Saturday, 31 March 2012

Canadian socialized medicine: myths and facts.

I have to say that I have been paying only on and off attention to the whole health care debate in the US. I have also listened to the news with limited interest and peripherally gone online to read some of the arguments. And I confess, I have done this all with the smug satisfaction of knowing that my health care and that of my family does not depend on the debate. 

Today, I read in a New Yorker article (thank you for the humurous post Dr. Aubertin) that in the debate arguments against socialized medicine and how ineffective it’s supposed to be, the Canadian plan was likened to genocide and I found myself shaking my head and saying: "These fools, what are they thinking? Where do they get their information?" The definition of genocide as per Merriam-Webster is: "the deliberate and systematic destruction, in whole or in part, of an ethnic, racial, religious, or national group. I have been in Canada for 21 years and I am a doctor, let me assure everyone I have no knowledge of people dying by the hundreds due to lack of health care.

To dispells the myths all that was needed was to quote Wikipedia! YES! Wi-ki-pe-dia!!!! I am not one to advocate the use of Wikipedia for solid information (althoug it often is - do not tell my kids or students I said that!) but if someone is going to make such uniformed statements the least they could do was have a quick look at it. So I have cut and pasted (so simple you'd think some of the anti-Obamacare lawyers could have had a look in advance eh?) the "Health care in Canada" entry here. A truthful, accessible, short and most of all, TRUE description of the Canadian health care system:

1) Health care in Canada is delivered through a publicly funded health care system, which is mostly free at the point of use and has most services provided by private entities.

2) It is guided by the provisions of the Canada Health Act of 1984.

3) The government assures the quality of care through federal standards.

4) The government does not participate in day-to-day care or collect any information about an individual's health, which remains confidential between a person and his or her physician.

5) Canada's provincially based Medicare systems are cost-effective partly because of their administrative simplicity. In each province each doctor handles the insurance claim against the provincial insurer. There is no need for the person who accesses health care to be involved in billing and reclaim. Private insurance is only a minimal part of the overall health care system.

6) Competitive practices such as advertising are kept to a minimum, thus maximizing the percentage of revenues that go directly towards care. In general, costs are paid through funding from income taxes, although British Columbia is the only province to impose a fixed monthly premium which is waived or reduced for those on low incomes.

7) There are no deductibles on basic health care and co-pays are extremely low or non-existent (supplemental insurance such as Fair Pharmacare may have deductibles, depending on income).

8) A health card is issued by the Provincial Ministry of Health to each individual who enrolls for the program and everyone receives the same level of care.There is no need for a variety of plans because virtually all essential basic care is covered, including maternity and infertility problems.

9) Depending on the province, dental and vision care may not be covered but are often insured by employers through private companies. In some provinces, private supplemental plans are available for those who desire private rooms if they are hospitalized.

10) Cosmetic surgery and some forms of elective surgery are not considered essential care and are generally not covered. These can be paid out-of-pocket or through private insurers.

11) Health coverage is not affected by loss or change of jobs, as long as premiums are up to date, and there are no lifetime limits or exclusions for pre-existing conditions.

12) Pharmaceutical medications are covered by public funds for the elderly or indigent,or through employment-based private insurance. Drug prices are negotiated with suppliers by the federal government to control costs.

So NO, NOT genocide just sound, cost-effectvie medical care for all.


Tuesday, 27 March 2012

You know you are 46 when ...


1) You look around in a movie theater (while waiting to get tickets to the Iron Lady who you know ONLY old people would watch) and realize that you and your friend are the OLDEST people there.

2) You find yourself bruised and have no idea how it happened.

3) You know who "The Smiths" are/were.

4) You dread the word "bifocals" more than any other word in the English dictionary.

5) You find yourself eating the same things most of the time because any foray into untapped dietary territory provokes incredible GI distress.

6) Your running playlist includes Michael Jackson, Erasure and Depeche Mode.

7) You find yourself looking for creative ways to hide forehead lines - bangs!

8) You can name every actor in The Breakfast Club, Sixteen Candles and Pretty in Pink.

9) You are still a little bit in love with Andrew McCarthy

10) Everytime you travel you actually ask the hotel, before making a reservation what kind of mattresses they have otherwise you end up sleeping horizontally across the headboard, because that is the only place where the mattress is decent and sleep hygiene is a top priority.

11) You can discipline with one look.

12) You pump up the volume in the car and loudly sing along to Tear for Fears "Shout".

13) You start to think that maybe just maybe you are actually beginning to look a LOT like your mother.

14) You have the self confidence to say EXACTLY what you mean.

15) You'd rather have a good brain than a good rack.


Thursday, 15 March 2012

Multicultural Canada or just "regular" people.

Today Benjamin came home from school to announce that his good friend is adopted. This to my absolute astonishment as she is, after all, African-American and her mother is as caucasian as they come. At first I thought he was joking, so I ask "Are you seriously surprised?" Yes, he is serious. "You mean you did not know?" and he says; "Of course not she looks JUST like her mother" Now I am even more baffled because I know he is smart: how could he not come up with this conclusion? Then it strikes me, the kid is color blind and I do not mean biological color blindness but social color blindness.

This has happened in the past. Two years ago he came home talking about Charlotte. How Charlotte and him were reading Harry Potter and she was a great reader. So we had a week of Charlotte did this and Charlotte did that. I of course had no idea who Charlotte was so I asked him to describe her to me, this way I could narrow the girls in his class down and hopefully figure out who this wonderful Charlotte was. His answer: "I don't know, she has dark hair" Ok, dark hair now I can eliminate 5 or 6 girls but I am still not even close. So I ask; "What color are her eyes?" and he answers "Who knows". No amount of questions could narrow the field down. A few weeks later I go to get him from school and he bounds up to me with this beautiful little Korean girl by his side - the famous Charlotte. In the car I ask "Hey why didn't you tell me Charlotte was Korean, that would have made it a lot easier for me to know who she was?" and he says "I didn't know she was Korean, she is just regular, you know, like everyone else."

Oh Canada! Our home and native land! Muticulturalism at it's best !!! And even better children don't even KNOW we are multicultural or at least they don't in the early years. To them or at least to mine everyone is just "regular" people. Isn't this great? Is this the generation that finally gets it right?

It reminds me of the time when we were in Church the very week that same sex marriage was approved in Canada and there is Father Paul at the pulpit talking about how we as catholics probably all have friends who are gay and how we must be confused about how to think of this same sex marriage decision and how confusing it must be to be congruent with our faith and it's beliefs but still be accepting. How catholic faith teaches compassion yet we are not being compassionate to people who are gay with our beliefs and on and on and on he went ..... confusion this and confusion that. As we leave the church Sebastian, who at the time must have been no more than 5 says to me: "So Mama, isn't same sex marriage when a boy marries a boy or a girl marries a girl." And I answer "Yes it is" and he says: "So I don't get it, WHY is Father Paul so confused?!" Yep! this kind of insight and wisdom at age five!!!

So as I see Sebastian head out tonight in a group of teenagers made up of one boy whose mother is Sri-Lankan and father is Argentinian, another whose parents are Chinese, another whose parents come from South Africa, another with an Peruvian father and Scottish mother and him, my Sebastian, Canadian father, Mexican mother I smile to myself and say Benjamin is right ---- just regular people.


Tuesday, 13 March 2012

Lauren's circuit class and Halle Berry

I work out at the gym with a personal trainer fairly regularly (at least 2 times a week) and run (at least 3 times a week) but lately my trainer has been sick and since I do not really like to go to the gym I have been avoiding it but I was feeling guilty so last Thursday I mustered enough energy to attend "Lauren's circuit class".

You should know I was very self concious and nervous about going so I texted Lauren a few times asking: "You have seen what I can do at the gym. Am I going to look like an idiot in your class?" While Lauren kindly reassured me that all would be fine.  I arrive for a treadmill run in advance - BIG mistake should have saved my energy for the actual class. Slowly people trickle in and they are all at least a decade younger than me. Already this does not bode well and I am thinking maybe I'll just keep running, forget the class.

Lauren, the Amazonian blonde beauty/trainer sets up a torturous circuit of 10 -13 stations. Anything from lifting an enormous bar, to the stair machine, to rope jumping or planking, or pulley arm work etc... Every one of these stations last 1 minute and then you transition to the next, so it is really like an exercise conveyor belt with very little rest in between.

The fist few minutes are the "warm up", let me tell you this in no gentle warm up it is a fast paced squatting thigh burning introduction of what is to come. Five minutes after this warm up she requests that we chose our first station and I look around for one that will allow me to either sit down (the bike) or lie down (the crunches on the mat), thankfully all of the other 20 to 30 somethings are really fit keeners who chose the hard stations so the easy ones are left for me.

I start with the bike. To my distress this biking has to be done at a level 25 not my regular 12 so I look around to avoid making eye contact with Lauren and lower the resistance thinking ........... noooo problem I can do this. Next is the big huge bar lift. Now, there are an assortment of weights strategically placed next to the bar that one is encouraged to ADD to the already very heavy bar to accommodate all fitness needs. I decide that the bar alone is heavy enough. Next, is the stairclimber. I do this all the time!! This is going to be a breeze - however this climbing is a SPRINT on the STAIRCLIMBER ie. more like super fast jogging up the stairs. I go as fast as I can all the time thinking WHY? WHY? am I doing this?

On to the arm work which should be a lot easier right? NO! This arm work requires that you squat at a 90 degree angle while leaning on the wall and lifting the 25 lb ball over your head first and then in front of you repeatedly for a whole minute! Burning biceps but I finish while all the time trying to convince myself that this will lead to Jennifer Aniston-like toned arms.

On to the jump rope, an activity I have avoided since age 12 due to the top heaviness mentioned in previous blogs. I jump like a girl. ie. I take that extra little jump in between the big over the rope jump so I look like an idiot but hey, I'm killing some calories. This goes on and on with all kinds of challenges. After one circuit she requests that we get on the machines for two minutes of cardio, CARDIO??!! Isn't that what we were doing? You mean to all others this is NOT cardio? Yikes!

Then we go back for the second circuit and I feel and do much better. At the end when I am ready to plop of the floor for some rest she asks us to get on the floor mats for the "Jane Fonda" leg workout. Not exactly a leg workout and more like an insanely painful butt workout but again I use positive thinking: "THIS one will lead to me getting a J. Lo type ass".

The next day I had a hard time getting in and out of the car, going up the stairs, sitting down, writing, feeding myself, even brushing my hair and my teeth. I have two more days to decide if I should go again and I am doing this by convincing myself that my commitment will eventually lead to me looking like Halle Berry did when she walked out of the ocean in that orange belted bikini in that James Bond movie. Hey, whatever works right?


Saturday, 10 March 2012

March 10 - 11 years ago today.

March 10 is the day that I welcomed Benjamin into my life, he arrived bluntly and unexpectedly.

It began at 2 am during my hourly visit to the bathroom (at 36 weeks gestation the bathroom is visited hourly FYI) and noticed bleeding. This is one of those situations where too much knowledge is both a good thing and a bad thing. Good thing because you automatically know what to do and bad thing because I knew this kind of bleeding is not the gentle let's-get-going-with-this-whole-birthing process but the kind of bleeding that is a dangerous harbinger of a placental abruption.

I woke Michael up and said "Things are not looking well, we've got to go to St. Paul's". The man bolts out of bed saying "I am sure there is nothing to worry about"  ahhhh .... ignorance is bliss so he dresses slow as a snail while I throw on my "last 4 weeks of pregnancy uniform", black overalls and white turtle neck, (women will get this, there is not much to wear at the end, is there?). I waddle my way to the van while every 3 seconds looking down  at my belly and anxiously asking: "Benjamin (we knew it was him already) can you please move? Can you move please? Can you let me know you are okay?" while getting no answer from the child.

We arrive at St. Paul's with me terrified and in tears. I get strapped to the heart monitor and I am instantly reassured by the solid 140 beat per minute strip but still no movement. The "du jour" medical student is there looking like he is 12 and very kindly and politely asks: "Hello Dr, Lopez, I am the medical student (nice kid), can I examine you?" Let me tell you at this point my level of distress is so high I wouldn't have cared if it was the gardener who examined me as long as I got some information.

Now, what is coming next, this right here that I am going to describe is why we need 4 years of undergrad plus 4 years of medical school and 3 of residency before being good doctors. Remember, this kid is a medical student, still a good 4 to 5 years away from being really good at his craft. Anyway he gets a speculum, puts it in and .............. GASPS!!!!!! GASPS!!! After he is finished training he will have learned that in medicine you DO NOT gasp, EVER!! Particularly NOT in front of your patient. Because, you see, now I KNOW something is really wrong and I very loudly ask: "Is it the cord? Can you see the cord?" while lifting my hips as high as my pregnant belly will allow and start giving stern do-exactly-as-I-say directions: "Listen carefully, put the table on Trendelenburg (feet, or in this case hips, high and head low) and go get a nurse." In comes GOD ie. the head nurse, who confirms my suspicion, yes, Benjamin has decided to come into the world cord first (you should know this is not right, baby needs to arrive BEFORE the cord, ALWAYS, ALWAYS) and proceeds to use all of her might to push Benjamin toward my chest and coax him to climb back up.

20 minutes later he is surgically removed from my body. Now he is out in the world and struggling to breathe. I hardly get a glimpse of him before they whisk him off to the nursery in a little plastic box. By 10 pm he is no better so he is transferred to the Children's Hospital Special Care Nursery. I see him once again at around midnight when the Infant Transport Team comes to my room for me to see him off. He is in the transport incubator on top of a gurney so I don't even get to touch him and off he goes - alone. Alone. Alone. Alone.

The next morning I haul my 24 hrs post-C-section ass to BCWH to go see him and end up in exactly the same room where I stayed when #1 was born! What are the chances? Out of dozens of rooms I end up in the same one??!!. My mother automatically decides this is a sign that everything will turn out okay and I want to believe her.

I go into the Special care Nursery where I have been a hundred times before but this time to see my own baby. There he is, first incubator on the right. By now his head is shaved off, IV's on his head, NG tube in place, heart monitor beeping and CPAP mask on his face because he is still struggling to breathe. That afternoon I go see him again and his doctor, my colleague, says "Oh, he is much better, we intubated him and he is doing much better." In another I-have-too-much-knowledge situation I am thinking "You INTUBATED him??!! HE IS NOT better! If you had to intubate him he is worse, much worse." Visions of all kinds of respiratory and cardiac disorders now swimming in my head.

With time, he makes slow progress, 4 doses of BLES later and he starts breathing without support. He gets moved to the "growers" section where again my breasts refuse to do their evolutionary job. However, he manages to guzzle happily on the bottle so I leave the ornaments alone - no pumping, no Domperidone, no breast feeding guilt. Finally, on March 20th, 10 days after he was born he gets to come home and my Dad is here from Mexico documenting his every move. Thankfully, otherwise I would have had no memories of his first days at home since my mind is temporarily parked in a blurry post-partum haze.

Today he is 11 years old, Candid, forthright, articulate, eloquent, outspoken, Benjamin. Irreverent Benjamin. Hockey loving Benjamin. Self-assured Benjamin. MY Benjamin. One of the two true great loves of my life.Happy birthday.

Tuesday, 6 March 2012

Trading intelligence for bigger breasts??? .............NOT!

I recently read in the Huffington Post that women would trade their intelligence for larger breasts. The story goes that 1,100 18 to 25 year old women were asked if they would trade their IQ's for bigger breasts and one third of the women said they would!!!!! 41% also said they would rather have bigger breasts than a higher IQ and 24% of the ones who preferred bigger breast said they would chose this because "they would make them look prettier."

Let me enlighten these idiots since I have ample :) prespective on this topic. Up until the age of 12 I was a slim flat chested girl who took ballet lessons at the London Royal Academy of Ballet in Mexico City and was quite good at it. The summer of 78 was my second year at Camp Quinebarge in New Hampshire and it was here that for the first time I became aware of breast relevance because of Tandy Betts.

Tandy was (probably still is) a gorgeous 15 year old blonde who went around camp bra-less. All the boys thought this was wonderful and she was motive for gossip and plenty of envy among the girls.The summer of 1978 was also the year I got mine, they were not expected and it seemed like they appeared out of the blue, all of a sudden - BAM!!! breasts!!! Needless to say I was semi-oblivious to them except for the fact that due to their size I very likely had to shift my center of gravity! So not only have I carried my large breasts around since age 12 which makes me a "de facto" expert, but I have also carried around bigger ones during and after my pregnancies. So from 34C in my "golden" years to 40E shortly after #1 was born (or as I like to lovingly call him "the 11 pounder") - I know it all!!

First from ages 12 to 32 at a solid 34C they hung on my chest happily and unassuming. I hate to break this to all but there were no hoards of men following me around wanting to look down my chest or whistling from construction sites. During high school I had a few boyfriends and I hope they chose me because I could carry a conversation and had a great sense of who I would become. But then again this is my impression, we can take a poll if needed, most of them are on Facebook. Later, during University and Medical School I know I was chosen because I was smart as there are very few opportunities to flaunt breasts around when your nose is tied to the books and you want to graduate.

Second let me say that mine have always been purely ornamental ie. they were useless for their intended evolutionary purpose - breast feeding. The 11-pounder required a substantial amount of nutrition and I just did not have it in me to give. No amount of Domperidone was going to help even after using the dreaded green sucking/pumping machine, 3 oz was all I ever got while the child needed 8 oz at age 24 hours because he was born the size of a 6 month old. The size increase of my breasts did not make me look prettier at all, if anything it made me look like a top heavy hippo. So nix the "they will make me look prettier" argument.

You will never catch a Plastic surgeon saying this but here is the unadulterated thruth - large breasts are a nuisance, or at least REAL large breasts! Bras that will hold them up are hard to find and the straps cause indentations on your shoulders. Sleeping on your front leads to them relocating themselves under the armpits and they get in the way. Sleeping on your side means they are squished in the middle (gravity). Sleep on your back and they slide off to each side (gravity again). Run with them and you will need an industrial design strong bra to keep them in place and forget being aerodynamic during running, the wind drag alone will cost you a few minutes of every race, then again all other runners will thank you for creating a wind tunel and coast behind you so you will make new friends!!

My intelligence on the other hand has always been a cherised treasure, it got me through school, high school University, medical school, a MSc degree, residency, two fellowships and a post-doc fellowship. AND it got me a job!! A really good one!! That I love!!

So NOOOOOOO I would not relinquish a single drop of my IQ for larger breasts. As has been said before - A mind is a terrible thing to waste.

5 reasons why we should pay teachers decent salaries

As a preface I should say that our British Columbia Teachers are currently on strike after many months of trying to negotiate a fair contract. Let me also say I am not a teacher but a physician, a physician for children with special needs so yes, I do have a "hidden" agenda - to provide adequate services for all children in this province and especially for those with special needs.

Here goes:

5) Teaching is a passion - who in their right mind would go through several cycles of applying to University Teacher Education programs and compete with thousands of applicants, not get in and apply again and then work really hard to graduate for a measly salary unless you were really passionate about teaching? Passion should be rewarded.

4) Every teacher will have a few kids in each class that have difficulties with learning, attentional problems, motor issues, sensory and social difficulties needing them to now be, occupational therpists, speech and language therapists, physiotherapists and behavioural interventionist. Yet they are doing this for the same salary.

3) Teachers in the past could be uniformed in their approach to all kids now they have to become the ultimate "designer" teachers, needing to address evey child's learning style in a different way. We pay well for designer clothes and NOT for designer education?

2) Access to information has incresed exponentially over the last 50 years and teachers are suppossed to keep up and be aware of it all. You will say, yes but we all have to do that at our job and I say YES! but we get paid a lot better than they do!! Where is the motivation otherwise?

1) Teachers hold the future of our country - hang on, no, not just our country, our PLANET in their hands. Educated children often become educated adults that will make educated decisions about our economy, our environment, our resources, our FUTURE. That responsability is sure worth at least a six figure salary!!

Monday, 5 March 2012

The first 13 days of Lent

On Ash Wednesday, exactly 13 days ago I decided that my Lent foray into self-denial would be to give up Facebook until Easter Sunday.

We all knew that for me and my daily 6 posts a day Facebook fix this was going to be tough so I have decided to blog. Yes, now not only will people get my eventual Facebook post but also my daily diatribes and thoughts on pretty much everyting. Thankfully you can avoid reading this, while facebook posts just show up on your news feed - mind you that can also be modified.

Here is the latest. On Sunday my lovely articulate and loving 10 year old agreed after much cajoling to go grocery shopping with me. I have to tell you this is quite a monumental event as currently his brain is full of hockey and hockey ONLY and being seen with his mother while picking out fruits and vegetables makes him cringe.

Anyhoo, TWO, count them, TWO minutes into our blissful act of togetherness the aforementioned child in his infinite distractability rams the back of my left ankle with the shopping cart HARD! Those of you who have experienced this pain will understand that the ONLY response to this act of unexpected violence is swearing (at the child)! So yes there I am the "illustrious" Dr. Lopez swearing at the top of my lungs in the middle of Save on Foods - the UBC save on foods to top it all off !!!!

Needless to say the ENTIRE place turns to look at me with derisive looks of "Can you believe how she is talking to her child?!" and only one lady comes up to me to say "I saw what happened, are you okay?". Thankfully ever the sisterhood of mothers she also says "Don't worry about the swearing we've all done it". Have we really? All done it? Have we?

Meantime the child is incredibly distressed and apologetic particulary after he sees me limp for about 5 days and reluctantly cut down my running routine for a week. Finally yesterday when once again I am showing him my ankle to mid-leg bruise he says "Okay I have apologized like 40 times already, it is Lent and even God eventually gave Jesus a break".

Maybe I should too eh?