The number of pregnant foreigners coming to B.C. hospitals so their newborns can get automatic Canadian citizenship continues to rise.
Births by non-residents of B.C. increased 24 per cent from the 2016-17 fiscal year to 2017-18, from 676 babies to 837 the following year, according to records obtained through freedom of information requests.
About two per cent of all births in B.C. hospitals are now by non-residents, just as the birthrate among B.C. residents is dropping.
Richmond hospital continues to be at the forefront of the phenomenon, with the total number of babies born to non-residents of B.C. at the hospital rising from 337 in the 2014-15 fiscal year to 474 by 2017-18. Four years ago babies born to non-residents accounted for 15.4 per cent of all births at Richmond Hospital, compared to 22.1 per cent in the last fiscal year.
By comparison, St. Paul’s Hospital and Mount Saint Joseph Hospital — both operated by Providence Health Care — had a combined 132 babies born to non-residents of B.C. in the 2017/18 fiscal year.
While non-resident births account for about two per cent of all babies delivered in B.C., at Richmond Hospital, that proportion is 10 times higher. Indeed, as a New York Times article reported, the hospital is now perceived around the world as a coveted destination for so-called anchor babies, a term to describe children born here to non-residents to gain citizenship.
Health minister Adrian Dix is concerned by the numbers.
“The immigration issues are in federal jurisdiction. This is where concerns must be addressed, not by turning health professionals and skilled health care workers into immigration officers. That is not their role,” said Dix.
Richmond Mayor Malcolm Brodie agreed with Dix that birth tourism is a federal issue but said there are significant local impacts as well.
“As a city council, we haven’t discussed this but there are individuals who have concerns about the impacts on our already crowded hospital resources,” said Brodie, referring to the aging facilities and to situations when local women are diverted to other hospitals when Richmond Hospital is full.
Brodie said he supports a change to federal laws because he doesn’t believe anchor babies should get automatic citizenship.
“The practice of birth tourism should be curtailed,” he said.
Birth tourism is not illegal and a report by the Institute for Research and Public Policy showed that the numbers are climbing year after year. In 2017, there were at least 3,628 births, mainly in B.C., Alberta, and Ontario, by mothers who live outside Canada.
As Dix has said, the provincial government has taken the approach that it doesn’t endorse the marketing and provision of birth tourism services but at the same time, patients needing urgent care can’t be turned away.
While hospital staff cannot refuse care when women in labour arrive at the front door, Dix said measures have been put in place to help ensure taxpayers aren’t subsidizing the costs of non-resident hospital care.
For instance, late last year the ministry and Vancouver Coastal Health decided to raise fees charged to non-residents when they go to the Richmond Hospital. The cost for a vaginal birth increased to $8,200 from $7,200 and the cost of a caesarean section rose by $300 to $13,300. If their medical care becomes more complicated patients are assessed higher fees.
In 2017, Vancouver Coastal Health billed non-residents of B.C. about $6.22 million for maternity services at Richmond Hospital.
“For maternity cases at Richmond Hospital … the majority of non-residents pay their bills in full,” said Vancouver Coastal Health spokesperson Carrie Stefanson. Approximately 80 per cent of billing to non-residents is recovered, she added.
But sometimes, as in the case of Yan Xia, a birth tourist from China, patients leave Canada after giving birth and leave behind a healthy bill.
Vancouver Coast Health has filed a lawsuit against Xia, who gave birth at Richmond Hospital in 2012. The bill for an extended stay in hospital due to complications totalled $313,000.
The case remains in legal limbo as Xia’s exact whereabouts are unknown and the bill may eventually have to be written off by Vancouver Coast Health.
Stefanson said the Xia case is believed to be VCH’s only maternity debt lawsuit over $100,000.
Richmond Liberal MP Joe Peschisolido has sponsored a petition calling on the federal government to end birth tourism. The petition garnered 11,000 signatures and denounces the practice as “abusive and exploitative” for “debasing” the value of Canadian citizenship. The Peschisolido petition was presented to Parliament last fall.
“The Government of Canada is committed to protecting the public from fraud and unethical consulting practices and protecting the integrity of Canada’s immigration and citizenship programs,” said Ahmed Hussen, minister of immigration, refugees and citizenship in response to the Peschisolido petition.
“To this end, (we) are currently undertaking a comprehensive review, with a view to developing additional information and strengthened measures to address the practices of unscrupulous consultants and exploitation of our programs through misrepresentation.”
Birth tourism will likely be an issue in the upcoming federal election as the Conservatives have vowed to withhold citizenship unless one parent is a Canadian or a permanent resident.
The Doctors of B.C. president, Dr. Eric Cadesky. Doctors of B.C. / PNG
B.C.’s physicians have voted overwhelmingly in favour of a new agreement with the B.C. government in a deal that will cost taxpayers at least $331 million over the three-year deal.
Last year, the government paid out $4.516 billion for physician services. By the end of the three-year deal that took effect on April 1, that will rise to $4.85 billion.
One of the elements of the deal is a signing bonus-like payment of $7,500 to each physician who earned over $75,000 in income in 2018, or in any of the past few years, to help offset rising overhead and other costs of running their offices.
Dr. Eric Cadesky, president of Doctors of B.C., said the sum is a one-time payment. But the help with overhead costs like lease payments doesn’t end there. In 2020, the government will give physicians — in Vancouver, Victoria and other urban areas — premiums to help offset inflationary costs like higher rents.
Doctors who have offices in Vancouver, for example, will get a five per cent increase that will be capped at a daily maximum of $60; Victoria doctors with private practices will get four per cent more with a maximum of $48 a day. And in Kelowna, Nanaimo, Kamloops, Vernon and Penticton, doctors will get three per cent more up to a daily maximum of $36.
There is no cap on this weekly “business cost premium”, so doctors who keep their offices open seven days a week could earn $420 more each week.
“A reasonably active physician in the city of Vancouver could earn an additional $13,200 annually when the BCP is implemented in 2020,” Cadesky said.
For several years, doctors in private practice have been complaining about rising costs of running offices. Cadesky said it was important to have a premium in the contract that would offer some relief. Alberta has a similar program but the premium is applied as a flat rate of 1.1 per cent across the province while in B.C., the premiums rise in communities where overhead costs are higher.
Clauses like this one clearly appealed to physicians even though only about 4,000 of the 12,000 doctors in the province voted during the ratification process. Only three per cent voted against the new deal. Doctors had sought a five year deal like the term they got under the Liberals but this government wanted to keep the deal at three years, consistent with other public service contracts.
Doctors will also get an additional half of one per cent more in fees in each of the three years and an assortment of other compensation payments to help with retirement plans, malpractice insurance premiums, and pay for work previously not compensated, like adding information to patient charts, writing reports, following up on lab and diagnostic tests, and maintaining electronic medical files.
The new contract is outlined in nearly 400 pages and is called the Physician Master Agreement. Cadesky said it will go a long way toward helping support family physicians who want to deliver a full spectrum of care — often referred to as cradle-to-grave patient care.
Patients should benefit because the new contract includes a commitment from the government to hire more doctors to “address growth in the workload of existing physicians (such as) emergency room physicians and medical oncologists.”
The contract also addresses some fee disparities between various medical specialists. There’s a sum of $42.73 million to shrink gaps between lower and higher paid physicians — highly paid ophthalmologists, for example, compared to geriatricians, pediatricians and psychiatrists.
The government has made good on its pledge to reduce the amount of money ophthalmologists earn doing cataract removal surgery. When negotiations began last year, the government’s starting point was a fee cut of 80 per cent, provoking a near revolt on the part of such surgeons. After many months of negotiations, the parties settled on a fee of $350, down from $425, about 18 per cent lower.
The savings — $4.7 million — are to be used to raise fees of other surgeons and specialists who are considered relatively underpaid.
The contract also boosts government funding for things like continuing medical education, disability insurance and rural physician funding. There are pledges by the government to consult more with doctors, including on violence prevention in health facilities, electronic medical records, and new payment models.
A boy died by suicide while in care at the emergency department in Lion’s Gate Hospital. NICK PROCAYLO / PNG
Parallel investigations into the suicide last month of a teenager at Lions Gate Hospital in North Vancouver are continuing by the B.C. Coroner’s Service and Vancouver Coastal Health.
The death happened in the emergency department.
Andy Watson, the spokesman for the coroners service, said all sudden, unexpected and/or unnatural deaths are investigated. A report will be written with the coroner’s findings and recommendations made to prevent future deaths by similar means.
An inquest may also be scheduled if a potentially dangerous practice or circumstance has been identified or if the death raises issues that are in the public interest and need more awareness. An inquest is conducted before a jury of five to seven individuals.
Vancouver Coastal Health is also doing a critical incident review, said spokeswoman Carrie Stefanson.
“The investigation is ongoing and we are restricted in comments we can make at this time. … The critical incident review will examine the circumstances surrounding the case and our processes in the care of this patient.”
The date of the suicide was March 23. According to an individual with knowledge of the event, a 17-year-old man on a “suicide watch” was alone in a dimly lit room when he used a piece of medical equipment in the room to asphyxiate himself. The hospital would not confirm the means by which the teen took his life.
Patients on suicide watch are generally monitored by guards or others and checked on frequently. It is believed there was someone sitting outside the room in which the teen was placed.
Watson said over 5,000 deaths each year are investigated by the coroner’s service. There are between 500 and 600 suicides annually in B.C., with 20 to 30 of them among individuals under the age of 19.
Meanwhile, the coroners service has announced a June 17 inquest into the death by drug overdose of another teenager, 16-year old Elliot Cleveland Eurchuk. Eurchuk died in April, 2018, after being found in an unresponsive state in his bed in his Oak Bay family’s home. His parents say that he became addicted to painkillers prescribed before and after surgery for athletic injuries. And then he became addicted to illicit drugs.
At one point, Eurchuk was discharged from the hospital even though he had overdosed in his hospital bed just days earlier. That inquest could last for two weeks as it will explore relevant issues around addictions and mental health, the education, health and justice systems.
The medical office of Dr. Viem Chung Nguyen at 1209 Kingsway in Vancouver. PNG
A Vancouver doctor who was ordered to repay $2 million related to medical service over-billings now faces a disciplinary hearing for refusing to answer questions from the College of Physicians and Surgeons of B.C.
Nguyen has been summoned to the college discipline committee meeting Feb. 12. The purpose of the hearing is to inquire into his “conduct or fitness to practise medicine in B.C.”
He is charged with failing to respond to multiple communications and correspondence from the college. But when there are serious findings by the Medical Services Commission about irregular, or even fraudulent, billing by doctors, as there was in 2017, the case often ends up back at the college for an investigation into the doctor’s ethical and professional conduct.
Nguyen graduated from the University of Montreal medical school in 2002. He specializes in physical and rehabilitation medicine, otherwise known as physiatry. Such doctors — there are three dozen in B.C. — have a broad range of knowledge about the musculoskeletal, neurological, rheumatological and cardiovascular systems.
Outpatient physiatrists (those working in communities as opposed to in hospitals) would see patients with orthopedic injuries, spine-related pain and dysfunction, occupational injuries and overuse syndromes, and chronic pain, for example.
Kristy Anderson, a spokeswoman for the Ministry of Health said Nguyen can’t bill the Medical Services Plan until he is eligible to re-enroll after May 31 of this year. Strangely, Nguyen’s medical receptionist told a reporter over the phone that an appointment could be booked after a doctor’s referral and that he doesn’t charge patients directly; a B.C. Services Card (formerly known as the CareCard) can be used, she said.
Although the government insists that doctors should never bill patients directly for medically necessary services, Nguyen can do so during the temporary de-enrolment.
“During this time, Dr. Nguyen can practise medicine; it is only the college of physicians and surgeons that can remove that right. But he cannot bill to the Medical Services Plan,” Anderson said.
Susan Prins, spokeswoman for the college, said that as a specialist in physical medicine and rehabilitation, “it is reasonable that a major part of his work might be privately funded, independent medical exams, but I can’t confirm that’s the case.”
Neither of the officials could answer why the receptionist told a reporter posing as a prospective patient that a visit would be publicly funded.
It’s unclear if Nguyen has paid back the $2 million he agreed to repay after an audit found a large number of billing irregularities. The government refuses to divulge such information.
“Due to privacy restrictions under the Freedom of Information and Protection of Privacy Act, the ministry is unable to release any third-party financial information or personal details,” said Anderson.
“If an individual fails to pay an amount assessed by the audit, they are referred to the Ministry of Finance to pursue collection action as outlined in the Financial Administration Act or the governing statutes,” she added.
Last year, the commission issued a report that said an onsite audit found poor documentation of Nguyen’s patient records and “for several patients, there was no evidence that Dr. Nguyen ever provided any care to that patient.”
According to the latest commission report, the government body was able to recover about $8 million in 2017-18 from 18 audited doctors who were deemed to have over-billed in recent years.
A woman who forged a medical licence so she could buy pharmaceuticals like Botox to then inject into duped customers has been given a 30-day suspended sentence and two years’ probation in B.C. Supreme Court.
Rajdeep Kaur Khakh’s digressions included contempt of court and passing herself off as a doctor so she could inject Botox into facial wrinkles and filler material into lips or other facial areas. Only licensed and trained doctors, dentists, registered nurses (or nurse practitioners) under the supervision of doctors, and naturopaths are allowed to perform such procedures under Health Professions Act regulations and Ministry of Health scopes of practice.
Khakh, who couldn’t be reached for comment, was cited for contempt in March 2018; she signed a consent order at the time prohibiting her from “practising medicine.” But last July, the College of Physicians and Surgeons of B.C. learned Khakh was up to her old tricks administering dermal fillers “numerous times at a location in Vancouver.”
The college has been trying to stop Khakh from posing as a doctor for more than three years but each time the college got promises from her to stop, she would continue to do it. For a time, she marketed her services under the Instagram handle “DrLipJob.” She also marketed herself as Dr. Rajii or Dr. R.K., when she injected customers in their homes, cars and other locations.
Although Khakh avoided jail, college spokeswoman Susan Prins expressed satisfaction with the sentence.
“The college … believes that the judge’s reasons will accomplish the task of getting Ms. Khakh to obey and respect court orders in future, and deter other unlicensed practitioners from engaging in unlawful practice. In her comments, Madame Justice (Nitya) Iyer sent a very serious message to Ms. Khakh about breaching consent orders and emphasized the critical public-protection role that regulators fulfil.”
Last November, the college filed a petition with the court in which it sought to have Khakh fined for contempt and/or jailed. Under the current sentence by Iyer, she will have to serve a 30-day jail term if she breaches any of the terms. Khakh must report to a probation supervisor once a week and must also pay a $5,000 fine. Of that amount, $300 is going to go to a former customer who was a witness for the college.
The college first learned of Khakh in 2015 when pharmaceutical companies informed it that she owed $164,000 for products that were advanced on credit. At the time, Khakh was providing services at a spa in Surrey and using a forged medical licence.
“It is certainly the only instance of forging medical credentials to further one’s unlawful practice that I know of,” said the college’s chief legal counsel, Graeme Keirstead.
According to an affidavit filed in court by the college, the forged licence was found on a photocopier at the Clearbrook public library by an employee who notified the college. The name “Dr. Rajdeep Kaur Khakh” was substituted for the original name on the certificate and the expiry date of the licence had been altered.
“Upon review, the document appeared to be a copy of a genuine, but expired, (licence),” Keirstead said, adding that the identification number on the certificate belonged to a practising physician who was registered with the college.
Khakh had previously told a reporter that she went to medical school at the University of Punjab but failed licensing exams.
The college went to great lengths to investigate Khakh, using a security company multiple times for undercover investigations and also going to the spa with a cease-and-desist letter.
The college pursued another similar case, but in that situation a patient got a serious infection after having surgery with a fake doctor in her home-based clinic. A public health warning was issued.
Patients of Khakh’s have complained about their results, but there don’t appear to be any serious adverse events reported.
The college said this in a statement: “Receiving a medical service such as injections from an unlicensed practitioner is risky and has the potential for complications, including reaction to agents, infections or greater harm due to human error. There is no assurance that the practitioner is competent or qualified to provide treatment or that the material and equipment used are safe.”
Prins said unlicensed individuals aren’t accountable to any regulatory body, “which means the public has nowhere to turn if the service or treatment they receive results in complications. We can’t emphasize enough how important it is for patients to check the credentials of the health practitioner they are planning to see to ensure they are licensed and registered with a health regulatory authority (college), and that they have the necessary credentials to perform the procedure.”
Physician credentials can be verified by looking at the directory on the college’s website at cpsbc.ca.
Dr. Mypinder Sekhon demonstrates catheters and the new brain bolt that were used in a life-saving procedure at VGH in Vancouver, BC, Jan. 16, 2019. Arlen Redekop / PNG
Brad Baylis doesn’t remember anything about the day last summer when he hit a moose while driving in northern B.C.
Indeed, everything the Prince George man knows about his close brush with death — not to mention the entire month afterward — he’s pieced together from friends, family and medical professionals who saved his life after the moose crashed through his windshield, sending Baylis careening into a ditch and trapped in his vehicle.
Baylis, 39, and the moose would be extricated from the vehicle and he would be airlifted to Vancouver General Hospital on life support. While he was in the intensive-care unit for a month, plastic surgeons would spend 10 hours perfectly reconstructing his shattered face and intensive-care specialists would make Baylis the first patient to get a new procedure called brain microdialysis.
With Baylis on the verge of dying from his traumatic brain injury, Dr. Mypinder Sekhon and colleagues deployed newly acquired tools that allowed them to frequently monitor Baylis’s brain-tissue chemistry so they could tailor the amount of glucose and other metabolic supplements he needed intravenously. They were also able to do real-time monitoring of oxygen and blood-pressure levels in his brain to deliver medications with doses tailored to his condition rather than giving standardized doses.
“The impact with the moose caused major hemorrhaging in his brain and he was suffocating from a lack of oxygen while emergency crews were extricating him from the vehicle,” said Sekhon. “It was a horrible, horrible injury with diffuse swelling throughout his brain. Often with this kind of swelling, brain death will ensue. We had no option other than to try the bolt.”
Neurologists drill a one-centimetre hole into the skull to place the bolt, which then allows doctors to pass a catheter through it so they can collect and analyze biochemical markers of brain activity (glucose, lactate and glutamate, among them).
The data is fed into an analyzer that gives a digital reading and then medical teams can adjust the amount of oxygen, glucose and nutrients that comatose and other brain-injured patients need to not only recover, but also to avoid permanent disabilities.
“It’s changed the way we prognosticate,” said Sekhon. “We can get a better idea of the disease process inside a patient’s brain. Before this, we would fly blind, essentially. You can give too much glucose and other supplements or not enough. Using this technique, we are now able to optimize the brain’s metabolism and personalize the care of the patient.”
Drilling holes into patients’ skulls is an admittedly invasive procedure that carries a small (0.5-per-cent) risk of infection or bleeding, but at VGH, microdialysis has been used so far on five patients, including Baylis (in the past five months), and four of them have recovered. (The fifth succumbed to the brain injury.)
After being in the ICU for a month, Baylis was then transferred to G.F. Strong for rehabilitation. He is overcome with emotion when he talks about the physical therapists there who helped him walk again, his girlfriend Carla Lewis, family members and doctors like Sekhon — all of whom “never gave up on me.”
While he hasn’t yet been cleared to return to his job as a welder, the father of three is incredulous that he’s been able to almost completely recover from a brain injury as severe as the one he had.
He hasn’t yet resumed driving and he’s in no rush to get back behind the wheel. When he got out of G.F. Strong a few months ago, he took the Northern Health bus back to Prince George and it was a trip that could have been terrifying and traumatizing but Baylis managed to take it in stride:
“During the latter part of the trip, the bus driver had to slam on the brakes to avoid hitting a moose. When you live in this area, you know this sort of thing is going to happen at some point. I don’t know if this last incident was luck or fate, but you have to respect moose, they are amazing animals.”
Sekhon says that when Baylis was airlifted to VGH he thought Baylis had only a 10-per-cent chance of surviving. But after a week, he came out of the coma and credits the new microdialysis tools for making the difference with his recovery. While the microdialysis tools are insanely expensive — startup costs of up to $500,000, then costs of up to $10,000 each time the suite of tools are used on patients — they would appear to be true lifesavers.
VGH is the only hospital in Canada using the microdialysis protocol and one of only a handful of hospitals around the world using it. A hospital in Calgary tried it for a while, but Sekhon said it became too expensive so it was abandoned. At VGH, donors to the hospital’s foundation covered initial acquisition fees, but now the costs are absorbed into the hospital’s annual operating budget.
Only in the last few years have specialists like Sekhon had access to tools that allow them to individualize treatment plans for patients. In 2016, Sekhon and colleagues were recognized for using brain-monitoring technology that helped salvage the neurological functions of a world-renowned freestyle skier after she crashed during an international competition. In that case, doctors drilled a hole into the skull of the 22-year old patient — Jamie Crane-Mauzy — so they could take real-time measurements of oxygen and blood-pressure levels in her brain, which enabled them to tailor medications and other interventions to her condition.
Sekhon estimates VGH will receive 20-30 patients each year who will benefit from microdialysis and other brain-monitoring. The hospital has developed a specialized neurocritical-care program consisting of neurosurgeons and intensive-care specialists so that patients with severe brain injuries can get such advanced brain-monitoring, increasing their chances of recovery.
A study published last year that tracked 113 patients with severe brain injuries showed that those who got care from the specialized team were 2.5 times more likely to have a full neurological recovery after six months.
My work as your “special tanned elf” — and my memorable time as a Vancouver fun run blogger — is done. Let me just say I’m not doing fist-pumps today about either.
Whether it was mugging for fun photos in my elf-fit with smiling strangers in humid downtown Bangkok and all the wonderful women at Kalavin Thai Massage in toasty Phuket, Thailand earlier this month, or standing with 525-plus costumed characters Saturday afternoon in chilly Stanley Park at the fourth annual Big Elf Run, it struck me that being surrounded by happy people in a sometimes troubled world should never be seen as a bad thing.
Esteemed Elf BaxterBayer, the brains and thin wallet behind the Vancouver-based Running Tours Inc. that never fails to put smiles on faces, was at his very best Saturday pumping up the kids and later the adults with his enthusiastic (and very original) warmups, hospitality and festive ambience at Lumberman’s Arch. You’d never know that seven days earlier, after the City of Vancouver revoked his event permit at the 11th hour, he was reeling and worried sick this superb show might not go on.
And while the turnout took a bit of a hit by the one-week delay, there was a lot to be said Saturday afternoon about quality over quantity. To those who couldn’t make it, for whatever reason, you missed a sweet upbeat Christmas party that included dogs and strollers — and lots of colour and imagination. If I had to pick one event to say goodbye, this was the perfect one to drop the microphone at.
One little girl told me she was going to kick her brother’s butt in the 1K Wee Elf kids’ race, and did just that. One teenaged girl told me she was going to kick my butt in the 5K, and then did (showoff!). One much older gal (smile) said my wedgie-tight elf suit wouldn’t last the 5K without a “wardrobe malfunction.” Thank gawd she was wrong!
The Big Elf Run, which checks all the boxes for having a good time, also raised awareness and funds for Canuck Place Children’s Hospice, a place where courage really lives. For the serious runners, and there were some real Dashers, Startline Timing ensured those “racing” in the 5K and 10K had accurate times to send to the North Pole, or wherever Garmin’s elves hang out! To check out all the finishing times, click HERE.
“Was a bit bummed out we had to delay this run a week,” admitted Bayer moments before the entertaining kids’ race wrapped up. “You try to avoid holding events this time of year what with last-minute shopping, vacations, the weather and traffic, but the schedule change was totally out of our control. My objective today was to put the best show on for those who could still make it, and hope everyone liked it!”
Well, mission more than accomplished. Judging by comments at the event, and later on social media, Bayer’s crew crushed another one out of the park. There were several who took advantage of the virtual run component, too.
This year Bayer’s small company launched a Big Fun Run Series that included the spanking-new La Gran Fiesta Run (Burnaby) and Big Superhero Run (Richmond), along with the established Big Easter Run (Jericho Beach). And if you took part in all four events, which my family did, you received a sweet Big Fun Run Series Go Big medal. And speaking of medals, this series had must-have bling that far exceeded expectations.
Tricia Barker, a new commissioner for the Vancouver Park Board and participant in Saturday’s run, said she had a ton of fun taking part in the fourth annual event, which American Express ranks in the top 14 worldwide as “seasonal events with a twist.”
“Great crowd, lots of spirit, great costumes and love the big medal,” she said, while joking out after inspecting my way too tight elf-fit that she’s also a personal trainer for getting people in shape. No problem, I get that a lot Santa!
One of my final official duties for the Big Elf Run was naming a new Mr. or Mrs. Santa Claus, having won the prestigious ambassador title at this event last year. This year’s winner is Shelley Hatfield of Aldergrove, the brains and beauty behind the Over The Top Fitness crew that dressed up as reindeer (along with Santa’s musical sleigh) on Saturday. Hatfield and her motley crew, who take the fun to every run, also raises funds throughout the year for a cat shelter in Richmond.
A couple of the Sole Girls leaders in Saturday’s run, who said they loved my pirate outfit at the Moustache Miler last month, made me promise that I won’t stop running or wearing new costumes in the new year. Told them my budget-wise wife now has full say on the wardrobe expense account after discovering additional hidden gems in my man cave! But I promised to keep running and surrounding myself with positive people.
Here are some other festive gems from Saturday’s Big Elf Run:
Folks do the festive thing, again!
My work colleagues gasped out loud after mentioning I just spent 2½ weeks in toasty Thailand with the in-laws.
“Did you lose a bet?” was the most common reaction, followed closely by “was it your choice?” and “wife forced you to play along?” (No, yes and no are the politically correct answers to those questions, by the way! And I refuse to take a lie detector test.)
Linda and Dennis Hill, great people to call family, really got into Bayer’s Big Fun Run Series. Initially it was because my father-in-law wanted a La Gran Fiesta Run bottle opener medal, and then it was to try out new costumes, a thing most in the family found shocking.
“You’ll never ever catch me wearing a run costume,” said Deadpool Dennis one short year ago. “Who does that stupid stuff?”
Not sure what changed his mind, but he dressed up for the La Gran Fiesta Run, then the Superhero Run, then the Big Elf Run, plus the Moustache Miler and a few other events along the way. In fact, he began calling from costume shops asking if I or his daughter needed anything for upcoming runs!
Yep, welcome to the “who does that stupid stuff” club big guy. And sincere thanks to you and mom for being some of the biggest run/walk boosters out there.
Dora the Explorer was a Blitzen
This year I took part in 45 weekend races, some so serious I actually wore real running clothes!
Along the way you meet people who become familiar faces, people who make race day brighter, better and memorable. One such lady is Dora Velazquez of Surrey who continues to improve, and amaze, and inspire.
She was worried Saturday that some of her speedy friends wouldn’t be at the seawall to push her efforts to crush the 10K. This friendly elf offered to be her pace bunny but when she mentioned shooting for the low 40s, I backed out, citing a need to make sure everyone at the back of the 5K race was safe!
Dora, who said her outfit “became super hot” as she burned up the course, finished in 42:18 — the first female elf across the finish line.
She gave me a quick lesson on proper warmup stretching, then asked what my running plans are for January and February, 2019.
“Which ones will you be wearing costumes for,” laughed Dora, who rolled her eyes when I told her I’d likely be the Chafing Cowboy for the half marathon!
Francis focuses on running elves
Francis Georgian, a photographer and video guru with my employer —The Vancouver Sun/Province newspapers — spent some time hanging out at at Stanley Park on Saturday.
Besides doing a full-page colourful photo spread in Sunday’s Province about the run, Georgian filed this fun video, too, which features Bayer and a lot of people you might know:
‘Potty animal’ gets ‘er done — with a smile
The good folks at iPOLPOPHOTOS, who were the official photographers at Saturday’s Big Elf Run, have been very supportive of this blogger, and this blog over the years.
Katia Reinhardt of Fort Langley, who I met while taking her photo four years ago before an MEC Vancouver race on the seawall, had this dream to expand the company and its app and has made major gains since. The co-founder and chief marketing officer of the company has been a regular race fixture on the Lower Mainland in the past couple of years.
“You have such an awesome happy and supportive spirit,” Katia said Sunday, before sharing a photo of me finishing the 5K. “The smile says it all about you and running. I don’t think I have ever taken a photo of you not smiling!”
Katia is way too kind. On Saturday, at the 2.5K mark, she missed a non-smiling moment as I had to find a washroom to get rid of the coffee, juice, water and tea intake! Eventually found one, wasted three precious minutes getting in and out of the elf onesie, and then ran like made to make up lost time.
Finished the 5K in 33 minutes, which is not bad given the detour. In fact, my Garmin says I ran 5.10 Ks and actually shows the zig-zags when I began the potty hunt mid-race!
Check out more on iPOLPOHOTOS great service and Apple/Android app by clicking HERE.
End of the blogging road for Uncle Elfie
So, as mentioned, this is the end of the road as a run blogger for yours truly.
Like all fat, out of shape people who work at The Vancouver Sun, you’re approached to be a Sun Run “guinea pig” and blog about your couch-to-starting line experience, which happened to this scribe four years ago.
After crawling through that Sun Run, I was pointed toward the first Big Elf Run as a starting point for this Fun On The Run hobby blog. And some 200-plus events later, and pumping the tires of many a runner, run company, elite and novice athletes and community events on my “spare time and own dime,” I’m back wearing green and calling it a day.
Baxter Bayer has been, without a doubt, my biggest supporter. He totally understood the concept of this fun blog’s intent — trying to push couch potatoes or weekend warriors to races to improve their physical and mental health, to socialize, to have fun, to improve, to appreciate the sport and race-day vibe no matter your skill level, to put down social media devices for a morning, to embrace the West Coast lifestyle and just do it. He also said thanks, which was pure money in my world.
Truth be told, I really suck as an adult runner most days. My feet are sore, my “strict” diet is iffy, my training routines leave plenty to be desired. But I have fun and never, ever have I regretted being at a race, or catching up with people, or hearing their success stories or future plans.
Bayer let me inside the so-called ropes at several of his and other neat events, shared valuable information that helped me do a better job, and always kept a positive attitude that rubbed off.
As mentioned last month, he also stepped up big time when my younger brother died unexpectedly last year and he made sure this writer and my family didn’t curl up and get lost in grief.
Some people asked why I bother to cover “non serious runs” and some mocked me for wearing costumes at “dumb events” or for not running faster. Isn’t social media grand? Good thing I have thick, well-padded skin as some critics pointed out! I wouldn’t have missed this awesome experience, and adventures, for the world.
With love from “Uncle Elfie,” and my forever grateful family, have a great Christmas holiday and super New Year. Keep smiling, keep embracing life and see you all down the road at a race day near you.
And for Star Wars nut Baxter and the lovely Jana, may the force always be with you and thanks for making a huge difference in this crazy world.
VGH Dr. Naison Garaway shows off the REBOA catheter, a new balloon device to temporarily stop bleeding for patients. Arlen Redekop / PNG
Vancouver General Hospital is the first in western Canada to deploy a new balloon-tipped catheter device to save the “sickest of the sick” patients who are at risk of bleeding to death following car accidents, stabbings and other injuries such as gunshot wounds.
In the past few months, trauma teams at the hospital have been practising on cadavers and simulation mannequins, but they recently used the REBOA (resuscitative endovascular balloon occlusion of the aorta) on a gunshot victim. He was in hemorrhagic shock after sustaining multiple wounds to the abdomen — and he survived.
Doctors say up to 90 per cent of patients in hemorrhagic shock can die after a thoracotomy — the conventional method of opening the chest to clamp the main aorta artery. But the REBOA device and procedure is less invasive and may help save more lives. Doctors expect it will be used on up to 15 trauma patients a year at VGH.
The technique for stabilizing patients in shock and in danger of bleeding to death from traumatic injuries to the chest (below the diaphragm), abdomen or pelvis works by controlling or stopping the hemorrhaging. In the trauma bay area of the emergency department, trauma specialists thread a balloon-tipped catheter up to the aorta, entering through the femoral artery in the groin. The balloon is placed inside the aorta, then filled with saline to temporarily block it off to stop further hemorrhaging.
The device stops bleeding in the lower half of the body, but maintains blood circulation to the brain, heart and lungs. Once the balloon is inflated, a patient’s dire low blood pressure should normalize.
The device is not unlike the flexible balloon-tipped tubes that are used in angioplasty procedures by interventional cardiologists to open up blocked coronary arteries. But in this case, the balloon is used to close up the artery. It is ideally suited to patients whose bleeding cannot be controlled through compression techniques because of their extensive injuries.
The REBOA is a stop-gap measure. Once the balloon has been inserted, medical teams have just under an hour to get patients onto the operating room table for surgery to repair the injuries to vital organs that are the source of the bleeding.
The disposable REBOA device costs about $2,000 and VGH doctors are upbeat about its potential.
“This new device will allow us to gain precious minutes in the patient’s golden hour during which controlling the hemorrhage is the single most important move to improve survival,” said trauma surgeon Dr. Emilie Joos, the first surgeon to use the REBOA procedure at VGH, and as it turns out, the first in Western Canada.
“For me, the decision was simple: either I would inflate this balloon in the patient’s aorta or he would die on the OR table,” said Joos. “REBOA allowed me to find and control bleeding from multiple injuries.”
Previously, trauma surgeons would have to make a large incision from the patient’s chest to pelvis and use a clamp to temporarily stop the bleeding, said Dr. Naisan Garraway, medical director of the VGH trauma program and a former Canadian Armed Forces doctor. He has done multiple tours of duty in Afghanistan and Iraq and said earlier versions of a REBOA-like device were used on battlefields to stabilize soldiers so they could be airlifted.
“Implementing REBOA will help us continue to be on the leading edge of care for the trauma patient,” he said.
The device got Health Canada approval last year. Trauma doctors in Montreal were the first to use it.
Local health regions are making significant progress in boosting the number of patients dying in place rather than being moved to facilities to obtain medical assistance in dying.
The Fraser Health region, where palliative care hospices have been especially resistant to providing medical assistance in dying (MAiD) on site because of philosophical opposition, has drastically reduced the number of patients transferred to other facilities on their last day or days of their lives, going from 27 transfers in 2017 and part of 2016 to only six in 2018, according to new data provided by the health authority.
“In each case, we carefully consider how to offer MAiD in the most patient-centred way we can as we strongly support the patient’s right to choose to access these services,” said Fraser Health spokeswoman Jacqueline Blackwell.
It has been one year since Fraser Health told hospices and other care facilities to stop transferring clients out for MAiD services. While some like the Irene Thomas Hospice in Ladner remain defiant, the latest data on the distressing, disruptive transfers that were occurring with much regularity last year show it is now becoming a more infrequent occurrence.
“We have been able to limit the number of transfers by understanding our patients’ end-of-life wishes and ensuring they receive care in a facility that can support them,” said Blackwell, referring to facilities that receive taxpayer funding.
“We believe hospice care is a critical part of the continuum of care, and we value those who provide this vital service, including the care providers, the volunteers and the administrators. We understand there are controversies surrounding this legal obligation and where and how to implement this. (But) we also respect that individuals and faith-based health care organizations can conscientiously object and not participate in the direct provision of medically assisted deaths, while providing safe and timely transfers for patients for further assessment and discussion of care options, if required.”
Between the time when MAiD was legalized midway through 2016 to Oct. 31, 2018, 257 medically assisted deaths were provided in Fraser Health. Half of those were conducted in 2018.
While there are still some holdout hospices in the Fraser region, hospices in the Vancouver Coastal Health (VCH) region are providing MAiD except for those that are faith-based facilities; from those, 17 patients have been transferred so far this year.
Overall in 2018, there have been 131 provisions of MAiD within Vancouver Coastal, including the 17 affected who wanted it but had to go elsewhere.
Vancouver Coastal Health spokeswoman Carrie Stefanson said the health authority does not allow publicly funded facilities to deke out of MAiD responsibilities unless they have a religious exemption:
“VCH policy, and the B.C.’s health sector generally, respects that individuals and faith-based health care organizations can conscientiously object and not participate in the direct provision of medically assisted deaths while providing safe and timely transfers for patients for further assessment and discussion of care options if required.”
Mark Warawa, Conservative MLA for Langley-Aldergrove, said in an interview that hospices providing palliative care in the Fraser Valley don’t want to offer MAiD because it is inconsistent with their mandate to provide a haven for “a natural death” process and not to hasten death.
He said he believes residential homes and hospitals are the best places to offer MAiD. “This shouldn’t be forced on hospices,” he said, referring to an edict a year ago from Fraser Health that patients should not be transferred out of their last health care setting in order to get MAiD.
Warawa said over the last 18 months, his office staff has tried to reach out to provincial Health Minister Adrian Dix multiple times to discuss the hospice issue. Dix said in an email that he has spoken with Warawa and knows about his beliefs.
Dix said B.C. has been leading the country in end-of-life matters and enabling individuals to “make choices in how they unfold.”
“We are a leader in organ donation. And through B.C.’s Representation Agreement Act, we are a leader in how we set out in our wills our wishes and instructions for key parts of our end-of-life medical care. Ensuring that MAiD can be accessed by patients who meet the stringent criteria puts the onus on us — and our health-care facilities — to ensure patients’ move to this end-of-life choice is free of friction and the additional suffering it causes.”
Warawa said provinces have been given plenty of time to build enough capacity into the health care system for “assisted suicides” and if hospitals and non-denominational facilities don’t have enough resources for MAiD requests, then it may be time to build stand-alone “centres of excellence” for MAiD services.
A year after Fraser Health told hospices and other care facilities to stop transferring clients for medically assisted deaths, the Delta Hospice Society continues to openly defy the edict.
Operators of many palliative care hospices — even those that are non-denominational — refuse to provide medical assistance in dying (MAiD) because they contend it conflicts with their principles that death shouldn’t be hastened.
Freedom of information documents (FOI) obtained by Dying With Dignity show there appears to be ongoing confusion about the process when it comes to patients seeking MAiD in facilities like the Irene Thomas Hospice in Ladner (operated by the society) that don’t want to provide it.
Each month, patients in pain are being moved from hospices to places like Queen’s Park Care Centre in order to get their dying wishes respected, the documents requested by Dying With Dignity reveal. The problem with transfers is that they’re uncomfortable and distressing for patients and their families.
“The documents speak to why Fraser Health made its decision late last year (to compel MAiD to be provided where patients reside), and they also complicate the Delta Hospice’s narrative that forced transfers for MAiD are not harmful and not a significant problem,” said Dying With Dignity’s spokesman Cory Ruf.
“I would say that the conflict between the health authority and the hospice is unique and potentially nationally significant. I’m not aware of any instances of a hospice battling a regional health authority over the provision of assisted dying,” he said, referring to the fact that Delta Hospice Society leaders have repeatedly stated they will not provide MAiD. The society’s leaders couldn’t be reached for comment Tuesday but in previous interviews Delta Hospice society operators complained they were victims of Fraser Health bullying and MAiD activists who want the service provided in all hospice palliative care facilities.
The FOI documents show that just over 20 per cent of MAiD deaths in the region between June 2016 (when MAiD became legal) and December 2017 (when Fraser Health told facilities to stop making transfers) involved a transfer from a hospice. During that 18-month period, 107 people reportedly used MAiD in the Fraser region. And of those, 27 involved transfers to homes, hospitals and other facilities so the service could take place.
“This number is astounding,” said Ruf, adding that while transfers are occurring across the country since many faith-based facilities are opting out of MAiD, hospices haven’t been given an exemption since they’re usually non-denominational.
“As an organization, we find it extremely problematic that people at end of life are being discouraged from getting, or are being denied access to, hospice palliative care simply because they’re considering a request for MAiD.”
Hospices are places where individuals go to receive palliative care for pain and symptom management of their life-limiting illnesses. Average stays are usually about two weeks. The goal is to offer physical comfort and emotional support at the end of life when dying is a “normal” process.
Fraser Health didn’t respond to questions about the controversy Tuesday, nor did the Ministry of Health.
The Ladner hospice has a contract with Fraser Health to supply 10 beds; it derives a sliver under half its income from the health authority while the rest comes from charitable donations and fees.
Ruf said transfers aren’t unique to Fraser Health. Dr. Ellen Wiebe, a Vancouver MAiD provider, said her patients are being transferred from hospices “on the last day of their lives.”
“People are in hospice because they are at the end of life and cannot manage at home. In hospice, they have comfortable private rooms with staff to help them. To be forced to transfer into a wheelchair or stretcher, travel by van to another facility, and then transfer to another bed can be exhausting and excruciatingly painful for someone at the end of life. In the last hour of his life, one of my transferred patients had to wait for an elevator beside three men using jackhammers. Another was so weak and exhausted after the trip that, although he had transferred himself at the hospice, he could not do so at the other facility and fell. This kind of suffering is preventable and unacceptable.”
On Vancouver Island, Dr. Tanja Daws said there are no non-denominational, non-Catholic hospital or hospices in Comox to deliver MAiD to her patients and in one case recently an individual had MAiD in the lobby of a funeral home while another had to be transferred from a hospice to a conference room where the board table and other furniture had to be moved around. “The janitor was just outside, in the hallway, and we had no choice but to try to keep him away.”
The FOI documents Ruff obtained show that there have been complaints over various matters, including one family being told in error that paying for the transfer was their responsibility when in fact that facility doing the transfer is obliged to pay.
“One social worker with the FHA’s MAiD program wrote that a transfer involved moving mountains and expressed concern that these policies don’t represent a patient-centred approach to care,” he said.
The federal legislation states that no individual can be compelled to provide medical assistance in dying. But it doesn’t define where assisted dying should be provided. It’s up to provinces and health authorities to figure out how to deliver services and to create policies.
The federal governments latest report on MAiD shows that across Canada there were 3,714 MAiD deaths from December 2015 to the end of 2017. Hospitals and homes are the preferred setting, each accounting for about 42 per cent of MAiD cases while hospices account for only three per cent of cases in Canada (five per cent in B.C.) B.C. and Ontario led the country in MAiD cases. There were 365 cases in the last half of 2017 in B.C. and about 100 more than that in Ontario.
Alex Muir, a Dying with Dignity volunteer in Vancouver, has sent a letter to the premier, health minister and other B.C. officials, describing procedures that are limiting access to MAiD. Patient transfers are a big problem, he says, because if a frail person nearing the end of life needs hospitalization and paramedics take them to St. Paul’s, a Catholic-based Providence Health facility, then they won’t get MAiD there since the hospital has been given a religious-based exemption by the province.
“The transfer itself can be physically brutal for the patient and emotionally draining to that person and their loved ones,” he said.
As well, since patients awaiting subsidized residential-care beds can’t always choose the facility where they will be admitted, they may end up in one that doesn’t allow MAiD, “again resulting in a forced transfer if they choose this path.”
The forced transfers should end, Muir says.
“While the government has allowed clinicians who oppose MAiD to opt out of directly participating in it, this right should not be afforded to facilities. An individual has a conscience. Bricks and mortar do not,” Muir said.
BBG Constructive & Security Installation Consultants is a multi-disciplinary property and construction consultancy. Working with businesses on built-environment projects, we are client-focused with the recognised experience, knowledge base, expertise and track record to tackle projects irrespective of complexity from a position of strength.