which left him feeling strange.

“I could feel all my bones,” he said. “When I stood up fast, I’d feel pressure in my ribs.”

Lock’s bone marrow was given to Charlie, after her own bone marrow and immune system had been wiped out by two weeks of chemotherapy.

Almost four months after the procedure, the family remains hesitant to use the word “cure.”


Charlie Lock at age 1 with her mother Bekah.

Nick Procaylo /

PNG

The transplant was largely a success. Early results showed 100 per cent engraftment, which meant Charlie’s bone marrow cells had been replaced by her dad’s cells and they were functioning as they should. The number has dropped a little since then.

“I’d say cautiously optimistic,” said Bekah, when asked how the family is feeling about the future.

After eight months in Toronto, the family wants to come home. Charlie still has several small hurdles to clear related to the liver transplant. The doctors are also monitoring her bone marrow numbers. Her immune system remains severely compromised from the transplants. But the family has been told they could be back in B.C. by fall.

Charlie’s first foray into the world outside her window was a quiet affair.

A few days before, her parents brought her to the wall of windows fronting the hospital. As they looked over the city, the little girl seemed content and comfortable despite the light flooding the corridor.

In early April, Charlie received permission to leave the hospital for a few hours. Instead of bundling her into a vehicle with tinted windows, the family walked in the sunshine to their apartment at Ronald McDonald House.

“I kept the cover off the stroller,” said Bekah. “It was kind of anti-climatic in a way, but it was also very, very sweet.”

For Kelsey Lock, the time in Toronto has been an opportunity to spend unlimited hours with Charlie. On leave from his job as a framer, he said it feels like he’s being “forced to take a vacation.”

His Father’s Day will be about simple pleasures: An ice cream cone, a park and a little girl with the whole world before her.

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12Jun

9,500 patient complaints lodged with B.C. health authorities over treatment quality

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A record number of complaints were filed with health authorities last year over patient care, more than 9,500 according to the Patient Care Quality Review Boards report for 2017/18.


Gerry Kahrmann / PROVINCE

A record number of complaints were filed with health authorities last year over patient care – about 9,500 according to the Patient Care Quality Review Boards report for 2017/18.

That’s up from 8,900 the year before and about 9,000 the year before that.

Patient Care Quality Offices and review boards were formed 10 years ago to give health system users and their families an outlet to voice their frustration. The boards in each health region accept complaints from patients and others only if their concerns about their experiences are not resolved to their satisfaction by Patient Care Quality Offices in each health region.

Less than two per cent of complaints are escalated to the review boards which suggests patients are largely satisfied with how their local health authorities are handling their concerns, said Richard Swift, chair of the Island Health Patient Care Quality Review Board.

Given the fact there are tens of millions of health care interactions, the number of complaints is relatively small, said Swift.

The latest annual report gives scarce information about the nature of complaints and recommended changes but a few of them include:

Island Health

• A complaint pertained to various issues including extraordinarily long wait time for care in a hospital emergency room for which Island Health acknowledged and apologized. The complaint also involved an allegation that a patient was assaulted by a staff member in the ER. The health authority agreed to develop a policy detailing what actions must be taken when such complaints are made, including when police or regulatory bodies for health professionals should be contacted.

• The Island review board recommended a hospital conduct exit interviews with patients to ask about their satisfaction levels with the quality of care and communication. Currently, the health ministry sends out surveys on a random basis which are then reported to health authorities on a quarterly basis. But Swift says more can be done to ensure patients are given opportunities to comment on their care.

Fraser Health

• A care aide escorted a frail patient to the bathroom but then left the patient alone to attend to another matter. The low cognition patient fell in the bathroom. There are more than a dozen policies regarding the prevention of falls, some of which were not followed in this case.

Vancouver Coastal Health

• A complaint was lodged about a vulnerable patient who went to a hospital emergency department. The board said the case was an example of how not to “prejudge patients who appear to be homeless, suffering from mental health, addiction issues and/or other challenges.” In response, hospital staff said there were departmental meetings where staff was reminded about the need to “provide care for the patients as a whole, the importance of listening to patients and their family, and the need to not prejudge patients on any aspect of their presentation.”

• In a case not highlighted in the annual report, a patient bled to death after paramedics could not get access to the individual’s Downtown Eastside building because of multiple security locks on doors and elevators. Health minister Adrian Dix said family members were not satisfied with the way complaints were handled so he has taken the rare step of ordering an independent review. 

The case pertains to Tracey Gundersen who bled to death last November after it reportedly took paramedics over half an hour to get to her sixth-floor suite. Firefighters who have master keys to such buildings were eventually dispatched to get paramedics inside. But a few years ago, B.C. Emergency Health Services changed policies and procedures to cut down on multiple crews attending each call so firefighters are no longer sent as first responders to many cases.

Gundersen’s daughter told CBC her mother was dying while on a phone line with a dispatcher and she’s angry that her mother’s case was not treated as life-threatening and that paramedics didn’t call for firefighters’ help sooner, especially since a firehall was just a block away.

Interior Health

• An incapacitated patient’s valuables and personal effects went missing at a hospital and were never recovered so the health region offered $500 in compensation. The board ordered the health region to have designated staff members whose job entails the safekeeping and documentation of patients’ belongings.

Northern Health

• A long-standing complaint going back to 2015 when Northern Health officials were alerted by a staff member to lapses in medical device disinfection and sterilization procedures related to instruments called endoscopes. Thousands of patients had procedures like colonoscopies that relied on the scopes but a consultation with the B.C. Centre for Disease Control did not show any “increase in specific infection types” during the two year period when the errors took place.

Although patients were sent letters to inform them of the breeches, the review board recommended a more fulsome public communication plan including direct meetings with patients or even town hall meetings to broadcast the errors, risks, actions, and any mitigating steps. As well, the region has to ensure that when such things happen, all affected patients should have a doctor who can address any concerns and ongoing needs.

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How and where to complain

8500 patient complaints




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9Jun

Moms-to-be ‘fearful’ as Chilliwack maternity ward to close for summer

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Chilliwack Mayor Ken Popove has requested a meeting with Health Minister Adrian Dix to express his concerns about the temporary closure of Chilliwack Hospital’s maternity ward.


Francis Georgian / PNG

The mayor of Chilliwack is requesting a meeting with B.C. Health Minister Adrian Dix to express concerns about a plan to close the maternity ward at Chilliwack Hospital for an indeterminate amount of time starting later this month.

The closure is caused by an “unexpected shortfall in obstetricians,” said Jennifer Wilson, medical director for Chilliwack Hospital. Due to a medical leave, the hospital is no longer able to ensure there is an on-call obstetrician available for emergency interventions and C-sections at all times.

Fraser Health is working on a plan to address the problem, but women who expected to give birth in Chilliwack after June 24 will have to go to Abbotsford Regional Hospital instead, said Wilson. “Our goal is to be up and running again as soon as possible.”

The doctor said the decision to close the maternity ward was not made lightly and she “respects” the concerns of women who are now faced with travelling outside their community to deliver. “We are really committed to making things as safe as possible for women.”

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But Chilliwack Mayor Ken Popove said it is “insane” that his community of 100,000 people will not have a maternity ward this summer. On average, there is between one to two births per day at Chilliwack Hospital.

“I understand that it’s difficult (for Fraser Health), but there should have been a plan in place,” he said.

The mayor said he is asking for a meeting with the provincial health minister to discuss the situation. He has also spoken to the mayor of Hope who is worried about the health of women who will have to travel more than an hour — possibly in rush-hour or long-weekend traffic — to reach the hospital in Abbotsford.

“It’s an hour on a good day. What happens if there’s an accident?” asked Popove.

The mayor said he hasn’t been told when Fraser Health plans to reopen the maternity ward. But he has been hearing from families in his community who are worried and anxious.

Former Chilliwack mayor and B.C. Liberal MLA John Les called the closure “a kick in the head” in response to a Chilliwack Progress news story about the closure.

“This is a bloody outrage,” he said in a Facebook post.

“If implemented, this two- to three-month suspension of deliveries will become permanent,” he speculated. “This has been Fraser Health’s dream all along: centralize everything in Abbotsford.”

Wilson said the hospital plans to maintain its maternity ward and is looking for long-term solutions to the staffing problem. It is also working to address transportation concerns from women who may have trouble reaching Abbotsford.

“We have reassurances from Abbotsford … (that) they have the capacity,” she said.

But registered midwife Libby Gregg said the closure is making women “fearful” about their deliveries.

“They are really suffering,” she said, explaining that some women will lose the doctor who has cared for them through their entire pregnancy because the doctor doesn’t have hospital privileges at the Abbotsford hospital.

“These women will be in an unfamiliar situation with people they don’t know,” she said.

Gregg said an increase in stress and anxiety in the late stages of pregnancy and during delivery can have negative impacts on mothers and babies, including a possible increase in inductions and C-sections.

“The implications are huge and far-reaching.”

Gregg said Chilliwack midwives are stepping up to offer their services to women who are scrambling to find a caregiver ahead of the closure, adding “we’re here to support as many families as we can.”

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1Jun

Child hospitalized after falling two storeys from a Vancouver home

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A B.C. ambulance.


Jason Payne / PNG

A child was hospitalized Friday afternoon after falling two storeys from a Vancouver home.

It happened in the 1200-block of East 11th Avenue around 2:45 p.m., a B.C. Emergency Health Services spokesman said. Paramedics tool the child to hospital by ambulance.

The agency could not confirm whether the child fell from a window or balcony and would not release the child’s age or gender.

The block where they child fell, near Clark Drive, is lined with single-family homes, most two storeys.

Paramedics and physicians have urged parents to install inexpensive window guards to prevent such accidents, particularly during warm weather when windows are more likely to be left open.

Six children have been treated at B.C. Children’s Hospital this year after falling from balconies or windows, and 15 were treated in 2018.

Last month, a six-year-old boy fell 15 metres from his bedroom window in North Vancouver, landing on concrete. He survived and is expected to make a near-full recovery, with some damage to his vision.

The World Health Organization says falls are the 12th-leading cause of death among kids aged five to nine, and that 66 per cent of fatal falls happen from a significant height, like a deck or window.

A B.C. Trauma Registry report found that 146 children were hospitalized after falling from a balcony in the province between 2009 and 2015. Eighty-five per cent of them were between the ages of one and six.

Over 40 per cent of Vancouverites now live in apartment buildings and more than 16 per cent live in buildings with more than five storeys, according to a 2016 Statistics Canada report.

B.C. Emergency Health Services provides the following safety tips to prevent falls from windows:

• Don’t underestimate a child’s mobility; children begin climbing before they can walk.

• Move furniture and household items away from windows to discourage children from climbing to peer out.

• Be particularly mindful of toddlers, who may climb on anything to get higher.

• Remember that window screens will not prevent children from falling through. They keep bugs out – not children in.

• Install window guards on windows above the ground level. These act as a gate in front of the window.

• Alternatively, fasten your windows so that they cannot open more than 10 centimetres (four inches). Children can fit through spaces as small as 12 centimetres (five inches) wide.

• In either case, ensure there is a safe release option for your windows in case of a house fire.

• Don’t leave children unattended on balconies or decks. Move furniture or planters away from the edges to keep kids from climbing up and over.

• Talk to your children about the dangers of opening and playing near windows, particularly on upper floors of the home or in a high-rise dwelling.

• Consider installing safety glass in large windows and French doors so they won’t shatter if a child runs or falls into them.

With files from Zak Vescera

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28May

Daphne Bramham: More needed to redress the tragic fact that Indigenous people are disproportionately victims of opioid crisis

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Overdose deaths linked to illicit fentanyl-laced drugs rose 21 per cent last year among First Nations people in B.C. even as there was a glimmer of hope that the crisis may have peaked among the general population.

Since the crisis began four years ago, B.C. Indigenous people have been overrepresented in the deadly count. Last year, they accounted for 13 per cent of the deaths, while making up 3.4 per cent of the provincial population.

Put another way, First Nations people were 4.2 times more likely to suffer a fatal overdose and six times more likely to suffer a non-fatal overdose than other British Columbians.

No one is suffering more than First Nations women and girls, who already have the worst health outcomes in Canada because of violence, exploitation and poverty.

They are unique in this epidemic where 80 per cent of the victims in the general population are men. Women, by contrast, account for 39 per cent of First Nations’ overdose fatalities last year and 46 per cent of the non-fatal ones.

They are bearing the brunt of marginalization, says Dr. Evan Adams, chief medical health officer at the First Nations Health Authority. Another measure of that is expected to come next week in the report of the murdered and missing women’s inquiry.

Among the reasons that he suggests for the widening gap between First Nations’ and the general population’s statistics are the effects of colonization including residential schools, the lack of social supports, childhood experiences and limited access to safe spaces and services.

The litany of dreadful statistics compiled by the provincial coroner’s office was read out Monday against the backdrop of a quilt with the names of some of the hundreds who have died. Among those names was Max, the son of the health authority’s knowledge keeper, Syexwaliya. Max died 12 days before his 41st birthday in March 2018.

“My son was just too lost,” she said. “I couldn’t do anything for him. I had to love and accept him as he was.”

Still, Syexwaliya takes heart from the statistics.

“The statistics make me feel that Indigenous people aren’t invisible and what’s brought out in the statistics and in the reports means that work is being done,” she said.

Addiction is a disease of pain — physical, emotional, mental and spiritual. Addiction piles tragedy on tragedy.

“It’s a journey of pain, a journey of suffering and a journey of seeking health services that couldn’t be found,” said the chair of the health authority, Grand Chief Doug Kelly.

Too many Canadians, too many British Columbians and too many First Nations people have already died, but Kelly said that for Indigenous people, things are not getting better. They’re getting worse, especially for those living in cities and most especially for women.

Overdose hot spots include the usual ones: Vancouver’s Downtown Eastside, the Fraser Valley, Chilliwack, Nanaimo, Victoria and Prince George. But for First Nations people, there’s also Campbell River and Kamloops.

Those stark differences mean distinct and targeted solutions are required. As Canada’s first Indigenous health authority, the First Nations authority (with its unofficial motto of “no decisions about us, without us”) is well positioned to do that.

With a goal of addressing causes of addiction, it has its own four pillars approach: preventing people from dying, reducing the harm of those who are using, creating a range of accessible treatments and supporting people on their healing journey.

The authority also strongly supports the call from B.C.’s chief medical health officer to decriminalize possession of all drugs for personal use as has been done in Portugal. (The suggestion was quickly shot down by the B.C. government, which says that could only be accomplished with federal legislation.)

Among the reasons Kelly cites are yet more terrible statistics.

Of Canada’s female offenders in federal prisons, Public Safety Canada reported last summer that 43 per cent are Indigenous. In youth detention, Indigenous kids account for 46 per cent of all admissions — a jump of 25 per cent in a decade.

Addiction is often contributing factor in the crimes committed, as is fetal alcohol spectrum disorder (although the report said there is no evidence that FASD is more prevalent among First Nations than other populations).

Because so many First Nations women are incarcerated, it means their children often end up in government care or with relatives, which only exacerbates the cycle of childhood trauma, loss and addiction.

So far, the First Nations Health Authority has spent $2.4 million on harm-reduction programs. It’s trained more than 2,430 people in 180 communities how to use naloxone to reverse fentanyl overdoses, has 180 “harm-reduction champions” and peer coordinators in all five regions.

But the biggest barrier is the one that led to Max’s death — lack of accessible treatment.

Last week, FNHA and the B.C. government committed $20 million each to  build treatment centres in Vancouver and Surrey and promised to upgrade six existing ones. Kelly says that’s great. But it’s not enough. They’re still waiting for another $20 million from the federal government for construction.

Still, where will the operating money come from? That’s the next multi-million-dollar question. But it must be found.

Now that there is evidence that First Nations communities — and women in particularly — are suffering so disproportionately, ignoring them is unconscionable.

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27May

B.C. becomes first province to force change to biosimilar drugs

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Biosimilars are manufactured after the 20-year patent period expires on biologics.


Francis Georgian / PNG

Starting today, over 20,000 B.C. patients with cancer or chronic diseases like arthritis, colitis and diabetes will have six months to transition to drugs that are similar to those they’re taking as the province becomes the first in Canada to stop covering some expensive, formerly patented drugs.

Health Minister Adrian Dix promised that no harm will come from the change that will initially save the government more than $96 million in its prescription drug program (PharmaCare).

The savings will be plowed back into the drug budget to allow for funding of drugs that have not yet been covered such as Jardiance, a medicine known as an SGLT2 inhibitor for diabetes. Another drug for psoriatic arthritis called Taltz will also be immediately available.

Since some of the soon to be phased-out government-funded drugs like Remicade have to be given at infusion clinics, Dix said there may be some inconveniences as patients find new locations. But patients will work with their doctors to make the switch to “biosimilar” drugs, which are the just-as-safe and effective copycat versions of brand name bioengineered drugs called biologics.

Biosimilars are manufactured after the 20-year patent period expires on biologics. They cost anywhere from 25 to 50 per cent less than the original biologic drugs which are said to be the single biggest expense for public drug plans like PharmaCare.

European countries have led the way in transitioning patients to biosimilar drugs, but Canada has lagged far behind.

In 2018, B.C. spent $125 million on Lantus, Enbrel and Remicade, three biologic drugs that treat chronic conditions such as diabetes, arthritis and Crohn’s disease.

“Biosimilars (like infliximab) are a necessary step to ensure PharmaCare provides existing coverage for more people and funds new drugs well into the future,” Dix said.

PharmaCare coverage for certain biologics will end Nov. 25. After that time, PharmaCare will provide coverage for the original drugs only in exceptional cases and they will be decided upon on a case-by-case basis.

B.C. has spent the last nine years studying the matter before making the decision. It consulted with physician and patient groups like the B.C. Society of Rheumatologists, endocrinologists, Doctors of B.C., Arthritis Consumer Experts, Canadian Arthritis Society, B.C. Pharmacy Association, Neighbourhood Pharmacy Association, regional health authorities, Health Canada, and the Patented Prices Medicine Review Board.

About 2,700 Crohn’s and ulcerative colitis patients will also be affected by the transitioning policy, but information for gastroenterology patients will be available in a month or two.

Rheumatologist Dr. John Esdaile said B.C. becomes an overnight Canadian leader with the cost-saving policy change.

“It’s a great day for B.C., for patients, for PharmaCare and for health care in general,” he said, noting that many European countries have had such a policy for 10 years with no evidence of detriment to patients. “I don’t know of any bad news,” said Esdaile, scientific director of Arthritis Research Canada, which has been “badgering” the province to enact such a change.

“For years, B.C has been spending money it doesn’t need to spend on expensive biologics instead of using biosimilars which I call biogenerics since they work just as well,” Esdaile said.

Cheryl Koehn, president of Arthritis Consumer Experts, said society will benefit from the new policy because coverage for other conditions and drugs will expand.

MORE TO COME.

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26May

Daphne Bramham: Tougher new regulations promise more agony for chronic pain-sufferers

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One in five Canadians lives with chronic pain, but the cries of an estimated 800,000 British Columbians are not only being ignored, their suffering is being exacerbated by regulators limiting their access to both drugs and treatment.

First, in a move unprecedented in North America, the B.C. College of Physicians and Surgeons imposed mandatory opioid and narcotic prescription limits on doctors in 2016 in an attempt to avoid creating additional addicts and having more prescription drugs sold on the street.

Physicians who don’t comply can be fined up to $100,000 or have their licences revoked.

Now, the college is setting tough regulations for physicians administering pain-management injections.

“I’m enraged,” says Kate Mills, a 33-year-old, palliative care nurse who has been on disability leave for the past 18 months. “People like me are living in chronic, intractable pain and being ignored by doctors who are either too scared or too callous to care.”

She has an uncommon, congenital condition that causes chronic inflammation near her sacroiliac joint and in her lower back, which pushes down on her nerves causing “exquisite pain” down her leg.

Her first doctor essentially fired her, refusing to treat the pain. The next one prescribed Oxycodone to help Mills through until she was able to receive a steroid injection at a clinic, which kept the pain in check for several months.

But by the time the injection’s effects were wearing off, her GP went on extended medical leave. The locum assigned to Mills refused to prescribe her any medication and told her to go to an emergency room where she was given a prescription.

After numerous ER visits, Mills finally found a doctor two weeks ago who is willing to provide medication for her between injections. But he agreed only after Mills signed a contract agreeing that she won’t sell the drugs, will only go to one pharmacy and take the drugs only as prescribed.

She is lucky, though. Her pain management clinic will likely meet the college’s new standards that were developed by an advisory panel over the past three years out of concern about patient safety.

“Increasingly,” the college says on its website, “Procedural pain management is being provided in private clinics and physician offices, but without much guidance on appropriate credentials, settings, techniques and equipment.”

The new regulations would require physicians’ offices or clinics to become accredited facilities with standards on par with ambulatory surgery centres.

That means having tens of thousands of dollars’ worth of equipment including resuscitation carts, high-resolution ultrasound, automated external defibrillators and electronic cardiograms with printout capability.

The college acknowledges that “patients do not require continuous ECG monitoring. However, the cardiac monitoring equipment must be available in the event a patient has an unintended reaction to the procedure.”

The disruption for patients will be huge, according to Dr. Helene Bertrand, a general practitioner, pain researcher and clinical instructor at UBC’s medical school.

She estimates that up to 80 per cent of the offices and clinics where the injections are currently being done won’t measure up and already wait times are up to 18 months.

When the new requirements come into force, Bertrand predicts patients will be waiting anywhere from four to seven years for treatment.

Bertrand herself will have to quit doing prolotherapy, which she has done for the past 18 years on everything from shoulders to necks to spine to ankles. That’s despite the fact she’s never been sued, never had a complaint filed with the college and has published, peer-reviewed research that revealed an 89 per cent success rate among 211 patients in her study group.

(Prolotherapy involves injecting a sugar solution close to injured or painful joints causing inflammation. That inflammation increases the blood supply and deposits collagen on tendons and ligaments helping to repair them.)

The college will not grandfather general practitioners already doing injection therapies. Instead it will restrict general practitioners to knees, ankles and shoulders. All other joint injections must be done by anesthetists or pain specialists.

For Joan Bellamy, that’s a huge step backward.

She’s suffered from chronic pain since 1983 and “undergone the gamut of medical approaches, often with excessive waits: hospital OP (outpatient), pharmacology, neurology, orthopedics, spinal, physiatry and private.”

Since 2000, she’s had multiple injections that have made a difference. But her doctor doesn’t meet the new qualifications.

“I am afraid that without her expertise … that pain will become an intolerable burden, and any search for treatment will result in inconceivable wait times and will debilitate me,” Bellamy wrote in a letter to the college and copied to me.

The near future for pain-sufferers looks grim with most physicians able to offer them little more than over-the-counter painkillers.

Ironically at a time when the provincial medical health officer and others are lobbying hard to have all drugs legalized so that addicts have access to a safe supply, chronic pain-sufferers are being marginalized. For them, it’s more difficult than ever to get what they need.

It’s forcing many of them facing a lifetime of exquisite and unbearable pain to at least contemplate one of two deadly choices: Buy potentially fentanyl-laced street drugs; or worse, ask for medically assisted dying.

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17May

Transcendental Meditation is food for thought in battle against ourselves

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Consciousness & Creativity with David Lynch & Bob Roth

When: May 23, 7 p.m.

Where: SFU Goldcorp theatre

Tickets and info: $27.50-$65 eventbrite.ca

These days it seems you can’t swing a string of Buddha beads without hitting someone who meditates or is about to start to do so with help from their freshly downloaded Headspace meditation app.

Despite some forms of it dating to as far back as 1500 BCE, it seems meditation really is all the rage today. You can tell that is true by how tightly the marketers have embraced the idea of selling inner peace. Everything from juice to moisturizing lotion and bubble bath come with the word mindful attached. If you are in the U.K. you can even order online meals from the Mindful Chef. However, you have to agree to not talk with your mouth open. Actually not talk at all. Kidding.

“Meditation has become so much more mainstream, all the different forms,” said Anne-Mareike Chu, who is one of the 20 registered transcendental meditation, or TM, teachers who work out of the Vancouver TM Centre. “We have lots of people who come to us who have tried different kinds of meditation or apps.”

If you’re the type of consumer that likes a good celebrity stamp-of-approval in these influencer-driven times then TM has you covered. Supermodel Kendall Jenner told Vogue it helped her with anxiety and to clear her mind. Fans of Ellen DeGeneres’s daytime TV show have likely heard her talk about her eight-year TM practice.

“It’s changed my life,” said DeGeneres during a show that aired a year ago.

She was talking about TM on this day because her personal TM teacher Bob Roth was on the show with his new book, The New York Times Bestseller Strength in Stillness — The Power of Transcendental Meditation.

The book is a quick and interesting guide to TM through Roth and other people’s (some famous, some not) experiences. It’s an engaging and unfailingly understandable guide to a meditation practice that was brought to North America 50-plus years ago by the Maharishi Mahesh Yogi.

Roth learned the practice from the Maharishi/guru to the Beatles and has been practising it for five decades. For the past four decades he has been instructing it to everyone from PTSD-suffering war veterans to Fortune 500 CEOS to anxious teens to Tom Hanks.

Aside from teaching, Roth runs the non-profit David Lynch Foundation (DLF) that he formed with the famed film director 15 years ago.

As part of the DLF’s international outreach (it has offices in 35 countries) Roth is in Vancouver for the Consciousness & Creativity with David Lynch (via live video link) & Bob Roth event on May 23 (7 p.m.) at the SFU Goldcorp theatre. He will also be travelling to Montreal and Toronto.

The event is a discussion of TM, Roth’s book and a chance for audience members to ask questions of him and Lynch. Lynch is the director behind such wonderfully weird works as Eraserhead, Blue Velvet and Twin Peaks.

“We’re both Eagle Scouts. Which is funny David Lynch as an Eagle Scout,” said Roth over the phone from his office in N.Y. when asked about he and Lynch’s connection.


David Lynch will be joining Strength in Stillness author Bob Roth in Vancouver on May 23 to talk about the power of transcendental meditation. The David Lynch Foundation for Consciousness-Based Education and World Peace is a global foundation founded by the film director to fund the teaching of TM in schools.

Josh Telles /

PNG

Currently there is a DLF office in Toronto and Roth says there are plans to expand in Canada.

The non-profit focus of the foundation is to bring free TM to inner-city kids, vets and victims of domestic abuse. Roth reports that the foundation in North America has delivered meditation to about one million of those people. All the proceeds from Strength in Stillness will go back into supporting that work.

Roth’s connection to famous folks began with Lynch. From there word of mouth brought him together with other bold names like Oprah, Jerry Seinfeld, Howard Stern and hedge-fund billionaire Ray Dalio.

“Whether they are CEOs or famous people they say: ‘Oh, you need a good cardiologist. I’ve got a good cardiologist for you. Oh, you need a good meditation guy, oh, I’ve got a good meditation guy.’ So that’s how it works,” says Roth about his famous clientele.

While more and more celebs and CEOs are signing up, Roth says there is another growing demographic — politicians.

It’s seems the lawmakers (sometimes) in Washington are a little bit stressed out these days. Hmmm, wonder why? Roth says he has been working with quite a few members of the U.S. Congress — members from both sides of the aisle.

“It can’t hurt,” said the affable Roth when asked about bringing meditation to the partisan gridlock of the beltway.

“There’s a different quality of stress in Washington, D.C. Everyone’s furious with them. The members of Congress go back to their districts and no one is happy with them,” said Roth. “You’re either not Liberal enough. Not Conservative enough. Nobody is happy and it is sort of this thankless task. They’re really stressed.”

A big driver for Roth these days is to help end what he calls the “epidemic of stress.”

“Modern medicine has no antidote to stress and people are eager to minimize the detrimental impact of stress,” said Roth.

“Canadians go to TM centres now: that means, all types of Canadians — students, retired people, doctors, business people, athletes, teachers, clergy, yoga instructors, because stress does not recognize age or religion or profession,” says Roth.

When talking about TM’s benefits Roth points to studies and peer-reviewed papers that support TM”s health-benefit (less anxiety, better sleep) claims. The American Heart Association has gone so far as to say the practice of TM helps to lower blood pressure.

Right now the DLF is in the midst of raising funds to bankroll more third-party research so that TM is considered in the same light as any other medicine or any other medical intervention.

“Right now we are in the process of subjecting TM to the exact type of studies so that we can go to all these insurance companies and employee assistance programs and government agencies and say, Hey this is as good or as if not better at reducing high blood pressure than this antihypertensive medication and there are no side-effects and we’ve got the same research by the same researchers as a drug,’ ” says Roth.

It’s the increase in and access to studies and discussions about meditation that Roth and Chu say have led to an uptick in interest in all forms of meditation.

“Meditation in general used to be seen as so out there, but now it is so widely accepted because people started realizing the power of our mind really lies within and now science is catching up to that finding,” says Chu, who worked in the sustainability field with Bing Thom, the famed Vancouver architect and TM enthusiast. “People are more open to natural treatment to improve their health and well-being.”

TM is easy. You sit down comfortably. And with your eyes closed, repeat a mantra.

“I use the analogy that you are in a little boat and you are in the middle of the Pacific Ocean and all of a sudden you get these 30- or 40-foot-high waves around you and you could think the whole ocean is in upheaval, but the word whole ocean is a bit of an exaggeration because if you were able to do a cross-section out there you would realize that the ocean is over a mile deep and while the surface of the ocean may be turbulent, by nature the depths of the ocean by its nature are pretty darn quiet,” said Roth when asked to describe TM. “The analogy is to the mind.”

The official TM course in Vancouver will run you $1,300 (centres do have discounts depending on individual circumstances) for a lifetime membership. The course consists of four consecutive days with 90-minute-to-two-hour sessions.

In Vancouver, the TM Centre says about 35,000 people have picked up the practice since the late-1960s.

“Vancouver is one of the most successful centres,” said Roth, who also hosts a Sirius XM radio show.

While TM is booming there have been detractors over the years. Some people have called it a cult (especially at the higher levels of the practice) and some just poo-poo it as some leftover flower-child, free love thing invented by a tiny hirsute Indian man who thought he could fly (look up yogic flying).

However, if social media and shopping habits are any indication, the times have changed and people no longer think yoga, organic food and meditation are only for the hippies and Gwyneth Paltrow.

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16May

St. Paul’s Hospital receives $1-million gift to buy life-saving equipment

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St. Paul’s Hospital has received a $1-million gift to buy special equipment that saved the life of a clinically dead man in February. From left to right: Dr. Jamil Bashir, patient Chris Dawkins, paramedics Thomas Watson and Benjamin Johnson, dispatcher Anne-Marie Forrest are pictured at St. Paul’s Hospital in Vancouver, BC, April 8, 2019.


Arlen Redekop / PNG

St. Paul’s Hospital has received a $1-million gift to buy special equipment that saved the life of a clinically dead man in February.

The dramatic story of Chris Dawkin’s rescue was a front-page story in a Postmedia paper last month. Among those who read the article was an anonymous donor.

On Feb. 5, Dawkins, a 55-year-old Vancouver physician, had just completed a workout on his rowing machine when he suffered cardiac arrest. His heart had stopped beating at 6:04 p.m. after a piece of plaque broke off a coronary artery and stopped the blood supply – Dawkins was considered clinically dead.

But his wife was present and able to perform chest compressions. The paramedics who arrived – Tom Watson and Ben Johnson – happened to be trained in a special emergency protocol for treating cardiac-arrest patients and were able to use a Lucas machine – one of six on loan to B.C. Ambulance Services by the manufacturer – to continue chest compressions while transporting Dawkins.

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When he arrived at St. Paul’s, a team of 15 specializing in cardiac arrest not treatable by standard therapies had been notified and was waiting. Dr. Jamil Bashir, a cardiovascular surgeon, had already performed two surgeries and was preparing to head home when he was called into emergency.

Dawkins was hooked up to a heart-lung bypass machine while Bashir operated. The machine is one of five at St. Paul’s.

But even after being clinically dead for 52 minutes, Dawkins survived the heart attack and surgery in great health.

The rescue story was written by Postmedia reporter Gord McIntyre and ran on the front page of the paper on a Tuesday morning in early April. After reading the article, an anonymous donor immediately picked up the phone and called St. Paul’s Foundation, said hospital spokeswoman Ann Gibbon.


A heart-lung bypass machine is pictured in the foreground and a Lucas chest compression machine is pictured in the background.

St. Paul’s Hospital / Handout

The gift would be $1 million and must only be used to purchase the machines and equipment that saved Dawkins’ life, the donor instructed.

“The great part of this story is that this protocol, started about four years ago, has come full circle with this donation,” said Dick Vollet, president and CEO of the St. Paul’s Foundation.

“It’s a great example of how innovation and donor support can come together to save lives.”

The $1 million gift will purchase three new heart-lung bypass machines at a cost of $250,000 each, seven Lucas chest compression machines, three TEE probes used to assess airways and one blood gas analyzer.

Paramedics treat about 400 cardiac arrest cases each year. Survival chances are one in 10 if an otherwise healthy individual suffers the arrest outside of a hospital.

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8May

MRI wait times fall sharply after government boosts scans

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B.C. Health Minister Adrian Dix says MRI wait times have dropped significantly since the number of scans was ramped up.


Francis Georgian / Postmedia News Files

VICTORIA — Wait times for MRIs across the province have fallen sharply during the past year after government boosted the number of scans, according to provincial data.

The median wait time for an MRI scan in the Northern Health Authority fell 66 per cent between April 2018 and March 2019, with a patient waiting roughly 24 days compared to the prior 71 days.

Vancouver Coastal Health saw wait times drop from 36 to 21 days, a 42-per-cent reduction, and Fraser Health saw a reduction to 48 days from 89 days, a 46-per-cent cut.

“I’m happy with the direction,” said Health Minister Adrian Dix. “This is what we intended to do.”

The data reflects elective or scheduled MRIs. Emergency scans are done immediately.

MRI scan reduction times released May 8, 2019


B.C.’s wait times for elective or scheduled MRIs fell after government expanded exams, according to data released by the Ministry of Health on May 8, 2019.

Ministry of Health/submitted

Last year, B.C. began running 10 of the province’s 33 MRI machines 24 hours a day, seven days a week and bought two privately owned MRI clinics  in the Fraser Valley to expand capacity, at a cost of $11 million (plus an undisclosed amount for the clinics).

Dix announced last week a further expansion of MRI scans in the coming year, but did not have the data to prove wait times had reduced. He said the ministry was compiling the final figures and provided the data publicly Wednesday.

The longest wait times for certain patients — known as the 90th percentile measure — also dropped. Some MRI scans in Fraser Health had taken 346 days last year, but fell to 224 days once government expanded capacity, a reduction of 35 per cent, said Dix.

But that is still not good enough, he said.

“I obviously like the direction, I think we’re getting there,” he said. “We wanted to see everything under 26 weeks, and everything is under 26 weeks, except this.”

The longest wait times in Vancouver Coastal Health fell from 114 days to 99 days, a reduction of 13 per cent, and in Northern Health from 257 days to 55 days, a reduction of 79 per cent.

“The huge difference in the north is obviously significant,” said Dix.

Government is adding another $5.25 million to the MRI budget next year, which Dix said will fund 15,000 additional MRI scans. Dix said the wait times should drop even further.

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