Let me share the remarkable journey of one patient. At 48 years of age, Gerry was a hockey coach, a personal trainer and in the final training stages for a triathalon. While doing upright rows, one day, Gerry felt a deep pain in his back followed by a burning that radiated down the outside of his leg. Three months later the only thing that changed in Gerry’s world was that the pain increased. Despite trips to his doctors, he had yet to receive any medical intervention.

You can read the full article at Canadian Chiropractor.

• Months waiting for a CT scan: Three.
• Months waiting for an MRI: Six more.
• Months waiting for meeting with neurosurgeon: 19
• Number of pain-killers taken each day: 25
• Months spent in bed unable to move: 18
• Number of times he thought of taking his own life: At least once.

The easiest way for him to track the long wait for help, and the hardest to stomach, is to look at his seven-year-old daughter.

“I haven’t lifted my daughter since she was born. I have never picked her up. I have never been able to.”

The latest number was too much to bear: A note from a London doctor saying Jubenville could indeed get an appointment to consider botox injections to alleviate his constant headaches and pain – in 29 months.

Tired of waiting, Jubenville called a Windsor company that specializes in getting Canadians out of Canada for medical treatment.

The company, International Health Care Providers, found a U.S. doctor who does the botox injections.

Jubenville called the doctor’s office.

A receptionist got back in an hour. What she said made him laugh.

“Well, first of all, I would like to apologize for the wait, but I can’t get you in until Thursday.”

Jubenville still laughs about it an interview a week later. “I was expecting months.”

Jubenville is one of thousands of Canadians leaving the country each year to get medical help. Patients call it surgical or medical tourism, partly because many companies offer recovery in a resort.

Some companies that send patients abroad prefer to call it global health care.

Whatever it’s called, it’s a thriving business.

In a three-part series that begins today, The Free Press takes a look at the business and politics of medical tourism and profiles some of the ordinary Canadians seeking treatment elsewhere.

Companies that send Canadians to the U.S., India, Costa Rica, Europe and other places are springing up each year.

It’s difficult to get a handle on the number of Canadians heading overseas or across the border in the U.S. for help, but it could reach the hundreds of thousands.

“Medical tourism has always been with us,” says Dr. Jeff Nisker, co-ordinator of health ethics for the Schulich School of Medicine and Dentistry at the University of Western Ontario.

“It has always been a way for wealthy people to jump the queue. The difference now is that the queues are longer. Therefore, the number of people willing to jump the queues is greater.”

Medical tourism is also growing because some countries offer services – such as organ transplants, surrogate surgery or stem cell procedures – that aren’t offered in Canada and Europe, Nisker says.

Even within Canada itself, medical tourism is growing, he adds. More people – the well educated and well-off – are leaving their community or province to get private health care elsewhere within Canada.

“It creates a two-tier system,” Nisker says. “It underlines the deterioration of our health-care system.”

Despite studies dating from the 1970s calling for more funding, successive governments in Canada have refused to put in the money to educate enough nurses and doctors and open enough facilities to take care of Canadians, Nisker says.

“We have one-third the doctors and one-third the nurses (per capita) than the rest of the world.”

Christine Elliott, health-care critic for the Ontario Tories, agrees medical tourism is a sign health care in the province is in trouble.

People shouldn’t have to travel overseas to get care, she says.

“We are already paying a lot in taxes and, in Ontario, a health- care premium,” she says.

But the system doesn’t need more money. It needs more efficiency – such as electronic record-keeping – to move patients through more quickly, Elliott says.

As medical professionals and politicians wrangle what’s wrong the system, people such as Kelly Meloche, head of Windsor’s International Health Care Providers, are watching a sea change in Canadian culture.

“We don’t have a precedence to acquire our own health care. We are not accustomed to questioning who gives health care. We just sit there and we wait,” Meloche says.

That’s changing, Meloche says, and she points to Jubenville, one of her clients, as a example.

Jubenville, 43, was born and raised in Windsor, and joined the family vision care business.

Thirteen years ago, he woke up one day with a stiff neck. Like many people, he just let it go, figuring it would work itself out.

After three weeks, he went to his family doctor and got a prescription for muscle relaxants.

“It never went away.”

He started on the long and circuitous path of waiting to see a specialist, waiting to get a test after seeing the specialist, waiting for the test results, waiting for a consultation about the tests, then signing up for new tests and so on.

Meanwhile, the pain spread to his right arm.

“The only thing they could do for me was give me pain-killers, the whole family of nightmare pills. I was becoming an addict. But what do you do? What are your options?”

Jubenville had no intention of leaving Canada to get health care. First of all, he trusted the system.

And second, “I always had that notion it was going to cost millions of dollars to go somewhere else.”

The pain in his neck became so bad he ended up spending days in bed. The days stretched into weeks and the weeks into months.

“I was 18 months in bed waiting for that first consultation. Then I couldn’t take it anymore.”

The pain grew so great he took an ambulance to the emergency department, quickly saw a neurosurgeon and two weeks later got surgery fusing some of the discs in his spinal cord.

“As soon as I woke up the next day my arm was back. It was great. ”

The relief didn’t last long.

“I started getting migraine headaches like you wouldn’t believe.”

From 2005 to 2007 he took weekly shots of Demerol for the headaches and Gravol to prevent the side-effect – vomiting.

Specialists told him there was nothing they could do because his spine had been repaired already.

“That’s when I ended up going a little mental. I told my family, ‘guys, I don’t know long I can do this for. Somebody better find somebody in the world, I don’t care where.’ ”

A Google search turned up Meloche’s company.

“Before I knew it, I was in Tampa, Florida, at the Laser Spine Institute.”

There, doctors told Jubenville a narrowing of the main nerve routes, called stenosis, was pushing pressure on his spine.

And there, doctors did a laser procedure not available in Canada, Jubenville says.

“I walked off the operating table. I felt great. It was crazy. It was almost surreal.”

As it turned out, the 2007 operation worked only for a time. Things looked great for a year and half, then the headaches returned.

Jubenville began another round of weekly injections to freeze the muscles in his neck and offered some relief. Once again, Jubenville had to cut back his time at work to half days. Every day, he had to lie down for several hours to relax his neck.

“It felt like my muscles are freaking out, like someone is taking a towel and twisting it and they just don’t stop,” he says.

More online research led him to London doctors, who offer botox injections for muscle spasms.

One doctor said he couldn’t do it.

On March 4, he received a letter from the second doctor. Sure the doctor could see him – in 29 months.

“Two and a half years and I am going to have to endure taking drugs I don’t need to take. And again, possibly not being diagnosed then.”

By then, Jubenville had already called up Meloche at International Health Care Providers and crossed the river to Detroit. In the space of three hours one day two weeks ago, he was tested and received botox injection.

He’s still waiting to see how well the injection works.

The botox injections cost him about $1,200. The laser surgery in Florida, which Jubenville still credits for relieving much of the pain, cost $17,000, “We just took a loan. We bought a car we never got. That’s how we look at the $17,000. It wasn’t out of reach, but it wasn’t something I would like to do once a year.”

“I don’t want to smash our (health-care) system,” Jubenville says.

“Our system works if you don’t have any serious issues. It works if the doctors know what you have. If you don’t, the doctor refers you to a specialist, you wait one to two years, and if they don’t know what’s wrong, you are right back to square one, waiting.”

HEALTH-CARE EXODUS

According to Statistics Canada’s most recent report on the issue in 2005, about 530,000 Canadians reported having trouble getting to see to a specialist, 208,000 had trouble getting non-emergency surgery and 280,000 had trouble getting diagnostic tests.

In Ontario, the jump in the number of applications to OHIP for out-of-country procedures jumped 25% to 30%, between 2001 and 2007, said a Health Ministry spokesperson.

Those numbers have levelled off — to about 4,000 a year — costing OHIP about $100 million a year. And that only represents Ontario residents who try to get funding for their procedures.

Detroit’s Henry Ford Hospital handled 385 in-patient cases and 5,897 outpatient cases from Canada in 2009 alone, according to officials there.

While the use of PET/CT is not currently indicated for diagnosing breast cancer, it can make a difference in the following areas:

• PET/CT accurately stages axillary and mammary lymph node involvement. Axillary lymph node dissection is currently a routine part of breast surgery, since it is the only way doctors who don’t know about PET have of staging breast cancer.
• PET/CT may detect distant metastasis resulting in more accurate treatment.
• PET/CT is also used to evaluate the response to therapy. Treatment can be altered, if necessary, for better results. 

• PET/CT is also used when there is suspicion of recurrent disease. Finding recurrent cancer early prolongs lives and increases the chance of beating the disease.

(1)   Source: Clinical Positron Imaging Journal, the official Journal of the Academy of Molecular Imaging, Vol 3, Number 5, Sept-Oct 2000.

How does PET work?

PET (Positron Emission Tomography) is a non-invasive diagnostic imaging procedure that identifies abnormal glucose (sugar) metabolism. Since certain cancer cells metabolize glucose more than normal cells, which often occurs before changes in anatomy, PET may identify the presence of disease earlier than other anatomic imaging techniques. As a result, PET may offer important information to aid in more effective treatment.

Along with Breast Cancer, PET/CT is considered particularly effective include lung, head and neck, colorectal, esophageal, lymphoma, melanoma, cervical, brain as well as other less-frequently occurring cancers.

I just spent time with a client as he recounted his ordeal with prostate cancer over two years ago, and I was struck by the fact that there were treatment options of which he was completely unaware. I was also struck by the fact that the way that his treatment process was described to him was frequently inconsistent, leaving him confused by many different scenarios presented to him as he moved from step to step throughout the process. To this day he remembers feeling “…as if the ground was always moving beneath him…” and he continues to live in fear that “…they didn’t get it all…” or “…it will for sure come back…” I felt sad that he had been left so confused by his providers, and talked at length about the treatment options for prostate cancer. I vowed that no patient would leave my office without knowing all of the options available to him!

International Health Care Providers connects its patients with the most up to date therapies available today. Prominent among these is the three-dimensional technology found in the operating rooms of our hospital partners; employing robotic technology, these techniques take modern prostate surgery to new level.

Robotic technology figures prominently in the spectrum of therapeutic techniques at Henry Ford Hospital in Detroit, housing the Vattikuti Urology Institute. To date, the Institute has performed more than 2,000 cases in this manner, and continues to perform more robot-assisted prostatectomies than any other hospital in the world.

With this procedure, the patient’s pain and blood loss, together with the risk of incontinence and impotence are significantly reduced. Recovery times in the hospital and at home are much shorter with this technique. With traditional radical prostatectomies, patients are expected to be in the hospital for two or three days. With robotic prostatectomy, most patients can safely be discharged one day after surgery.

Speaking of Henry Ford’s new operating suite for robotic surgeries, Mani Menon, M.D., director of the Vattikuti Urology Institute, says,
“This operating room is going to change the way operations are done. It is light years ahead of anything else that exists in the world.”

If I should have cancer, I want my care to be the most modern available – and I want no less for our patients! Dealing with cancer is one of the most stressful life experiences that patients will ever have. They deserve a thorough understanding of their options and the knowledge that their care is a the forefront of medical therapy. With care of the caliber of the Vattikuti Institute, Canadian men can face the challenge of a diagnosis of prostate cancer with confidence. For Canadian men, the quality option is just across the border….without the wait!

Patients experience continuing pain and disability – and so do their families. One patient experiencing excruciating pain while waiting for a knee replacement expressed her frustration as “I couldn’t participate in my life. I did not want to turn my husband into a caretaker.” Patients tell stories of lives put on hold; in those months of waiting, a lot of life, and lot of memories, are left in the ‘what-could-have-been’ dust.

As they move from waiting room to consultation then back to waiting room, patient’s pain worsens and hope declines. Many needing a joint replacement have worked hard most of their lives to be able to live their passions in retirement. “Passions” means chasing your grandchildren, crisp mornings on the golf course, and sunset bike rides with your life partner. Rarely do “Passions” come equipped with crutches and pain killers.

With our partner hospitals, the wait is short, and life can begin again. Before and after treatment, many other modalities are available to aid recovery. We can connect our patients with physiotherapy, chiropractic treatment, massage therapy, and pain management. We are dedicated to ensuring that each of our patients has a care plan throughout the process, and ensure that every patient has complete aftercare arranged before they leave for the hospital.

Canadians have health care options. Our partnerships with U.S.health care providers are the product of long hours at board room tables, ironing out every detail of our client’s recovery. The IHP team has worked hard and passionately at creating these health care choices, allowing patients to safely and seamlessly evolve from ‘waiting patient’ to ‘willing medical traveler.’

To those Canadians on waiting lists for health care, there are superior resources and options for you to consider. Call our office today and allow us to help you in making health care choices that will bring you back to your passion.

The “Liberation Treatment” is based in the thesis that blockages in the cerebral veins (CCSVI, or chronic cerebrospinal venous insufficiency) are responsible for some, and possible many, cases of MS. This concept, and the possibility that clearing these blockages may represent an effective treatment for MS, offers hope for those who are dealing with the symptoms of MS. To date, medical centers in the U.S. and Canada have taken a very conservative approach to this treatment; most are not pursuing treatment until well-validated research studies can be completed and the relationship of these changes to MS can be better understood.

There is rarely a day that goes by that my email or phone doesn’t chime in with an interested party looking to obtain access to what MS patients so dearly hope is the magic bullet they’ve been praying for. IHP is very anxious to help these patients – but only when we can connect them to a treatment that is safe and of proven effectiveness.

You may have heard that other groups are pursuing this therapy more aggressively, and are now sending patients overseas for surgical treatment. Unfortunately, the relationship of CCSVI to symptomatic MS is not well characterized, and, although many patients appear to benefit from clearage of their venous blockages, it is not clear what proportion of MS is due to vascular problems. Therefore, we have elected to wait to refer patients until we are sure that the safety and efficacy of this approach has been fully and rigorously evaluated.

CCSVI occurs when blood from the brain has difficulty flowing properly from the brain back to the heart due to blockages or narrowing of the veins. This concept was pioneered by Dr. Paolo Zamboni, one of the best-known investigators in this area. At the moment, there are no research studies being carried out in Canada, nor is any diagnostic protocol available at any Canadian medical center. At present, active research on vascular treatments for MS in the United States is being carried out at the Buffalo Neuroimaging Analysis Center (BNAC) under the supervision of Dr. Robert Zivadinov.

In a recent conversation with Dr. Zivadinov, it was quickly apparent that he cares deeply about his patients, talking with cautious excitement about the preliminary successful results of the Institute’s studies. He is dedicated to waiting until the clinical trials are completed to offer this treatment to the public.

Although this understandably creates a ‘wait time’ stress for MS patients, please be advised that we are monitoring progress in this area closely, and will advise our clients as soon as a safe and effective treatment is available.

What is available now at BNAC is a complete diagnostic evaluation including the following elements:

MRI of the brain and neck
Doppler ultrasound
Clinical visit with a neurologist
Neuropsychological evaluation
Blood testing.

The availability of this evaluation is very important for MS patients for two reasons: First, because no multitest workup specifically designed to evaluate vascular changes in MS is available in Canada, and secondly, because these changes are subtle, and scans should be viewed by radiologists specifically familiar with MS-associated vascular changes. Even highly competent general radiologists may not be entirely familiar with all of the subtle venous changes occurring in multiple sclerosis.

If you are interested in being evaluated for MS-associated vascular changes, please contact us. We invite MS patients and their families to complete the contact form on our website so that we may continue to keep you informed of new developments..

International Health Care Providers is pleased to announce the appointment of Dr. Collins to the Board of Directors of the Cowichan Seniors Resource and Support Society.

Congratulations Dr. Collins.

Having just returned from being the guest speaker representing Canadian patients at the Health Care Globalization Summit in Miami, Florida, I find myself , incredibly inspired and enriched.  This was an invitation only leadership conference where those of us interested in raising the bar of medical travel convened to share ideas, create opportunities and formulate standards.

As the regarded expert in medical travel for Canadians, I have spoken as the industry expert on both sides of the border, helped developed strategies for successful implementation of Internationl Patient Programs as well as created a business model that caters to the Canadian health care consumer, who despite somethimes having their lives in jeopardy, sometimes are more comfortable at working towards becoming “patient patients” rather than manufacturers of their own health care fate.

In 2003, when Canada was in full swing of the Universal Health Care rationale and struggling with wait time challenges, I was operating a wellness centre specializing in sports performance and chronic pain.  My clientele ranged from competitive athletes to grandmothers, all coping with severe pain.  It was here that I first experienced patients’ struggles with present day waiting lists within the Canadian system.   Witnessing patients forced to wait in pain and suffering while seeing this torment ripple through their families, was a tragedy from which I could not turn.

Along with this wonderful opportunity that medical travel offers Canadians, I also deeply caution potential medical travellers to be aware that this is currently an unregulated industry  This means that anyone can designate themselves as a medical travel facilitator and hide behind the smoke and mirrors of fictitious statistics and partnerships.  You need to arm yourself with questions and expectations.  Here  are some suggest questions to ask of your medical traveler facilitator:

• Who are your provider partners and why have you partnered with them?  What is your process for approving a hospital into your network?
• How do you get paid?
• Can I speak to former clients of yours before I make a choice?
• What is your background prior to entering into the Medical Travel Industry?
• How many clients have you facilitated in the past?
•  Can I speak to a representative of one or more of  the hospitals within your network to establish their satisfaction in working with you?

Working with a medical travel facilitator can relieve you of a tremendous amount of stress while expediting your care options at discounted rates.  Trust your instincts when deciding on what agency to work with and by all means, do not compromise quality for cost.  There are very few high quality, reputable agencies out there right now.  If it sounds too good to be true…then it probably is.

Taking your health care into your own hands is a liberating decision.  Yet delicate emotionally.  We are here to help you along the way.