marriage issues

No One Tells Me Nothing


Animated sagittal MRI slice of my beating heart

Image via Wikipedia

The Canadian health saga continues with Rob’s first cardiac rehab meeting yesterday. His cardiologist – the one I’ve yet to even lay eyes on and who he saw just once during his procedure (which the doctor didn’t perform but merely supervised in any case) – referred Rob to a five week program designed to assess his fitness to return to work and get him back on the healthy heart road via an exercise program and fun little classes on weight control or sexual function.

Oh, that last wasn’t an either/or, but examples.

The cardiac rehab is located in Edmonton. Per usual the parking options were limited. So hard to come by in fact that a portion of the orientation is devoted to parking issues.

Rob was probably one of the youngest participants. Certainly no one else showed up with an eight year-old in tow. There was perhaps one gentleman in his late 30’s or early 40’s, everyone else was qualified for the discount menu at Humpty’s.

As we walked in, each patient receives a personal packet of info containing his/her appointment schedules and a menu of rehab class options in addition to the ones pre-selected to match his/her “event”.

No one has heart attacks. There are “cardiac events” only. It’s a pc thing.

The nurse who conducted the session tried hard to be brief and witty and was neither, but she told a little story at the onset which neatly sums up the health experience here from my perspective.

The operator at the hospital received a call one afternoon from an elderly woman wanting to inquire about the status of a patient.

“Who is the patient?” asked the operator.

“Helen Finley,” the old woman replied.

“Well,” the operator said, “I’ll be happy to get an update for you. Let me put you on hold and I will contact the nurse on the ward for information.”

A few minutes go by and the operator returns with good news.

“The nurse tells me that Helen is doing quite well. Her blood work came back normal and her blood pressure and other vital signs are good. In fact, she’s doing so well, that her doctor is planning to release her this evening.”

“Oh,” the old woman’s voice shook, “that is good to hear.”

“I’m glad I could help, ” the operator said. “Is Helen your daughter?”

“Oh no,” the old woman said, “I’m Helen and no one tells me nothing.”

Of course no one laughed. I suspect that any of the other people in the room could tell stories that mirror our experience. But the nurse didn’t mean to highlight one of the chief problems with the system here; she was trying to make a point about asking questions. The assumption being that patients are in the dark because they don’t ask questions rather than the fact that often there is no one to ask questions of.

After the presentation, which could have been mailed to Rob and lost nothing by way of information, we hung around until the auditorium cleared. Rob’s goal for the afternoon being to arm wrestle someone into giving him return to work clearance.

“After your stress test tomorrow and a couple of monitored exercise sessions,” the nurse explained, “you will meet with the occupational therapist, who will give you her recommendations to take to your family doctor. He will give you clearance.”

“Um, that’s not what I’ve been told, ” Rob said and went on to inform her of the buck-passing he’s encountered ever since he first asked “when can I go back to work.”

He had hopes of heading off to work on Monday when Dee returns to school. I kinda had hopes in that direction myself, but it could be another week or so.

Provided nothing goes wrong at the stress test.

That thought just won’t completely go away, and it’s silly because Rob hiked six miles not two weeks after he got home from the hospital. He’s installed air conditioners, and this last weekend, we were up and down the stairs at the Shaw Conference Centre from the river to Jasper Avenue more times than my legs care to recall. If he was going to drop, he’d have done it by now.

And his job is, frankly, physically more restful than any of his hobbies are.

Do I Have to Boycott Target?


I mean it will be fairly easy seeing that we don’t have Targets here in Alberta, but it’s my go-to store whenever I am in the States.

I love Target. The super-sized ones especially. One stop and a Starbucks to boot. What’s not to adore?

Apparently though the corporate arm of shopping nirvana decided to test out that whole “peoplehood” thing the Supreme Court granted companies a while back by donating $150,000 to the Republican gubernatorial candidate in Minnesota. Target is headquartered in Minneapolis and I am merely guessing, but I imagine that in spite of his stance against same-sex marriage, the candidate is pro business in a way that only Republicans can be.

So, the gay community – offended and rightly so – are calling for a boycott unless Target makes an equal contribution to some organization they support or that supports them.

I think there was probably a good reason why businesses have been forced to surreptitiously contribute to political campaigns in the past, don’t you? Betting Target would agree right about now.

Anyway, I was all set to back to school shop my little heart out in Great Falls next week because our trip to Yellowstone would have taken us that way, but Rob’s still reacting to one of his meds, and since we don’t know which one, we are scrubbing the whole summer vacation thing now.

I would have shopped Target anyway though. I understand the outrage, but think the “compromise” is a weeny cop-out.

You’ll boycott Target until you force them to make a second contribution to save face and void the first one?

How does an equal contribution to an entity or candidate who supports same-sex marriage cancel out the first one? The first $150,000 is out there already. Check cashed. Damage done. A second donation would be merely done to appease and lure you back.

Will you go back? Knowing that Target – despite its pro-gay worker and family practices in its company and at its stores – gave money to a Republican who hates gays only because they liked his stance on business?

Nothing will be any different after Target has been forced to capitulate. And they will cave. What’s $150,000 when billions are at stake? Money that will come out of your pocket and you’ll do it willingly then take home your goodies, spread them on the floor and roll around on them like an overheated pig in mud.

The same-sex marriage battle is nearly over now that it’s in the courts. The Supreme Court will either affirm the right (because they don’t really have any other legal choice) or they will kick it back to the states and we will have civil unions across the board. This has nothing to do with Target or idiot Republicans pandering for mid-term votes anymore.

Still, a person should do whatever helps them sleep best at night.

Tales from a Canadian ER


They call it “emerge” here. It’s Canada-speak for “emergency room”, and it confuses me in the same way that “ah” sounds are “aaaa”. Paaaasta versus pahsta. Just off enough to make me pause for a moment so my brain can catch up to my ears.

But whatever. When medical situations arise, Canadians go to the “Emerge”. And so went Rob and I on Friday just shortly before noon because he’d slept late and woke feeling light-headed and slightly heart-attacky again.

“I hope we don’t have to wait long,” he said as we walked in the front entrance of the Fort Saskatchewan Health Centre. Not hospital. It’s not big enough to warrant the title and that’s not my opinion only but the provincial health system’s too.

“Just mention the chest pains and follow it up with the fact that you had a heart attack three weeks ago,” I suggested. “I’m pretty sure that will warrant queue jumping.”

If there is one thing that Canadians pride themselves on it’s queuing up for health care. No one jumps the line. No. One.

Incoming patients are evaluated and served according to the seriousness of their condition but for the most part, everybody waits.

And waits.

I have yet to go to the doctor for any reason and not sit for at least two hours before actually being seen.

And absolutely everyone gets the same slightly understated care.

“Hi,” Rob greeted the admissions clerk, a big haired woman with that “another one” look on her face that they all have.

“Alberta health card please,” she asks even before inquiring what brings Rob to the centre that day because not having that card means that the next question is “and how will you be paying today? Cash or credit?”.

“I was here three weeks ago and had an angioplasty,” Rob tells her when she finally asks the nature of his visit.

Rob still has trouble with voicing the heart attack thing.

“And you’re here today…?” Because “angioplasty” doesn’t clue her.

“I’ve had chest pains …”

To her credit, he doesn’t get any farther. She directs him to the ER intake and asks me to come back for his paperwork.

Chest pains opens doors and makes hospital folk look attentive and even behave in a way that makes one feel as though perhaps their attention has been adequately captured.

That’s just an fyi.

We walked through the packed waiting room. I noted with interest the young punk-ish woman sitting between two RCMP officers manically chatting away for the alarming edification of all. A mother gathering her brood ever closer as the girl babbled.

“I told the operator that they could come get me and bring me to the emerge or send someone for my corpse.”

More on her later.

To gain admittance to the emerge wing, you go through triage which is manned by an EMT trainee – always – no exception that I have ever seen. You don’t see a nurse or a doctor until the trainee has practiced on you.

Rob assumes the position in one of two chairs they’ve set up for patient triage and the young man glances about with a slightly vacant but confused enough to convince me he is tracking mentally look on his face.

“Do you have paperwork?”

Protocol, people, it’s all about the proper paperwork.

“He’s having chest pains,” I explain, “the woman at admitting told me to bring him here and then come back for his paperwork.”

Big eyes. Falters slightly and then he begins intake while I head back for Rob’s passport to health.

At the desk the clerk has finished admitting Rob. She and her co-worker express horror at the fact that Rob is just 48. I am calm. That’s how it goes. Your spouse suffers from something that most people cringe away from and you are calm. Like there is another option, but people, by and large, find it hard to wrap their minds around. Been here before but forgot to get the t-shirt.

Meanwhile, the wild-eyed looking punk girl in the lobby is regaling the officers with her manic tales of suicidal intentions. As I listen, I gather that mental health services here are no better than in the States. The girl had been trying to get help for some time but units are full and the only way in is to suicide or state an intention to do so. She’d called the police, threatened to kill herself and they sent officers around to pick her up and get her admitted. She reminded me a bit of my brother when he is in one of his demonic up periods. I didn’t blame the others in the waiting area for seeking seats far away from her.

It took less than ten minutes to get Rob checked in and into a room. Chest pains rate a room as opposed to sitting in chairs that line the hallway. Which turned out to be good because an hour or so later, they brought a young man in on a stretcher and left him in the hallway – just across from the chairs – and he spent a good 30 minutes violently retching into a basin. Followed by another 15 or 20 minutes hacking up phlegm. I never did discover what happened to him though I knew that when Rob hit the 5 hour mark, the young man was still there. He’d been put in one of the cubicles and was no longer vomiting but they wouldn’t give him so much as a glass of water to rinse his mouth out because they were still waiting on test results. Canadian health care is big on assuming that anything could lead to surgery and therefore, no food or liquids.

Because of his history – Rob has a “history” now and it’s still something we are adjusting to – they followed the standard protocol.

Protocol demands two sets of bloodwork six hours apart and ecgs periodically over the span. In all, with the heart in play, expect to spend a minimum of 8 hours and as long as 12 being “observed”. And be advised that you could be in “emerge” for the duration.

There is nothing to do but wait.

We read and I occasionally broke the monotony by eavesdropping on the EMT as he admitted people.

One guy was quite interesting because it revealed something about the system here that in all ways but one is exactly the same as the plight of the un or underinsured in the U.S.*

He’d broken his arm.

A year ago.

He was in the Fort visiting his in-laws and his mother-in-law made him come to emerge because the arm was bothering him to the point where he couldn’t lift anything.

The nurse, and I, listened to his story and I suspect this is the norm for working poor.

He lived several hours away from the nearest health centre/hospital. He waited until the next day to go in because of the distance and he couldn’t miss a day of work. The x-rays revealed two hair-line fractures and he needed a cast but they wanted him to come back the next day for it. He couldn’t. A trip to the hospital cost him a whole day.

“It would’ve been seven hours,” he told the nurse. “I don’t have that kind of time to waste and the bus service ain’t that good. I wouldn’t have been able to get back until the day after.”

But as he was on vacation and in Alberta, health care works the same in Fort Saskatchewan as it does in Calgary, he let himself be talked into coming.

“i just need you to put a cast on it.”

Of course after a year it wasn’t that simple and the nurse finally gave up trying to explain it. She sent him to x-ray. Let the doctor deal with him – when he got the chance.

There was just one doctor on call. There is only one. There are five rooms and at least ten chairs plus a waiting room full of chairs. So in theory, the doctor can be responsible for over a dozen patients in varying stages of diagnosis and severity over the course of a shift.

The doctor this time – at least – discussed the situation with us and I actually got to listen in.

In the end, it wasn’t another heart attack. It turns out that the Lipitor is a hard drug and it could be that Rob won’t be able to tolerate the muscle pain it causes. Some people can’t. Some people are even debilitated by Lipitor as it breaks down muscle tissue in addition to scouring the veins of cholesterol. Lipitor actually triggered ALS in my cousin’s father within months of his starting it. He died a horrible death.

So it’s the Lipitor. The heart is okay. I am a tiny bit less worried about Rob dying on me anytime soon, but the ghost snuggled up to me in bed last night. Really. So things are apparently dicier than they appear.

*Universal health care sounds nice. You don’t have to worry about not being able to pay for the doctor visit or the trip to the hospital. But … isn’t there always? Drugs are covered. The time off work isn’t covered. And in a country where there are few big cities, many people live hours away from care. Getting to and from is arduous to impossible and that’s if they can afford to take time away from work or children. For the poor and working poor, the obstacles to care will always be. Just having access to care isn’t the end of the problem.