Tag Archives | Canadian Medicare

“Inside His Mind” – A Must-Read about Dual Diagnosis

I came across an incredible blog post over the weekend about a young man with a dual diagnosis.

http://www.li-kids.com/2012/02/01/inside-his-mind-an-interview-with-r/

I’ve never read this blog before, but the post in question is a mother’s interview with her teenagedual diagnosis son   (I’m assuming that ‘he’s a teenager; his age is never given, but one of the tags is “teenager” and the Twitter tweet that led me to the article said he’s a teenager) who has Asperger’s syndrome, bi-polar disorder and obsessive-compulsive disorder. This is called a dual diagnosis – developmental disability and mental health diagnosis. It’s a fascinating read, and a couple of things about it really struck me.

1) R’s Level of Insight into His Dual Diagnosis and His Disabilities

When I worked with teens with intellectual disabilities who could understand that they had a disability, we had a lot of conversations about what “disability” was. Some of them didn’t realize that they had one. Some knew that they had one, but simply didn’t consider themselves people with a disability. Some didn’t want to be considered one of “those people” out of fear of being teased, or of being associated with groups of people with whom they felt they had nothing in common.

I tried to get the message across that if you understand what your disability is and how it affects you, you know how to ask for what you need – from doctors, from formal supports, from informal supports, even from potential employers. I struggled with depression and obsessive compulsive disorder in high school and through my twenties, and I know that I could not have explained nearly as clearly as R how these things affected me.

R’s family needs to look at this ability to reflect on his dual diagnosis and to explain what it’s like to be “in his mind” as a strength that he can utilize.

2) Which Disability R Perceives As Giving Him The Most Difficulty

Some of the difficulties that R experiences likely come from his Asperger’s diagnosis. The trouble picking up on social cues and the social awkwardness are symptoms of Asperger’s (they can be symptoms of other things, too, but if he’s been diagnosed with Asperger’s, those things likely are likely part of that disorder for him.) The fixation on video games and technology may also be a part of his Asperger’s, even though he seems to identify it as something separate.

Based on this interview, it seems to be the bipolar part of R’s dual diagnosis that causes him the most distress. It makes me think about the controversy over the proposed changes to the diagnostic criteria for autism for the DSM-V, and wonder:

  • How many of the R’s medications are treating Asperger’s-realated issues?
  • Are the new psychiatrist and psychologist he’ll be seeing supporting him for the bipolar? The Asperger’s? Both?
  •  What are his doctors’ take on the video games as an addiction (as opposed to another manifestation of Asperger’s)?

3) A Downside to Canadian Medicare

I’ve never said that there weren’t any.

In emergency situations, Canadian Medicare has always served me well, as I’ve blogged on before. But when I read that R will be seeing a psychiatrist…I thought, “Wow, just like that?”

In Ontario, it’s very difficult to see a psychiatrist or a psychologist anymore if it’s not an emergency situation.  It wasn’t always like that. But it is now. It’s very frustrating when you’re supporting individuals who need a psychiatrist and it’s so difficult to get them access to one.

I realize that for people without insurance in the United States, this sort of treatment is very expensive. But with non-emergency psychiatric care so hard to come by in Ontario…it does make me wish sometimes that it was as easy as being able to find a psychiatrist and pay for services, just like that.

I guess there are no easy answers when it comes to health care.

Thank You, Ashtyn Evans and R

Ashtyn printed all of R’s responses about his dual diagnosis unedited in her blog post, and plans to blog about her feelings later.

I’m looking forward to reading her thoughts about R’s dual diagnosis.

 

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Obama’s Inner Tommy Douglas

My father told me a story over the weekend about Tommy Douglas, the man responsible fortommy douglas bringing universal health care to Canada.

Tommy Douglas and Medicare in Canada

Medicare in Canada began in the province of Saskatchewan. Tommy Douglas was Premier of Saskatchewan when he introduced the legislation for Medicare in 1959, and the doctors in the province were so upset about its potential ramifications that they went on strike in 1962. The town of Kindersley was especially divided over the Medicare issue. It had its own system of health care provision management operating within the town, and didn’t want to give up control to the government.

Douglas asked for a meeting in Kindersley with the town’s biggest supporters and biggest opponents of Medicare. He walked into the meeting, simply said, “You all know who I am, and I know who you are. Medicare *is* going to happen, and it’s going to happen my way,”” turned around and walked out. He got a phone call the next day saying that the folks in Kindersley had managed to work out their differences about Medicare. And a few years ago, Canadians voted Tommy Douglas the Greatest Canadian.

After hearing the story, I thought, “Obama needs to show a bit of that spirit. There’s not enough of ‘This is how it’s going to be’ about him right now.”

Obama Finally Puts His Foot Down

I think we saw some of it the other day, when Obama spoke about the Supercommittee’s failure to agree on how they’re going to make more than a trillion dollars in cuts to the US budget.

Obama expressed regret that the Supercommittee wasn’t able to figure out how to do this.  He said that if they’ve still got time to figure it out before their deadline of 2013. He also said that if they can’t figure it out, there are automatic cuts locked in, totaling 1.2 trillion dollars.  He’d just rather that this be done with a “scalpel” rather than an “ax”.

And he said to those in Congress who are already trying to get those automatic cuts undone, that he’ll veto any of their efforts. The message to me was that, one way or another, these cuts are going to happen…whether people like it or not.

As frightened as I am by what 1.2 trillion in cuts could mean for people with disabilities in America (however the cuts come about)…this is an Obama that I like. He’s finding his inner Tommy Douglas, and that man got a lot of good things done.

More on Tommy Douglas:  http://www.tommydouglas.ca/?page_id=88

Obama’s speech about the Supercommittee: http://www.youtube.com/watch?v=ZYb0C2lvazE

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Happy Thanksgiving

So today is Canadian Thanksgiving…and with that in mind, here are some things that I’m thankfulthanksgiving for:

1. I’ve got all my basic needs met: food, water, a place to live, affordable medical care, etc.

2. I’ve got a wonderful, supportive family…including my beautiful niece, Gillian, who is celebrating her first Thanksgiving today.

3. Even though I haven’t got a job, I’m actually doing a lot of what I love right now – writing. And I’m taking steps every day toward turning that into a job.

4. I live in a community that, over and over again, has shown itself to be full of friends, sometimes when I least expect it and most need it.

5. I have friends all over the world. That’s a really cool feeling.

6. I live in a country that values peace-keeping, human rights and taking care of its vulnerable citizens.

7. I’m much more than my disabilities.

8. “The Big Bang Theory” is on every night now. :)

Happy Thanksgiving, Canada.

 

 

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Canadian Health Care – The Other Side of the Story

Elizabeth McClung has generously agreed to let me post the comment that she made on the post that I sent to ReflectionsPN as my “guest blogger” post – the one that appears in this blog as “Grateful to Be Canadian”, in which I talk about how positive my experience with Canada’s health care system has been. Elizabeth’s story needs to be told too.

Unfortunately, Elizabeth’s comment only address a little bit of how Canadian health care has failed her as a person dying of a very, very rare disease affecting her autonomic, autoimmune, and neurological systems. I follow her blog (Screw Bronze! on my blogroll) and have talked with her through email a few times, and am truly saddened and angered by what she and her partner Linda have had to endure just trying to get barely adequate medical and home support care for her – often not even that.

But she’s probably got the most positive attitude of just about anyone I know. If you read anger or pain in anything that I quote here – I believe it’s just because she’s understandably had enough of fighting against a system that, while it for whatever reason worked for me, seems determined to work against her:

 

“I am really glad you live where you live as being in District of Nanaimo you would have not been sent to the hospital you were sent to, and you would have not have gotten an MRI (since it only operates until 2:30 in the afternoon due to budget cutbacks in staff, which had to take a 10-12% paycut, so most quit and went to Toronto and Calgary), as there is the ONE, and it was bought 30 years ago and has generally a nine month wait list.

I repeatedly am told from people in Toronto, ‘that’s not like it is here.’ which is what people from have-not provinces, from the maritimes to British Columbia end up hearing. I am glad you had Ontario health insurance, which may have made this possible (since, I am not sure that Coast Health would want to cover two operations and rehab in another province, nor have I heard of anyone getting any rehab for stroke out of province – maybe, except the 22 year old I know in this city who simply lives with ‘short life’ and no immune system for something that can be treated…in Ontario).

I am glad it worked, and the story is one which due to the complex nature of payment of healthcare in Canada might be a good example case. My nan did well in living out of our healthcare system, having four cataract transplants; but poor in dying (as hospitals in this city are often full, and up to 60% of the beds are in use by seniors waiting for other seniors to die so they can be slotted into a home). As the worker who told me they were off to take care of 32 individuals for X hours – the idea that individual oxygen or any other needs could be met at less than 2 minutes per person per hour is humorous, and so the turnover rate at our centers are quite high (a month seems to be the average rate, even if they survived 6 months waiting in hospital, once in, a month is about the average, some 2 weeks, some 6).

I am very glad you had a good diagnostic and Vancouver has a great cluster of hospitals, but I think Toronto is even better. If someone is going to cut into your brain, get the best.

I am still in awe that you have a seizure specialist (and that there were two or more in that location). I am glad life moves on and out of the valley of beige and sanitizer. Your experience represents the best of Canadian medicine, thankfully.”

Elizabeth, if there’s anything I can do, you know you just need to ask.

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Encore Post: Grateful to Be Canadian

I know that it’s a little early to be re-posting material, but today is Canada Day, and this post seemed especially appropriate. I’ll be back on Monday with new material. Happy Canada Day, and have a great weekend!

—-

Thanks to dedicated staff in Canada’s health care system, I am both an AVM *and* a stroke survivor. I’m a very lucky person, to be where I am right now.

My AVM Story

I sometimes feel like I spend a lot of time defending Canada’s health care system. I know that it’s not perfect. I can tell some stories of some real atrocities that have happened to people I love, in fact.

But it was there for my mother, right from the time that she was diagnosed with cancer to her death. She was treated, as far as we as we could tell, to the best of the doctors’ ability, with respect and dignity. We were treated with respect by hospital staff as well.

The medical system has always been there for me as well, in spades. Like I said, I’ve been very fortunate.

I had my first stroke in the middle of a job interview in British Columbia. I was twenty-two at the time. I was rocking that interview. They wanted a coordinator for a symposium on youth violence, and I could tell that they liked me (I ended up getting the job, actually).

But it was not to be, because in the middle of the interview I got an incredible headache that came on like a train – fast and forceful. “So this is a migraine,” I thought, faltering over my words. I had to stop and explain what was happening. Someone on the interviewing panel gave me some Tylenol, and I managed to finish the interview, but at the end of it they wouldn’t let me go until I’d promised to go to straight to the doctor.

I didn’t protest. I could feel my neck getting stiff. “So this is meningitis,” I thought.

I’d only been in British Columbia for a couple of months. I’d just put my application for BC health insurance in the mail that morning. I walked into the town health clinic, put my Ontario health card down in front of a receptionist who didn’t know me from Adam, and said, “I think I have meningitis.”

Five minutes later, I was in a doctor’s office.

Five hours later, after an ambulance ride to the nearest city, I was checked into the nearest hospital. I’d had a CT scan and a lumbar puncture and I was scheduled to be transferred to a larger, more specialized hospital in the morning.

Five days later, I’d had an angiogram and I’d had been diagnosed with arteriovenous malformation, or AVM (check the Glossary on the About Me page for definitions of unfamiliar terms). A consult had been set up for me in an AVM clinic in a Toronto hospital, and I was cleared to fly home to Ontario.

Five months later, I’d been seen in the AVM clinic in Toronto Western Hospital twice.  The doctors had decided on a course of treatment based on another angiogram: embolization to reduce the size of the AVM, and then a craniotomy. The surgery hadn’t gone as well as they’d hoped: A small segment of AVM could not be treated, and I’d had a stroke that had significantly compromised my left side. My treatment team was arranging in-patient rehabilitation at a facility closer to home, so that my father wouldn’t have to do so much driving. They were just waiting for seizures to stabilize before they sent me.

Penetanguishene General Hospital kept me for as long as they could, and then sent me to Ottawa Rehabilitation Centre, which kept me for as long as they could. My in-patient rehab was seven months in total. I still see a seizure specialist (and, because I didn’t like the first one to whom I was referred, I asked if I could switch, and I was accommodated).

When It All Comes Down to Money

There’s a chance that I wouldn’t be here if the medical system hadn’t been here to support me the way it had. My family would not have been able to afford my AVM surgeries, let alone my aftercare and rehabilitation, if we’d lived in country without universal health care. As I said, the system isn’t perfect…and I really feel for people that have had a bad outcome because they’ve been put on a waiting list or because they’ve had to sit in an ER too long.  That absolutely shouldn’t happen.

But I can’t imagine living in a country where people sometimes go without treatments that they need simply because they can’t afford it.

It makes me grateful to be Canadian.

 

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My Brain AVM Story: Grateful to be Canadian

Thanks to dedicated staff in Canada’s health care system, I am both a brain arteriovenous malformation (AVM) *and* a stroke survivor. I’m a very lucky person, to be where I am right now.

My Brain AVM Story

I sometimes feel like I spend a lot of time defending Canada’s health care system. I know that it’s not perfect. I can tell some stories of some real atrocities that have happened to people I love, in fact.

But it was there for my mother, right from the time that she was diagnosed with cancer to her death. She was treated, as far as we as we could tell, to the best of the doctors’ ability, with respect and dignity. We were treated with respect by hospital staff as well.

The medical system has always been there for me as well, in spades. Like I said, I’ve been very fortunate.copyright FreeFoto.com

I had my first stroke in the middle of a job interview in British Columbia. I was twenty-two at the time. I was rocking that interview. They wanted a coordinator for a symposium on youth violence, and I could tell that they liked me (I ended up getting the job, actually).

But it was not to be, because in the middle of the interview I got an incredible headache that came on like a train – fast and forceful. “So this is a migraine,” I thought, faltering over my words. I had to stop and explain what was happening. Someone on the interviewing panel gave me some Tylenol, and I managed to finish the interview, but at the end of it they wouldn’t let me go until I’d promised to go to straight to the doctor.

I didn’t protest. I could feel my neck getting stiff. “So this is meningitis,” I thought.

I’d only been in British Columbia for a couple of months. I’d just put my application for BC health insurance in the mail that morning. I walked into the town health clinic, put my Ontario health card down in front of a receptionist who didn’t know me from Adam, and said, “I think I have meningitis.”

Five minutes later, I was in a doctor’s office.

Five hours later, after an ambulance ride to the nearest city, I was checked into the nearest hospital. I’d had a CT scan and a lumbar puncture and I was scheduled to be transferred to a larger, more specialized hospital in the morning.

Five days later, I’d had an angiogram and I’d had been diagnosed with a brain arteriovenous malformation, or brain AVM (check the Glossary on the About Me page for definitions of unfamiliar terms). A consult had been set up for me in a brain AVM clinic in a Toronto hospital, and I was cleared to fly home to Ontario.

Five months later, I’d been seen in the brain AVM clinic in Toronto Western Hospital twice.  The doctors had decided on a course of treatment based on another angiogram: embolization to reduce the size of the brain AVM, and then a craniotomy. The surgery hadn’t gone as well as they’d hoped: A small segment of brain AVM could not be treated, and I’d had a stroke that had significantly compromised my left side. My treatment team was arranging in-patient rehabilitation at Penetanguishene General Hospital, a facility closer to home, so that my father wouldn’t have to do so much driving. They were just waiting for seizures to stabilize before they sent me.

The rehabilitation hospital kept me for as long as they could, and then sent me to Ottawa Rehabilitation Centre, which kept me for as long as they could. My in-patient rehab was seven months in total. I still see a seizure specialist (and, because I didn’t like the first one to whom I was referred, I asked if I could switch, and I was accommodated).

When It All Comes Down to Money

There’s a chance that I wouldn’t be here if the medical system hadn’t been here to support me the way it had. My family would not have been able to afford my brain AVM surgeries, let alone my aftercare and rehabilitation, if we’d lived in country without universal health care. As I said, the system isn’t perfect…and I really feel for people that have had a bad outcome because they’ve been put on a waiting list or because they’ve had to sit in an ER too long.  That absolutely shouldn’t happen.

But I can’t imagine living in a country where people sometimes go without treatments that they need simply because they can’t afford it.

It makes me grateful to be Canadian.

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