Alberta HealthCare


English: Alberta Health Services logo from vis...

… in which case, it’s a hodge-podge of incredible inconvenience, outdated ideas and control freak issues.

One of the reasons I wait to go to the doctor until I absolutely can’t home remedy myself to semi-functionality is that the system created by Alberta Health, and zealously overprotected by the medical profession here, sucks sweaty donkey balls.

Factoring access issues out (because family doctors – who are the gatekeepers to all other doors unless you opt to simply brave the emergency room), the main problem is timeliness coupled with time sucking runaround.

Back in Iowa, I could call my doctor’s office and generally get in to see her the same day. X-ray and lab were on site, so there was never a need to run about the city and diagnosis or action plan was meted out at the same appointment.

If I needed to see another doctor or have additional tests, it happened within a couple of weeks. Only rarely did one wait a month or more during the diagnostic phase. A good thing because though most issues are minor and not life-threatening, one can’t really know this for sure in the initial stages. Timely diagnosis is more than a little bit crucial. And so is treatment – depending.

Here it is a very different story. Nothing is on site at the doctor’s office. Nothing.

X-rays? They send you over to queue up at the hospital behind in-patients and the rabble choking the ER.

Blood tests? There is a lab at the hospital and a private lab over by the Starbucks. The doctor will get back to you with the results in a few days. Maybe.

Need a referral? Sometimes the PCN, which is the overlord of the system, will be notified and when the scheduling nurse gets to your referral (they will tell you to call PCN if you haven’t heard anything in a month’s time), she/he will call the office of the doctor you’ve been referred to and set up the appointment for you. You are notified and then asked if the time works. You will make the time work because rescheduling will only throw you further down the list.

Once you have been seen by a doctor, you are theoretically allowed to call and schedule further appointments for yourself. Or not. Sometimes, it’s back to the referral mill for you.

Which is where I am.

My doctor easily granted the referral I needed and told me she’d fax it that same afternoon. However, when I called this morning to make the appointment, the receptionist informed me that, “We don’t take faxes. Only phone calls. Your doctor will have to phone us.”

Which won’t happen. Doctors don’t make their own phone calls. The PCN does it for them. So instead of possibly snagging an appointment in early September, which is where the bookings for the doctor I need to see are currently, it could be October or November because I am now relegated to PCN nurse scheduling hell. Phone tag and “no, that day doesn’t work”.

What doctor doesn’t use fax? Or email. Or e-script to pharmacies?

Doctors in Alberta, that’s who.

Is this the 21st century? Because it is in Iowa and has been for the past decade and a bit. I – O – W – A! When you are more backwards than a corn belt state in the Midwest of the United States, it’s time to be concerned.

Every doctor in Alberta is physically welded to a laptop, but that’s as far as the future goes. Everything else is 1970’s. This includes office decor and hospital rooms. Going to the hospital or doctor’s office here is like stepping back into my childhood pediatrician’s clinic (which housed an x-ray, lab and multiple specialists under the same roof – back in 1971).

I am half-way tempted to just say “fuck it” and see if my sister, DNOS, can’t get me an appointment with her doctor when I am visiting next month.

This is ridiculous bullshit. Our tax dollars pay these people and Rob’s paycheck is docked considerably to purchase the supplemental insurance which keeps us from, among other things, having to beg for pharma samples. A lot of money goes to the cause of the Alberta Health System treating us like inconveniences between them and their provincial paychecks.

On bright side, the odds of my current physical woes being fatal are low. Not nothing. But low. As a Canadian, I am supposed to rejoice in that because “at least I won’t lose my house like people in the States do”, which is a fallacy for another day.

UPDATE (July 16) – Four phone calls to the office of DR I need to see, and three reminder calls to the DR who is referring me late, and I still have no appointment. And there’s no way around this. The local network that “controls” this section of the province is only a database that would – at best – point me to yet another gate keeper to restart the referral process. If Rate My MD is to be believed, the vast majority of my other local choices really suck. The guy I want to see is the best going even if he has zero personality and less bedside manner than is typical even for here. At this point, the only way to speed things up would be to just park in the ER where – at minimum – I would at least get the tests I need and some sort of confirmation as to whether my issue is trivial or something that needs more investigating.  We leave for holiday inside the month and a quick Google of my Iowa hometown revealed that despite having a population of just under 58,000, it boasts as many specialty DR’s of the type I need to see as the area where I live, which is approaching 1,000,000, give or take. Worse case is, according to my sister, I could easily be seen and screened over our three week stay. I’d rather not do that. I am Canadian enough at this point to look down my nose at the sort of person who queue jumps or, worse, flaunts their economic privilege by heading south of the border. It’s one thing to get your dental work done in Mexico when you winter over in the American Southwest or take a winter siesta from Canada’s winter, but quite another to use the US healthcare system. However, I am a little bit worried and my husband is more so. His past experiences with “the system” are more unpleasant than mine, and I would prefer he not have to go through anything similar with me. Today I am feeling stoic (though I came close to tears when talking with the refDR’s receptionist), and I will give it another day or so. All bets are off after that. Patience is a seldom rewarded virtue in the diagnostic stage of unknown medical issues. I learned that quickly when my late husband was stricken. Squeaky wheels inspire momentum if only to get you moving quickly to the next leg of the journey so that you are someone else’s pain in the ass.


The change in ribs

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They say that chest pains should never be ignored. Rob refused to give his credence and look what happened. He could easily have died last summer.

So when I woke with chest pains in the wee hours Wednesday morning, I debated about 5 minutes before waking Rob.

I’d been seeing a physical therapist for rib pain that I thought stemmed from a neck/shoulder injury and just really bad desk ergonomics, but the pain I felt at 4 A.M. was across the top of the chest mainly and in the breastbone, so off we went to the E.R.

The E.R. in the Fort is a dicey proposition. The doctors are hit/miss in terms of interest and bedside manner and the nursing staff even mores so. But we lucked out, and there were just three other patients already in rooms when there could just as easily have been sick folk packing the lobby and stacked in the hallway like cord wood.

The doctor was foreign. They are all foreign. I don’t think white people pursue medical careers in Canada. And he was very young. My own doctor is Indian and not even as old as Edie. As a result, I am not quite sure if I am simply being imprecise with my description of what ails me or they are working from different English grammar book than the one I used to teach 7th graders with. Regardless, I always end up feeling frustrated and cut off, but eventually, the Dr. Ali Baba seemed to understand what I was trying to say.

Part of the problem was that I couldn’t fix on what the pain felt like other than it hurt and the doctor and nurses kept trying to spin what I was saying to match up with their checklists.

But Dr. Ali Baba did at least exam me. Canadian doctors so rarely look up from their laptops, let alone put them down and lay hands on you that I am beginning to wonder if they have divine powers.

Diagnosis? Costochondritis. An inflammation of the cartilage that connects the ribs to the breastbone. It can result from injury or from overuse or as a result of a chest infection. I am three for three on all counts this last six weeks.

Prescription?

“Rest your torso,” Dr. Ali Baba said.

As the torso makes up, well, pretty much everything that isn’t appendage, I am struggling with that and the contradiction …

“And also exercise and stretch.”

The nurse came in with a trainee who then was allowed to practice on me. The doctor ordered an injection of an anti-inflammatory which hurt probably more than the inflammation, and after it kicked in – we were cut loose.

Dee, naturally, had to be awakened from a sound sleep for our trip in. To her credit she was a trooper and betrayed not even the slightest bit of worry. She gets that from Rob.

Rob dubbed me an “official crisis weenie” though because I was a bit more than a little freaked out.

Well, duh. It was chest pains and he nearly died last summer.

But, I am a marathon girl not a sprinter, I need time to adjust and slip back into sanguine. Perhaps I should look for that meditation teacher and build up my calm muscles?

Yesterday then, and today still, I feel worse than I have for a week. I am propping myself in front of the infrared heat lamp and getting ready to sauna again before lying down to read on the heating pad. I have to teach yoga tonight, and I need to build up a bit of ease in the trunk, but in all likelihood, my students might spend the entire class prone.

This couldn’t have come at a worse time. Drywalling looms and Rob was counting on me at least to be his helper for the duration because the older girls and Sliver have limited time off to help.

In yoga, they say that injury is a sign to slow down. When one is moving too fast and doesn’t recognize the subtle signs that leisure and contemplation are necessary, it whacks you. And I won’t deny that I have been thinking and pondering changes and that be more mindful and leisurely would help facilitate the process. So, universe, duly noted.

But the ribs? Seriously. A little carpal tunnel wouldn’t have been done just as well?

 


Stress at a plane with an arbitrary orientatio...

Image via Wikipedia

Our entire summer could easily qualify as pushing the emotional boundaries, but aside from a few ER trips and a two nighter at the hospital, it hasn’t pushed me physically over the edge.

During the years I took care of my late husband, solo-parented and held a full-time job as a middle school teacher, I regularly broke physical stress limits.

I averaged 5 hours of sleep a night, worked out sporadically and ate just as haphazardly. When the body protested – and it manifested its displeasure vehemently – I ignored it.

“Suck it up, Buttercup.” Was my response. And for the most part it did and gave me what I wanted.

Today the old bag of bones is not so willing.

Less than 7 hours of sleep?

I don’t think so, says the body. We will now be sick.

Seriously, my body goes on strike if it is asked to do anything even remotely reminding it of days of yore.

So, this summer’s events have really only pushed my emotional buttons and redirected my thoughts to dark places I remember but have no real interest in revisiting.

This morning the phone rang. And rang. And rang.

Not quite 9:30 and I was still in bed.

Vaguely I recalled Rob getting up earlier and wondered why he wasn’t picking up, so I scrambled across to his side and grabbed the receiver from the nightstand.

“Hello,” I wheezed.

“May I speak with Robert?”

Robert is official. Someone who has business with him calls him “Robert” whereas telemarketers ask for him with a “Mr” followed by a rather East Indian pronunciation of our last name.

“Hang on,” I tell the woman as I scramble into my robe and head down the stairs to hunt up my husband.

He is nowhere but Dee is in the kitchen getting her breakfast.

“Where are the waffles?” she asks.

“Where’s Dad?” I reply.

“Oh, I haven’t seen him,” she tells me.

I have sent her out to the garage to look for him before I remember he had a doctor appointment in town.

“May I take a message,” I ask.

“This is a reminder about his stress test tomorrow with Dr. La at the crack of dawn,” and she begins to ramble off instructions for preparation.

“What?” I interrupt. “He has an appointment tomorrow? I thought it was this afternoon. No one told us about tomorrow.”

“Yes, ” clearly she is annoyed. She is a robo-receptionist and I am asking questions that prevent her from merely vomiting information and moving on to the next patient call on her list. “well, today is the rehab intake and tomorrow is the stress test.”

Which tells me all of nothing and it par for the Canadian medical experience course. In fact, I think the motto of Alberta Health is “information is for the professionals; just listen and obey”.

“He should take all his medication as usual, eat a light breakfast, dress appropriately as he will be on the treadmill and refrain from smoking prior to the test.”

Smoking?

When Rob got home, I told him about the appointment.

“Oh, it’s probably about my back to work release,” he said. “What time do I have to be there?”

“Dawn, more or less.”

“Really?”

We live outside of the city, an early morning appointment – factoring the rush hour means everybody up and ready with the sun – or there ’bouts.

“That’s pretty early for you and Dee,” he remarked. “Assuming you are coming along.”

“I was planning to. Don’t you want me there?”

“Well, yeah, just in case I drop dead it would probably be a good idea.”

“I wish, ” I replied, ” I could say that it hadn’t occurred to me that you might die, but it totally did.”

Why? I mean people take stress tests every day and mainly survive. My near 80 year-old mother just had one in the spring and emerged just tired.

Rob’s late brother-in-law, however, dropped dead after his.

I suppose that’s what they mean by “context”.

I reminded again by all this that I haven’t cried. Teared up once at the hospital the day of the angioplasty when they “lost” Rob for about an hour, but haven’t cried.

It’s like I am waiting for something to cry about because, as it’s been pointed out to me, nothing awful has happened to me.

And the point has been taken. So I suck it up like the Buttercup I am.