Canadian health care may not be as poor as the CBC would have you believe

This morning Heather Hiscox used a story about a B.C. man who has been unable to find a surgeon to operate on his pineal gland as her program hook to hold listeners and keep them from slipping away during the commercial break.

It was a good hook but proved to be a poor story. Heather Hiscox is a bright lady. I knew her at Western many years ago. She is a trained journalist. She has a Masters degree from the London, Ontario, university. Why can't she read this bumph before taking it to air and spike it rather than reading it.

Is Hiscox really nothing more than a talking head, a television personality? Has she forsaken her journalist roots? Here is a link to the story, headlined on the Web as B.C. man sells everything to pay for brain surgery in U.S. after being denied in Canada - Canadian system maintains surgery unnecessary for certain patients.

The U.S. study to which the CBC story links begins by stating "Surgical indications for patients with pineal cysts are controversial." A quick search of the Web uncovers an American doctor, Derek A. Bruce of the Children's National Medical Center, who posted the following on the Web:

I have never in my career, 43 years, found it necessary to operate on a pineal cyst. . . . The incidence of asymptomatic pineal cysts at autopsy is 10%. . . . Do not operate on this lesion until you are completely convinced that it is causing progressive hydrocephalus with symptoms.

Does the fellow in the CBC story need surgery on his pineal gland -- a gland buried deep in the brain. Maybe. It is a possibility. But another possibility is that the Canadian surgeon who said "it's not ethical to cut into your head for no reason" may be voicing a solid concern -- a concern shared by many American doctors as well as Canadian ones. Maybe this surgery IS unnecessary for certain patients.

I understand that American doctors face more threat of being sued for malpractice than Canadian ones. The fact, reported by the Los Angeles Times, that the doctor slated to do the surgery on the Canadian man "has been sued for malpractice about 17 times in his career" may mean nothing. And the fact that a judge said the U.S. doctor was "more interested in marketing than he was in medicine" may also mean nothing.

Still, the judge did find that the doctor "committed fraud when he performed an inappropriate surgery." Read the L.A. Times story, L.A. surgeon ordered to pay Maryland couple $800,600 in malpractice case, and make your own decision.

There is a story here. There may be a number of stories here. And one of the stories may find that a multitude of Canadians have undergone brain surgery at great expense south of the border for questionable reasons.

The other story may be that the resistance to doing pineal gland surgery is misplaced and it is time for more neurosurgeons to offer this option to their patients. Whatever, the story is not the one emotionally presented by the CBC reporter Rosa Marchitelli.

Mandatory flu shots for healthcare workers: Good or bad idea?

Are mandatory flu shots for nurses and other health-care workers a good or bad idea? The answer depends on the newspaper article and the reporter one consults. If you read The London Free Press you can be forgiven for believing mandatory vaccination is a critical weapon in the fight against the deadly flu virus. But do a Google search and you may find the answer is not so clear cut.

For instance, a report in the Cochrane Library states there is no evidence that vaccinating health-care workers prevents flu or its complications ( such as death due to lower respiratory tract infection) in individuals aged 60 or over. There is no evidence of a pressing need to institute compulsory vaccination of health-care workers caring for those 60 and over.

The Globe and Mail reports Dr. Michael Gardam, director of infection prevention and control at the University Health Network in Toronto, thinks the growing trend toward mandating flu shots to health-care workers is a bad idea.

According to the Globe article:

It turns out that the evidence in favour of mandatory vaccination policies is far from conclusive.

Just for the record, I personally like the flu shot. I get mine annually and as early as possible. I have heart and lung problems. I don't feel like sitting on the fence waiting for the definitive answer. If the shot doesn't help me, I am not worried that it may hurt me. In all the years that I have had the shot, I have never had a bad reaction and, it may be coincidence, but I have not had a serious bout of flu either.

This post is not an attack on the flu shot. I simply believe newspapers should strive to be more balanced.

Seniors are not embracing downtown living en masse

How truthiness is spread by the media. Image edited in Photoshop.

There is a myth, almost an urban legend, that aging baby boomers in high rise apartment filling numbers are forsaking their suburban homes to relocate in city centres. My local paper tells me the move to downtown is "typical of what's happening in other cities." But is it typical?

Joel Kotkin wrote in Forbes / Business a couple of years ago:

Perhaps no urban legend has played as long and loudly as the notion that “empty nesters” are abandoning their dull lives in the suburbs for the excitement of inner city living.

But there’s a problem here: a look at Census data shows . . . that rather than flocking into cities, there were roughly a million fewer boomers in 2010 within a five-mile radius of the centers of the nation’s (U.S.) 51 largest metro areas compared to a decade earlier.

If boomers change residences, they tend to move further from the core, and particularly to less dense places outside metropolitan areas.

It must be admitted that Joel Kotkin is not a promoter of downtown living at the expense of the suburbs. Kotkin has an agenda but, with all that out in the open, one must acknowledge that Kotkin may be right. Now, Kotkin is American but the figures in Canada tell a similar story. Using Stats Canada numbers only made available to researchers, a Concordia University study found "seniors prefer the suburbs."

Lookout Crt. view the equal of those from many apartments.

Capital preservation is a big goal of many retirees, if not most. It is not a fear of death that occupies the minds of many seniors but a fear of living -- a fear of living so long that they out live their wealth.

My home in Byron has three bedrooms, three full bathrooms, and a lovely view of the city from the side of the glacial moraine on which it is built. My property taxes, heating and cooling plus water and electricity costs amount to about $8610 a year ($717.50 per month). This is small change in comparison to the $25,200 a two bedroom, two bath apartment in a new luxury downtown London high rise might run.

This was a bad year for us financially. Our furnace failed last Christmas and we had to cough up some $8700 come March. We replaced both the furnace and the central air. This summer we had to have some extensive remedial brick work done. This cost about $1650. Still, even an expensive year in our home only set us back $18,960. We saved $6340 over living in a beautiful new apartment in the core.

From my Byron home I can walk to a couple of grocery stores, to three drug stores, an LCBO and more but I admit I often drive. I burn 17-cents of diesel fuel when I drive to the nearby No Frills and back. Am I an aberration? Not according to Stats Canada which reported:

Seniors do not use public transit more often as their main form of transportation as they get older. Nor does occasional use increase with age. Rather, the proportion who had used public transit at least once in the previous month declined with increasing age . . . 

I opened with one urban legend (seniors are moving downtown en masse) and I'm closing with another (many seniors choose to use public transit over the car.) Sadly, urban legends which feel true are all too often spread by an unquestioning media. Stephen Colbert had a word for this: "Truthiness."

The United States is not healthcare nirvana.

A recent newspaper story introduced a young girl with Ehlers-Danlos syndrome to tens of thousands of readers across Ontario and possibly Canada. The story originated at The London Free Press and was carried by many other papers owned by the same chain. The young teen has found it impossible to get treatment in Ontario and the province is balking at paying the out-of-province treatment costs — costs that can easily surpass the 100 thousand dollar mark.

If you didn't see the story, you must be wondering "What exactly is Ehlers-Danlos syndrome?" Answer: It is a group of inherited disorders affecting connective tissues — mainly skin, joints and blood vessel walls. According to the paper, the disorder "affects one in 5,000, only some of whom suffer the worst symptoms." The paper goes on to claim that this translates into about 100 Ontarians with Ehlers-Danlos with 20 of those having symptoms so severe their lives are consumed seeking help from doctors who don’t know what to do.

A little bit of quick, ballpark math says that a province with population of some 13 million must contain about 2600 people touched by the genetic disorder. It is interesting the reporter only discovered 100 known Ehlers-Danlos patients in Ontario. A little googling reveals why: The condition is under diagnosed. Doctors, both in Canada and the States, lack familiarity with it and there is no consensus regarding diagnostic criteria — this revelation is from the American Journal of Nursing.

But what really troubled me was the claim "there is speedy treatment south of the border." Not true. The wait time to see a specialist is often months and if the doctor does not accept insurance, or the patient is uninsured, the cost of treatment in the States may be prohibitive. One American with the disorder wrote, "I do not have insurance, nor can I get it privately. Testing and surgery will have to wait."

Read a comment taken from the newspaper's own Internet site:

"I'm in the US and recently was diagnosed with EDS after being told for 30+ years, on and off, it was all in my head too. I'm so sorry that you have to endure the ignorance of the medical community and the additional pain that comes with all that. I have been waiting for a list of experts from my insurance company in the US for 2 months now ever since my diagnosis. From what I am told, all the"true experts" in EDS are on the East Coast. I live on the West Coast 3000 miles away...like another country away and my insurance may not cover the referrals. This syndrome is probably not as 'rare' as it has been made out to be, just rarely diagnosed. It's time that doctors become aware and learn how to treat it. Keep fighting and keep having faith."

The treatment for Ehlers-Danlos is expensive. The newspaper got this fact right. And the costs are never ending. This can be a painful, genetic disorder keeping sufferers awake at night while giving medical insurance actuaries nightmares. To further complicate the financial picture, the Stateside specialist the young Canadian is seeing is an out-of-network provider.

About Health has this to say about out-of-network specialists: An out-of-network provider is one which has not contracted with an insurance company for reimbursement at a negotiated rate. Some health plans, like HMOs, do not reimburse out-of-network providers at all, which means patients are responsible for the full amount charged by the doctor. Other health plans offer coverage for out-of-network providers, but the patient responsibility is higher than it would for an in-network provider.

Read the Barbara Calder story in The Wall Street Journal: How U.S. Health System Can Fail Even the Insured. Calder has Ehlers-Danlos Syndrome but despite having health insurance she spent a year battling numerous roadblocks just to see a specialist who could diagnose her condition.

According to The Wall Street Journal:

Mrs. Calder's difficulties mirror those of millions of insured Americans who get lost in the U.S. health-care system's giant maze. For many, the journey is frustrated by coverage limits, denied claims and impersonal service.

When Barbara Calder finally succeeded at getting an appointment with a specialist, she learned the doctor had an eight week waiting list. Unfortunately, her husband had lost his job and their insurance was coming to an end. The couple could not afford the $1,267 a month in premiums.

Ontario has to do better. Our health care system needs improvement. In this, the newspaper position is dead-on. But health care heaven is not to be found just an hour or two down the highway.

Just as Canadians seem to be going to the States for treatment, Barbara Calder has been looking outside her home turf for medical help. According to the journal, Barbara Calder has been lobbying her husband and her children to move to Belgium, where she once lived, arguing that they could get good care there cheaply through the country's universal health-care system. One of the leading researchers of EDS is a Belgian geneticist working at the University of Ghent.

Calder's bright hopes for finding help in Belgium might come as a surprise to EDS patients living in the small, European country:

Every day is a kind of fight against the pain, the fatigue . . . but also against the institutions when you try to obtain support to cope with the disease". — Florence Simonis, president of the Belgian GESED (Groupe d'Entraide des Syndrômes d'Ehlers-Danlos — a support group for Ehlers-Danlos patients). She suffers from Ehlers-Danlos syndrome (EDS) herself.

A must read for those concerned with the state of journalism

The Sad Story of Canadian Geographic

Former employees say the nature magazine became a paid mouthpiece for oil companies and others.

Pizza that adhers to Weight Watchers guidelines

This thick layer of artichokes, sweet peppers, mushrooms and pepperoni is sitting a a pizza.

Dr.Oetker pizzas often go on sale. One can pick up the doctor's four cheese pizza for just under three bucks. My wife and I like to stock-up whenever we get a chance. We use these pizzas for the base on which to build our own Weight Watcher friendly pizzas every Tuesday night: our Pizza night.

One half a pizza, two slices, of our enhanced Dr. Oetker pizza is 14 points. That's a lot of points but not crazy high. We watch our points during the day, taking care to leave some head room, or in this case stomach room, for the pizza.

I add lots of mushrooms - no points, sweet peppers - again, no points, artichokes - no points, pepperoni - one point and hot pickled peppers - no points. Our pizza is filling, healthy (low in cholesterol and saturated fat) and delicious. (I precook the mushrooms, sweet peppers and pepperoni. This cuts down on the fat and removes some of the excess water from the vegetables. The hot peppers and artichokes go straight onto the pizza.)

Can we really afford to have this pizza once a week. I can't afford not to. I weighed about 215 pounds when I started eating Weight Watchers friendly meals with my wife. Today, I weight just under 170 pounds. My waist has dropped from 41-inches to about 37-inches. I may have to buy a new belt. I've tightened my present belt to the point that I'm running out of holes. I don't want to lose too much more. Please, pass the pizza.

Tasty can be healthy

Not a fine photo but it was a fine dinner. Maybe I'll get a better shot next time.

I don't recall how I discovered Elena Paravantes' blog Olive Tomato but as someone who regularly enjoys Mediterranean cooking I have found her blog inspirational. A recent post encouraged readers to quickly fry sliced zucchini and serve it warm with sprinkles of parsley and feta cheese. The picture that Paravantes posted made her zucchini look quite appealing. Inspired, I decided to use a both yellow and green zucchini as a side dish.

My wife and I are trying to adhere to the diet advised by my heart and stroke doctor while also trying to adhere to a Weight Watchers-friendly diet. This dinner met both requirements: low in fat, low in cholesterol as there's neither meat nor eggs but lots of fresh vegetables. This dinner delivered a Weight Watchers low point total.

The star of this dinner was potato gnocchi. At a little over 100gms per portion, the gnocchi contained only four points. It was boiled until it rose to the top of the bubbling water. After a minute it was removed using a slotted spoon.

Meanwhile the small tomatoes were fried in a little olive oil seasoned with finely diced garlic . The zucchini was fried in the same pan at the same time. Two minutes on each side in a very hot fry pan was enough for the zucchini. The tomatoes were removed when the skins began to split. Both vegetables were placed on waiting dinner dishes.

The chopped asparagus was tossed into the hot fry pan with a little more finely diced garlic. After a minute the gnocchi was added to the pan with the asparagus. At this point about 90 gms of Alfredo sauce diluted with an ounce of the gnocchi water was added. The sauce immediately began bubbling, thickened, and coated everything in the pan. A couple of tablespoons of chopped dill were stirred in and the mixture spooned onto the dishes with the zucchini.

While I cooked the gnocchi and asparagus my wife sprinkled parsley and feta cheese on the hot zucchini and tomato. Next, she sprinkled a little grated Parmesan onto the still hot food. With a small glass of wine, this dinner came in at only 15 points. It may have been even less. The only cholesterol was in the small amount of cheese and the light cream used in the sauce.

I have been eating like this for a little more than a year. I had my arteries checked a couple of months ago and the plaque has diminished. Of course, I am also taking some powerful drugs and so it is impossible to say to what extent the Mediterranean diet has been responsible for the improvement.

There is one improvement that I can credit to my new eating habits: My weight. I've lost some 45 pounds.