Category: healthcare

Notes on Canadian Healthcare

August 23, 2025

While sitting on the porch facing the lake with my laptop open on the table, healthcare unexpectedly came to mind. It was a perfect summer morning, and with a coffee in hand, I thought about how true it is for a healthy life to live with and enjoy nature.

 Canadian healthcare has a good reputation, particularly outside the country. Although it is a universal system, accessibility remains an issue, especially for those without a family doctor. Twenty percent of Ontario families have no family doctor. These individuals end up seeking medical assistance in emergency departments, where there is a shortage of emergency physicians and nursing staff. Because of that, many emergency departments have been forced to close for a day or even a week.

A tragic example highlights this issue: a sixteen-year-old boy arrived at an emergency unit and was triaged as a “second” priority patient. This designation means that a doctor should ideally see him within fifteen minutes. The boy received attention only several hours later. He ultimately passed away due to the delay.

Not in the same horrid category as the above example, I had experience with our healthcare system recently that raised some questions in my mind. I twisted my leg, which made walking quite painful. After a few days with no improvements, I visited my family doctor, who provided requisitions for an X-ray and an ultrasound to determine what was wrong with my knee. However, I expressed my concerns about the long wait times for an ultrasound— the imaging center near us has openings in six months. She heard from other patients about the long wait times and suggested an imaging place on the east end of Ottawa, where one of her patients had the treatment in a month. I wondered if I really had to wait that long to find out what was wrong with my leg before any treatment could begin.

In the meantime, the doctor gave me Voltaren to help alleviate the pain, but it didn’t work for me. As a result, I scheduled an appointment with a physiotherapist, who used needling and massage techniques on the painful area and prescribed some exercises. I noticed significant improvement within just a few days.

I went to the doctor with the expectation that she would diagnose the issue and recommend a treatment plan. Instead, she provided me with requisitions for further investigations. Since the pain has been subsiding with exercise the physiotherapist suggested, I have not followed up with the requisitions. The doctor did not mention physiotherapy as a treatment.

While speaking with my family doctor, I requested a prescription for an EpiPen. I had one previously, but it had expired. She informed me that my records did not indicate a need for an EpiPen, so she was unable to prescribe one. I do not know what policies exist for prescribing EpiPen. I reminded her that I had used an EpiPen for ten years. However, she reviewed my records with this medical group that goes back six years, and there was no documentation of my previous EpiPen use. (We joined this medical group when our previous family doctor retired, and the practitioner we initially started with did not request my medical records although I offered to get it). I also mentioned to her that I had a wasp sting incident after stepping on a wasp nest. Following that, an allergist gave me shots for a few years to build my resistance to wasp stings and prescribed an EpiPan for ten years.

Following my explanation, the doctor gave me a prescription for an EpiPen. Still, this experience made me realize that a lifetime healthcare data system would be highly beneficial. Everyone should have their complete health history in one place.

I have access to my health history that is on multiple data systems. Two of the three hospitals that I visited in Ottawa use a system called “MyChart” that includes all my testing and hospitalization data. The third hospital in Ottawa uses another system called “ConnectedCare” and has my history with this hospital. Then I use a lab for blood work and other tests, and I subscribe to their data system to access their results. And, of course, my family doctor receives data from all of these systems. What is missing is the history from my retired family doctor, when most of the data was handwritten.

But beyond medical results, we use other health-related experts. We visit dentists, optometrists, physiotherapists, personal trainers, and other health care professionals. Wouldn’t it be beneficial to have all of this information together in one system?

Regaining Your Mojo After Tick Illness

July 22, 2025

Have you ever lost your mojo? Your ability to function? Do you enjoy making decisions and following through, but have lost the ability to do so? Have you ever felt in the dumps, with no ambition to do anything? Tired and spent, and the only thing you can do is sit around and maybe have coffee? In other words, you have lost interest in life and feel incapable of accomplishing anything, searching for a sense of purpose.

What would cause such a state? Perhaps you lost your job, were reorganized out of a job, or what they call today, the organization was right-sized! You may have lost your home to one of the out-of-control fires that have been spreading in many states and provinces. I lost my mojo due to a tick, a small bugger no bigger than a poppy seed. They are small, and most of the time, when they find you, you do not feel them. But when they get hold of you, they gorge on you and swell up, and that is when you can see them. If you discover them within twenty-four hours, you should liberate your body from them and go to a pharmacist who will give you a double dose of prophylactic, and that is the end of it. If, however, you never see and feel them, they can create havoc with your body.

I suffered the consequences of one of those nasty critters, ending up in the hospital for four days, trying to get my health back via IVs dripping medicine into my veins and also taking doxycycline for over a week. Yes, I lost my mojo for a few weeks; I was tired all the time, with no ambition to do anything.

When I was well enough to leave the hospital and, in a week, return to the cottage, most bothersome was my paranoia about walking in the tall grass around the cottage, the natural home for ticks, and fearing another one of those tiny monsters crawling on me again. I did not want to go through the hospital routine once more. So, what could I do?

I discovered a jacket in one specialty store that is both mosquito-proof and, more importantly, tick-proof. I had to have one of those. Based on this finding, I searched for other clothing that is tick-proof but could not find any, except for a pair of pants called “bug pants”, in an outdoor store, that are designed to protect against bugs. So, I had to have one of those. To protect my head, I decided to use my wide-brimmed Tilley hat, which I sprayed with an anti-tick chemical. Now I was ready to tackle the outdoors again. Once dressed, I felt as if I were in a hazmat suit. The bug pants and the protective jacket were hot, especially during the heatwaves.

I was still paranoid going to the cottage because that is where I think the tiny and nasty critter attached itself to me, sending me to the hospital. The problem was the tall grass that I had to cut back and trim down. Although I have a corded weed eater, I decided to buy a battery-powered one to reach every corner of the yard, both up front and in the back. There was no question in my mind that I had to clear the entire property of tall grass to make sure ticks would not feel at home there.

In addition to buying protective gear, I learned that I should also pull up my socks over my pants to create a firm closure so no ticks can wander onto my skin. Another tip I learned was to visually inspect myself when entering the cottage to detect any ticks on my clothing that I should remove, and also to check my body for ticks at night while showering. And place all the clothing I wore outside into the dryer to kill any ticks that may be on it.

Whenever I went outside the cottage to cut the grass, dressed up with all the protective gear, I felt nervous. But I knew that I had to overcome this fear and try to regain my mojo, the confidence to take care of the yard as I used to do before. And I am succeeding; the more times I work outside, the more comfortable I feel now.

My gout story; Canadian healthcare

February 14

When I woke up one night with a pain in the first digit of the middle finger of my right hand, my first impression was that it had to be gout. I had some gout flareups before and it always started with sudden pain during the night. The weirdest thing is that once it happened in Dawson City after we hiked the Chilkoot Trail in Alaska and the other time it happened in Chennai, India when we did charity work. Perhaps it happens during unusual and maybe stressful times, although I remember it happened at home, in Ottawa years ago as well. The usual treatment has been some anti-inflammatory tablets for a week. But not this time.

I wanted to see my GP but met a doctor substituting for her, whose first comment was that my swelled digit was a powerful middle finger to show someone to bug off – said in jest and taken as such. Then he sent me for an x-ray and gave me a prescription for anti-inflammatory medicine. And come back in two weeks. So far, so good. When I returned, I was scheduled with another doctor. She said the x-ray did not show gout and said I was on the right track. Then she examined all my fingers and toes and noticed that I had a toe enlarged by an accident a few years ago that never healed properly and looked like gout with puss oozing out of it. So she prescribed anti-biotic medicine for me and another anti-inflammatory to speed up the healing. Again, come back in two weeks. This third visit, with yet another doctor at the clinic, told me I was improving and took pictures of my finger and toe. The next time a fourth and again, a different doctor said that I was on the right track but sent me to a rheumatologist to deal with my gout for the long term and also noticed that one of my toes is pink, indicating perhaps that blood circulation is lacking and therefore sent me for an ultrasound test for my vascular system. Aha. I saw four different doctors, all subbing for my GP,  sent me for tests, and prescribed medicine. Now you would consider that our medical system is great. And it is and was accessible for me; appointments secured quickly. But was I over-medicated? In previous bouts I have had with gout, a doctor gave me one prescription to reduce the swelling and decrease the pain and that was the end of the treatment.

I told the four doctors my history with gout; I had flareups once every five to ten years and in total not more than half a dozen times. And each time, they treated me with medicine that lasted a week. This time, the doctors treated me differently. Perhaps they intended to solve my recurring gout on a more permanent basis; if so, I did not understand why. I was wondering, though, about the cost to our medical system.

I was happy to get an appointment with a rheumatologist quickly but disappointed in having a remote consultation. I explained on the phone what my gout looked like but I would have preferred if the doctor saw me in flesh before prescribing a couple of medicines that I understood to be taken for life. This was another one of today’s health care practices: remote consultation. After the consultation, I read up on gout and found that diet has a major role and with an appropriate diet, one may reduce flareups. I would much prefer to use dieting to taking pills for life, and at least have the pros and cons of this more moderate approach explained to me.

The rheumatologist also sent me for a blood test to provide a base case for “uric” acid that triggers gout. The doctor probably assumed that my level of uric acid was high. Imagine my surprise when the results came back, showing that the level of uric acid in my blood was right in the mid-range of the acceptable level.  When I inquired why to take pills when my results followed recommended levels, the doctor told me she would like to see the uric acid level further decline in my blood. It made me think perhaps I should have had the blood test first, based on which to prescribe the type and amount of medicine.

Healthcare was accessible to me and practiced by well-educated professionals. But I had a feeling that I did not have one doctor who knew me and my history and advised me accordingly. So each doctor gave me his/her best opinion and prescriptions, but continuity was not there. I thought that perhaps the first doctor who saw me should have taken the pictures that subsequent doctors could use in examining my gout. And I was quite willing to see the rheumatologist in person instead of remote consultation. But I was not asked if I preferred it. Frankly, I am confused about how our medical system is delivered; whether it is cost-effective, and whether it is patient-centered.

I consider myself extremely lucky to have seen five doctors in six weeks, triggered by a gout attack in the first digit of the middle finger of my right hand. This is when people are searching for general practitioners with a short supply of doctors and when elective surgeries are postponed because of Covid. I was given five prescriptions, sent for a blood test, an x-ray, and an ultra-sound. I was overwhelmed.