Sunday, November 22, 2009

Jobs for the boys...

An unusual title for an article, I’m sure you’ll agree. Allow me to explain.

In the past week or so, I've skated around something major that occurred in my life.  Nothing terrible, thankfully, but certainly made me a little introspective and most of all, grateful.

The next couple of posts will be about this incident and the repercussions from it.

The post title is an expression my Mother uses a great deal, especially when it comes to describing, specifically, cronyism.

Lately, however, she has been bandying it around with alarming regularity especially in conversation when it comes to Ontario’s oft negatively smeared health care system and the practice of referrals from one doctor to another. Most of the time Mum would liken a battery of expensive and possibly unwanted and perhaps unnecessary tests, all on the tax payers tab, to supplement the income of medical practitioners. For the record, this was the very same woman who had life-saving surgery earlier this year to remove an aortic aneurysm – two of them, in fact.

As we all know, Ontario’s health care system is beaten up so regularly by critics, pundits and armchair quarterbacks, there are times when it must surely feel like a piƱata.

There were many occasions lately, that I too, had to reluctantly agree with Mum’s point of view.

Until the other day, that is.

When we moved into the Kawartha Lakes region six years ago, we could not find a family doctor. My wife, Sheryl and I went on waiting lists. In Peterborough there was not even a true walk in clinic; there was one you could call, hope to get through and secure an appointment with whatever doctor was on duty in the clinic that day. However, if you missed a window of opportunity when the lines were not busy, it invariably led to disappointment. We ‘kept’ our doctors in Toronto.

In the late fall of 2008, we were advised that, if we were interested, a new-to-the-region doctor was opening a practice. Did we want to arrange an interview? This process allowed both parties to talk frankly with one another. It was at this interview that I first met Dr. Carolyn Brown.

Carolyn attended the University of Toronto where she received her medical degree in 1977. From there, Dr. Brown moved to Calgary Alberta where she completed the Family Practice residency program in 1979.

For the past 12 years, Dr. Brown and her husband Dr. John Ashbourne worked in Dhahran, Saudi Arabia.

At the end of the interview, we agreed that we would ‘test drive’ each other. Sheryl, too.

In the spring of 2009, Dr. Brown scheduled a full physical for yours truly. From that, I was referred to an allergist (nice enough fellow) but I could have confirmed I was allergic to cats – we have five of them. Due to chronic sinusitis, I also saw an ENT specialist and ended up having my sinuses cleaned and scraped – again.

Due to my being a certain age and the fact I am diabetic, have experienced elevated blood pressure and cholesterol issues (all well managed through medication and lifestyle) and a family history of heart issues on both Mum and Dad’s side (mild issues), she wanted to refer me to a cardiologist, Dr. Brian Mackenzie – for a thorough look see, to establish a baseline. I had never exhibited any symptoms, chest pains, shortness of breath – nothing directly associated with a heart issue.

“Here we go again,” I thought as I heard my Mother’s voice repeating her cynical mantra.

A series of tests was ordered over a six week period, including an EKG, being installed for a Holter monitor (this also involved vigorous and quite random shaving of my chest) and finally having a stress test where a radioactive substance, Thallium, was introduced to my system through an intravenous line as I exercised on an ever-inclining treadmill. Images are taken then and a few hours later.

A couple of weeks later I sat down with Dr. Mackenzie and we reviewed my results. Now, as many of you know, I have rediscovered exercise after having a hip replacement three years ago. I would work out at least five times a week, usually an aggressive cardio session, taking aerobic classes with spandex-enrobed nymphs and older folks like me who wanted to be healthier. Anyway, it seems that there was something ‘unsettling’ that he could vaguely see on the images. Given that I had exhibited no symptoms, he spoke of anomalies and false positives. He did, however, advise that the only way to be certain was to undergo an Angiogram which he then explained in detail.

At this time, Sheryl and I were about three weeks from moving house and we were up to our ears in boxes as we packed. Plus, ironically enough, I was completing ‘The Bug Stops Here©TM’, an innovative educational comic book project for Peterborough Regional Health Centre. Timing was not great. We compromised and agreed that we would schedule the procedure for shortly after the move.

October 23 was the day. Reluctantly rising just after 4.00am, downing a couple of thick double espressos each standing over the kitchen sink, we drove the two hours from Barrie back to Peterborough. Sheryl sleepily asked where my insurance policies were and inquired if they were up-to-date.

The hospital staff we encountered that day at PRHC was fantastic. Caring and human. Treating all including, this big lug, with respect and dignity. One nurse, Cathy, proudly told me she had recently completed her power tools course at a large box store as she wielded an electric shaver and proceed to create a crude and rudimentary ‘Peterborough landing strip’ in my groin! Any questions I had, they answered. When I joked with them, they joked right back. Without crossing any line, real or imagined.

My surgeon for the procedure was Dr. Peter McLaughlin. He spoke with me beforehand and described in detail what he was going to be doing. I was kept comfortable and warm in very a cold environment and given a mild sedative to take off the edge.


A short time later, I was wheeled into the procedure room, an even colder place like a walk in meat locker (sic) with monitors, wires, much expensive-looking equipment and what I thought was way too many people.

I was covered with special blankets to shield most of my body from the potential harmful rays of the diagnostic imaging equipment that would monitor the progress of the wire that was inserted though my groin and travelled up into my heart. Images were taken from all angles and finally, a contrast dye was injected so that definitive pictures might be taken. This was an odd sensation. I was forewarned I would feel a warm flush-like sensation. I thought that my bladder had voided then and there on the table!

Moments later, it was done. The actual procedure likely took less than 15 minutes. Radiation vests and spatter guards were removed and I was returned to the recovery area. To my safe little cubicle with beeping monitors and friendly faces.

Presently, Dr. McLaughlin came in and asked how I was, then punched a few keys on a multi-coloured keyboard and brought up an image on the flat screen monitor. I listened intently as he spoke softly yet with gentle authority.

One of my heart’s arteries was 99% blocked with plaque. I heard 99% and it seemed to echo in my mind for minutes. McLaughlin explained everything. And although not completely unprepared, I managed to ask reasonably intelligent questions. For the record, cholesterol is 80% hereditary, 10% environment and 10% lifestyle.

There are three courses of action; medicinal (pills); PCI (Percutaneous Transluminal Intervention; and, a coronary bypass. Even while we were talking, Jeff Dunlop, the energetic Regional Cardiac Care Coordinator was burning a CD of my images and preparing a package to be overnighted to the Angioplasty group at The Toronto General Hospital.

I was contacted by TGH a few days after the angiogram and was advised that an angioplasty was scheduled for November 12 and would be performed by Dr. Paul Daly. There will be a pre-op consult November 6. Things continue to move forward in an expeditious manner.

So there we have it. No symptoms, no obvious warning signs and more than likely, within a few weeks I will be in Toronto having the problem fixed – one way or another.

So, the maligned system can and does work. For me, at any rate. Jobs for the boys? Perhaps, but to everyone at PRHC – my thanks. Especially Melanie, my lead nurse. To Dr. McLaughlin and Mackenzie – sincere thanks and gratitude. To Dr. Carolyn Brown; I will never be as skeptical again about the medical profession. Your professionalism, doggedness and diligence led to my heart problem being discovered.

For that, I will always be grateful.

Thursday, November 19, 2009

Nothing quite like it...

OK. Hands up all you readers who suffer (is there any other more appropriate word?) through either an occasional or frequent migraine headache? OK, sisters, hands down; we know all about you!

I come by mine honestly enough; both my Mum and Dad had them as adults but pretty much grew out of them in later life. I'm told that I was a ‘victim’ as far back as my infancy.


Fast forward a decade or five and on the morning of November 12, I came down with one for the books.

Readers will know this was the day I was a ‘guest’ at the Toronto General Hospital. I was to have an angioplasty (more on that in other posts). Waking up at 4.00am that morning and crawling from the warm comfort of bed, I realized that I had a headache. Just a headache. Given I was under instructions not to take anything by mouth from midnight on (dinner the evening before was finished at around 7.00pm -- dubbed, The Last Supper by TLATO); I declined to chew on a few generic-branded acetaminophen with codeine. Also, no two, double espressos this morning. And, I drove to the hospital through darkness and soon-to-become-searing headlights.

By the time I was checking in on the 6th floor of the Eaton Wing at TGH, my once annoying headache had begun to mutate.

There was absolutely no anxiety on my part regarding the pending procedure; I was actually looking forward to it and could not blame the war drums in my temple as being symptomatic of (obvious) stress. I will put it down to not enough sleep, any breakfast and caffeine withdrawal.

Sensing I was not feeling 100%, the ever attentive Danielle, my day-shift nurse that morning, gave me a couple of Tylenol. Way too little, way too late.

At around 11.30am, an orderly arrived to take me to the catheter lab on the second floor. Well-meaning, he began to ratchet the head end of the gurney, causing mini whiplash-like incidents. By the time I was in the elevator, the small piercing lights were already searing into my eyeballs. I felt horrible. Nauseous. Pain sweats ensued. By the time I was wheeled into the very cool procedure room, I was in the throes of a full blown migraine attack.

The cardiologist took one look at me and requested a complete scan of vitals. All was well. Except, of course for the pain in my head. They determined that the procedure would proceed and since I am allergic to morphine, shot a dose of fentanyl into my IV delivery system. For good measure, a nurse stayed by my side with cold compresses – and a vomit bucket.

The lights in the procedure room were unlike anything I had seen before -- unless you count two weeks previous when I went through an angiogram. There lights are unusually bright and depending upon what is occurring in the room, blink on an off. Even through closed eyes, I could still feel their effects.

Due to the fentanyl I did not even feel the dye being injected into my heart. The pain over the next two and a half hours did begin to diminish, but not vanish.

In post op, I was provided with Percocet -- and a fresh gown.  Dehydration due to profuse sweating did not help my condition any.

For the rest of the day, I was prescribed additional Percs and ultimately Gravol since the nausea returned with a vengeance.

By the time I was taken from my bed and made to walk the 6th floor, the migraine had pretty much been conquered. Thanks to medication, rest, TLC, a cheese sandwich -- and lots of ice water.

Much like my parents, the frequencies of these often vicious and debilitating attacks are reducing.
But they can still occur. Sometimes without any warning whatsoever.

As much as I hate them, over the years, I have learned to respect them. Sound weird?

Obviously, you have never had the unfortunate pleasure...

Monday, November 16, 2009

Say what...?

Just last week I was a guest at one of Toronto's largest hospitals, Toronto General Hospital.

Located on the eastern edge of Chinatown, this world class facility is a part of the University Health Network.

Now before we go too much further, let's not misunderstand anything here; this entry is only intended to have you scratch your heads and 'say what?'

So, while 'checking in' at 6.25am on the morning of November 12, I was to be admitted to the 6th floor, East Wing in the Peter Munk Cardiac Centre until approximately 10.00am the following day.

Thanks to an exhaustive pre-op conference the week before just about anything and everything I had experienced health-wise was on file.


That morning, I was, once again asked if I had any allergies. Affirmative; morphine. Hold on, what about cats? What about sulfites? What about MSG? Morphine is, for me, a deal breaker. It's serious. I neglected to mention the other three since I was in a hospital and did not think that I would be served Asian food with a glass of bad red wine while stoking a purring feline. But ever cautious as hospital staff are, a special allergy wrist band was prepared. Fair enough.

After a successful procedure and some time spent in recovery, I was shuttled back to my semi-private room (could have had private but I could not remember if my insurance (for which TLATO and I pay a healthy monthly premium covered me.). No matter

Lying relatively still for the next four hours or so, my nurse at that time, Danielle, inquired if I would like some dinner. Now remember; no food had passed my lips since about 7.00pm the evening previous. I was famished. A request was made that come suppertime, Mr. Taylor would like a hot meal, please and thank you.

A couple of hours later, a sheepish individual from the hospital kitchen left me a tray and said that there was no hot meal for me this evening. A plain cheese sandwich would be it. Did my 'request' come down too late? Au contraire. The hot meals being 'served' that evening, all apparently contained MSG.

This became the talking point at the nurses’ station.

Go figure. A world class health facility, preparing food with a major preservative which many people react to.

I may have been better ‘served’ ordering broccoli with beef from a nearby Asian restaurant.