Tuesday, August 19, 2008

British Columbia Health Care

In British Columbia, we would like to believe that we live under a security blanket of insurance and medical professionals. Our insurance is affordable and under most circumstances care is just a phone call away. Sadly, that blanket is a thin sheet offering little warmth. Much of what our doctors come across is the mundane day-to-day ailments a small community produces. The question is, can a person living in the north survive a serious illness in our province? In my case, I’m not so sure.

On April 2nd 2008 my wife, Wendy and I were visiting my parents-in-law’s near Portland Oregon. I had just stepped out into the hallway after using the restroom when a strange painful sensation of moving fluid, started in my upper shoulders and rolled over the crown of my head, overcoming me. I had never felt anything like it before, but I knew immediately that it was bad. Awareness was slipping away and I wandered down the hall to find someone who could help. The first person I came across was my mother-in-law. “I need to go to the hospital right away,” I remember saying.

She asked me about what I was feeling and I remember saying that I was experiencing the worst headache of my life. That wasn’t entirely true, but I knew that I didn’t want anyone to waste time trying to help me. They called 911 immediately. My mother-in-law helped me to the sofa where I lay face down with my face resting over the edge. It seemed only moments had passed before the paramedics arrived. They moved me to the ambulance and rushed me to the nearest hospital. A neighbor and a retired surgeon, I was told, recognized my condition immediately. He phoned ahead to the McMinnville Medical Center to ensure the hospital was prepared.

My memories at this point are sketchy at best. I remember arriving in the McMinnville hospital, but very little other than that. Someone, I don’t remember who, told me that a helicopter arrived to Life Flight me to Oregon Health & Science University, but due to a malfunction, it never left the tarmac. Instead, the team and I boarded an ambulance and made the trip with sirens blaring.

During the weeks that followed I underwent numerous scans and tests. I spent weeks in the ICU and remember making a concerted effort to distinguish night from day. I tried to use my wife’s visits to help figure out the time of day, but since she spent as much time with me as she was allowed, her coming and going didn’t help with this particular problem.

After arriving at the hospital on April 2nd, I was surprised to learn that the major surgery to put a shunt in for the spinal fluid buildup did not take place until April 8th. After that, memories are clearer. I was able to spend one day on the regular ward and this was great. Visitors were no longer restricted to one or two. Unfortunately, I cannot say that I was a good host. I slept when I was tired and visited when I could. At least some family members, who do not have much of a chance to visit, did.

The following day nurses loaded me onto a stretcher and took me back to the ICU. Although I was one of the healthiest patients in the ward, my condition was not as stable as they would have liked.

I feel lucky to have had this emergency in the United States. Care was immediate. I shudder to think of the series of events that the Canadian system of health care creates. An ambulance would have been called and the distance from dispatch could have meant a half of an hour wait. I could have spent an hour or more waiting to be seen at the hospital - through no fault of any of the competent general practitioners. Once they recognized my condition I more than likely would have been sent to the next largest centre. Unfortunately, there they are not equipped to deal with brain trauma.

After having spent hours in the system I may have been transported to Vancouver British Columbia. If I was lucky enough to have survived the trip without suffering irreparable damage, my treatment would have begun then – possibly a full day after the initial bleed. I have little confidence that if this worse case scenario had been realized that I would have survived.

I spent another week in the US recuperating before traveling back to Canada.

When I arrived home I made an immediate appointment to see my doctor and he scheduled a follow-up CAT scan. I received a copy of that scan and one was sent to a specialist in Vancouver British Columbia as well as to the neurosurgeon in the United States. My wife scheduled an appointment in the US because the hospital offers free follow-up for three months. Upon seeing the scan, my doctor in the US was immediately concerned. I explained that we were from Canada and reluctantly she released me saying that she wanted us to get another scan right away when we returned. She hoped that the healing process would close whatever hole was allowing gas to enter my brain.

The next CAT scan didn’t occur until July. In the mean time my doctor advocates in Canada were working hard to get the specialists in Vancouver to understand my plight. They informed me that I had an appointment scheduled in November. In the mean time the gas in my head was causing me to be nauseated. Every time I got sick, I ended up in the hospital dehydrated. Toward the end of July I came down with some kind of virus and because the doctor was afraid that whatever it was might move to my brain, he admitted me into the hospital. More contact with the surgeon in Vancouver finally bumped my appointment up to September – a month away as I write this.

A second follow-up appointment in the United States showed that the space inside my head was not getting smaller. Some of the smaller spaces seemed to have disappeared, but the main space, that I figure was somewhere between 50 and 100 mL, was larger if anything. There was a white ring of inflammation along the edge of my brain. I was getting scared.

The doctor arrived after looking at the scan ignoring the list of questions I had written down. He said that the symptoms that I was experiencing were probably associated with the air pressing against my brain. He informed me that they were scheduling an operation immediately. When the appointment was over, the surgery was set for a week later. I left the office and went back to Canada.

My first order of business was to try to get one of my four insurances to cover the upcoming surgery. All declined.

The day before I was scheduled to return to the US I received a call from my family doctor. He said that there was a doctor available in Vancouver and they could life flight me there to see him. After discussing the issue with my wife, I agreed to take the flight, mostly because this route would be covered by my insurance. I quickly packed and was driven to the hospital. When I got there, my doctor was still discussing the issue with doctors in Vancouver. The final verdict was that I should go ahead and borrow the money and have the operation in the US, so the next day we loaded into the truck and began our trip south.

Where am I now? I am currently at my in-laws in the United States and recovering well. Yesterday was my first day without medication and most of the pain I am experiencing has to do with recovery. I am confident that the problems I’ve been facing since April are behind me. When I get home my priority will be to find some way to pay for this life saving procedure. In the meantime, I’m just happy to be alive.