Early-onset dementia, a heart-rendering disease that took Dales Judd in his prime

Early-onset dementia, a heart-rendering disease that took Dales Judd in his prime

Greta Judd: early-onset dementia took her husband, Dales, during a physically fit and productive time of his life  |  George Le Masurier photo

Early-onset dementia, a heart-rendering disease that took Dales Judd in his prime

By George Le Masurier

Before Feb. 11, 2016, Greta Judd, like most people, had only a general awareness of dementia. She just knew Alzheimer’s disease was a form of dementia that affected older people. No one in her family had suffered from dementia. And she had never heard of early-onset dementia.

Many years before, Greta had started to notice subtle changes in Dales, her husband and high school sweetheart. But at first, these seemed simply to be the normal signs of ageing, like needing glasses to read a book.

So when Dales’ anxiety levels started to increase in his early 50s, she wrote it off as getting older and becoming more set in his ways. When the avid cyclist fell off his bike, he was just clumsy. When he couldn’t remember the name of something, he was merely forgetful.

“With dementia, you lose the person in increments”

But over the years, Greta had become increasingly worried about the changes she saw in Dales. She circumvented Dales’ family doctor and pressed for a clinical diagnosis from an Island Health specialist in seniors care.

On Feb. 11, 2016, the Judds learned that Dales was living through Dementia with Lewy Bodies, an incurably rare disease with characteristics of both Alzheimers and Parkinsons, but one that progressed more quickly than both.

“Getting the diagnosis was horrible,” Greta told Decafnation. “It was devastating to realize my husband of 45 years wasn’t coming back. This wasn’t something we could fix.”

She cried a lot at first but hid it from him by going out for walks.

“He fed off my moods and I didn’t want to upset him,” she said.

Lewy Body Dementia represents between five percent to 10 percent of all dementia cases in Canada. Most of the 500,000 Canadians with dementia are over 65 and have Alzheimer’s or vascular dementias. Lewy Body typically exhibits earlier, around age 50, and tends to afflict slightly more men than women.

Dales’ life expectancy was pegged at three to seven years.

After slowly declining over almost 20 years, Dales died exactly on Feb. 11, 2019, at age 68. But he did not die how you might imagine.

 

SEEING THE SIGNS

Looking back, Greta can see now the little signs of dementia that Dales had been exhibiting for more than a decade before his diagnosis.

He always had poor sleep patterns and frequent insomnia and he experienced noticeable weight gains and losses. Both are commonly accepted indications of a propensity to develop dementia.

He started to forget simple words like ‘refrigerator.’ “You know,” he would say, “that place where we keep the food.” Once an avid and daily sudoku puzzler, he suddenly stopped altogether.

Dales Judd: a victim of early-onset dementia

When they went to a restaurant, Dales seemed to always forget his reading glasses. “Just order me something,” he would say. Greta understands now that he couldn’t read the menu because the words weren’t making sense to him any more.

It’s common to develop masking and coping strategies, but as the disease progresses they become harder to hide.

On a driving trip to the Grand Canyon several years before his diagnosis, Dale asked one morning, “Where are we?” Greta took out the map to show the route. But she soon realized his question was more profound than a specific town or campground.

His symptoms worsened. More than once during his sleepless night, Dales flooded the kitchen floor by washing the dishes and leaving the plug in the sink with the water running.

When he left all four elements burning on the stove, about a year before his diagnosis, Greta could no longer leave him alone in the house or outside.

And neither Greta or Dales’ sister, Carol, with whom he was very close, knew until after the diagnosis that he had been having visual hallucinations. They were friendly but frightening.

Dales continued to recognize people right to the end, Greta believes. He just couldn’t say their names or speak.

“He would try. His mouth would open but the words just wouldn’t come,” she said.

Finally, the only way he could communicate or show emotion was to cry.

 

WHO WAS DALES JUDD?

Greta was 18 when she married Dales, 23. They were married for 45 years. They moved to the Courtenay from Canmore, Alberta in 2003. They semi-retired from Dales’ career as the Canmore community services director and previously as director of a YMCA in Calgary. Dales drove a school bus for the Comox Valley Schools.

Greta remembers Dales as a tremendous athlete.

Dales on his ride to Newfoundland

For a while, he mastered all the racquet sports. Then he got into long-distance cycling. He cycled from Canmore to Alaska twice. He cycled once from Canmore to Jasper over to Prince Rupert, ferried down to Port Hardy and cycled down the Island and then back to Canmore. He and his sister, Carol, once cycled from Victoria to Newfoundland.

Dales always needed a goal, something that he was training for. He ran many marathons and half-marathons.

She also remembers Dales “big sense of humor and he was incredibly funny.” Greta says he was “kind, generous and a superb father. He was proud of his children. He made it a point to expose his children to as many activities and experiences as he could.”

 

THE END IN A CARE HOME

The tragedy of Dales Judd’s death was not that he died. Greta, her sister-in-law and their children all knew the end was coming.

“I had been grieving for three years already,” she said. “With dementia, you lose the person in increments.”

When Dales’ physical deterioration became too difficult to manage safely, Greta made the difficult decision to move him into a residential care home.

And that’s when the tragedy of Dale’ death occurred. He did not die from his dementia. He died from the Norwalk virus that had spread through the Comox Valley Seniors Village for the second time in 10 months.

Dales with his grandchildren in the care home

Dale had survived the first outbreak, but he and the residents of three adjoining rooms, none of whom were mobile, all died from the second virus outbreak at about the same time.

Because the restrictions of the coming COVID virus pandemic were not yet underway, Greta and Dale were able to spend the last hours of his life together.

But Greta and the family members of the other victims were angry.

“His life in the Seniors Village was horrible,” she said. “Staff all did their own thing then. There was no leadership. Some of the staff even resented family members’ visits.”

Greta was doing all of Dales’ person care and even feeding him. That was common among the residents, she said because the facility was so short-staffed.

She says family members had become the privately-owned facilities’ essential workers even though they were paying the care home $7,000 a month (family cost plus public subsidy).

“I think it’s better now,” she said. “But by the time he died I was grateful that he didn’t have to live that way any longer. It was a demoralizing, demeaning way to live.”

 

MOVING FORWARD

There is another tragedy that accompanies all forms of dementia: the toll it takes on family caregivers.

According to B.C. Seniors Advocate Isobel Mackenzie, there are roughly one million unpaid caregivers in B.C. Ninety-one percent of them are family members, usually adult children (58 percent) or spouses (21 percent).

In a report, “Caregivers in Distress: A Growing Problem,” Mackenzie said 31 percent of unpaid caregivers were in distress in 2016, which represented a 14 percent increase in the actual number of distressed caregivers over the previous year.

She defined ‘distress’ as anger, depression and feeling unable to continue.

Fortunately for Greta, Dales was able to age in place at home for a while with the help of some friends, family and Island Health home care aides. But even so, she says, the burden of having to do everything from pay the bills to take the car in for repairs while providing almost 24/7 personal care took its toll.

“The home care we did get was wonderful, but it was only minimal care. They would sit with him so I could go to buy groceries or run other errands. But it was just to make sure he was safe. They didn’t shower him or do any personal care,” she said.

Greta and Dales Judd

What Greta really needed was longer-term mental health breaks for herself so she could recharge. She was able to get a week-long respite bed only two times in three years, one each in Cumberland and Glacier View Lodge.

But she eventually connected with a group of five other women while taking their husbands to a weekly Minds in Motion dementia program at the Lower Natives Sons Hall. The group continued to have coffee regularly after their spouses were in care homes.

Now, the women have all taken up the ukulele and formed a group called the Uke-A-Ladies and they play together via Zoom.

And Greta has become active in other groups lobbying the BC government for more long-term care beds and respite beds for the Comox Valley.

Now, she’s thinking of selling the travel trailer the couple purchased long ago with intentions to explore North America. She might trade it for a travel van and make a few trips with her dog.

“We can’t move on,” Greta said. “But we have to move forward with our lives.”

 

 

 

 

 

 

WHAT IS LEWY BODY DEMENTIA?

People with dementia with Lewy bodies have a decline in thinking ability that may look somewhat like Alzheimer’s disease. But over time they also develop movement and other distinctive symptoms of Parkinson’s disease that suggest dementia with Lewy bodies.

Dementia in British Columbia Dementia is a broad term used to describe the symptoms of a number of illnesses that cause a loss of memory, judgment and reasoning, as well as changes in behaviour and mood. These changes result in a progressive decline in a person’s ability to function at work, in social relationships, or to perform regular daily activities.

In British Columbia, current estimates of the numbers of people with dementia vary between 60,000 and 70,000. As the numbers of seniors grow, dementia cases will rise.

 

TYPES OF DEMENTIA

Alzheimer disease: A progressive disease of the brain featuring memory loss and at least one of the following cognitive disturbances that significantly affects activities of daily living: Language disturbances (aphasia); An impaired ability to carry out motor activities despite intact motor function (apraxia); A failure to recognize or identify objects despite intact sensory function (agnosia); and Disturbance in executive functions such as planning, organizing, sequencing, and abstracting.

Vascular Dementia: A dementia that is a result of brain cell death that occurs when blood circulation is cut off to parts of the brain. This may be the result of a single stroke or multiple strokes, or more diffusely as the result of small vessel disease.

Dementia with Lewy Bodies: This disease often has features of both Alzheimer disease and Parkinson’s disease. Microscopic ‘Lewy bodies’ are found in affected parts of the brain. Common symptoms include visual hallucinations, fluctuations in alertness and attention, and a tendency to fall.

— Internet sources

 

BY THE NUMBERS

Over 500,000 — The number of Canadians living with dementia today.
912,000 — The number of Canadians living with dementia in 2030.
25,000 — The number of Canadians diagnosed with dementia every year.
65% — Of those diagnosed with dementia over the age of 65 are women.
1 in 5 — Canadians have experience caring for someone living with dementia.

Over $12 billion — The annual cost to Canadians to care for those living with dementia.
$359 million — The cost to bring a dementia-treating drug from lab to market.

56% — of Canadians are concerned about being affected by Alzheimer’s disease.
46%  — of Canadians admit they would feel ashamed or embarrassed if that they had dementia.
87%  — of caregivers wish more people understood the realities of caring for someone with dementia.

— Alzheimers Society of Canada

 

 

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LAST CHANCE TO TAKE OUR SURVEY ON LOCAL GOVERNMENT PERFORMANCE

Let’s vaccinate the whole world against the COVID-19 virus as we did with polio

Let’s vaccinate the whole world against the COVID-19 virus as we did with polio

Photo by Daniel Schludi on Unsplash

Let’s vaccinate the whole world against the COVID-19 virus as we did with polio

By Guest Writer

BY LORA E. PETERS, CROSSCUT

There was a time when the good of the world was put ahead of the profit of a nation or a company. Polio ran wild throughout the world, debilitating millions of children for decades until doctors Jonas Salk and Albert Sabin developed the vaccine in 1955, still in use today.

When CBS reporter Edward R. Murrow asked Salk who owned the vaccine, Salk responded, “Well, the people, I would say. There is no patent. Can you patent the sun?” Salk never patented his vaccine, thereby creating what we would call today an “open source” vaccine available for replication throughout the world. Within a generation, polio was nearly eradicated from the planet.

As of this writing, nearly 1.5 million people have died of COVID-19 all over the world. That’s twice the population of Seattle. Pharmaceutical companies have teamed up with major universities in a race to find the vaccine to stop this pandemic in its tracks.

Now they report success. They’ve found the virus’s vulnerability and engineered ways to block it. This is the most exciting news of 2020. What a triumph!

“This is one instance where capitalism’s market-as-driver is in direct conflict with a greater moral imperative”

Right on its heels comes news of hackers who have attempted to access proprietary data that would reveal the formulations for these vaccines, potentially allowing anyone to create and distribute their own vaccines. Tom Burt, Microsoft’s corporate vice president for customer security and trust, dedicated an entire blog post last month to the horrors of this hacking. And, in a recent KIRO 7 report, journalist Gary Horcher explained, “The country able to reopen their economy first would suddenly have a geopolitical advantage worth untold billions of dollars.”

The moral imperative undergirding Salk’s response to the question about patent seems nowhere to be found in the current conversation about vaccines. Instead of offering free, worldwide access to the formulas, thereby allowing all governments the ability to work together for quick, local development and distribution, pharmaceutical companies, universities and governments are spending millions of dollars on cybersecurity companies to hide their formulas from the world.

Imagine everyone in your neighbourhood is dying of a highly contagious illness, and you all know Neighbor X has come up with a cure. Rather than give everyone in the neighbourhood the cure, Neighbor X builds a wall and hires security guards to stand atop the wall and keep everyone out.

The entire neighbourhood can hear Neighbor X’s family laughing and partying away. Meanwhile, neighbours continue to die. Your child dies.

Horcher observed in his report that the motivation for protecting the vaccine formula is a presumption of financial advantage. There is much wrong with this view of the world, steeped as it is in a form of what some are calling vaccine nationalism.

What Horcher didn’t say, but can be inferred, is what will happen to those countries that are not first to vaccinate. Not only will they not make “untold billions of dollars,” their citizens will die at an unnecessary rate. And what impact will that have on their future trust and relationships with the countries that held the vaccines behind cyber walls?

Let’s make the formulas public and allow scientists around the world to have free access to replicate the results. This provides local control and a standard against which health systems can ensure the safety of the vaccine, while simultaneously providing distribution to billions of people by creating hundreds of sources, thus eradicating the virus more quickly.

Like the post-World War II Marshall Plan, in which the U.S. provided the equivalent of $217 million toward the recovery of European countries, there is much to be gained in helping the rest of the world recover.

Contrary to the 1980s adage, in this case, greed is not good. Greed is death. This is one instance where capitalism’s market-as-driver is in direct conflict with a greater moral imperative.

As we move into this season of giving, shouldn’t we rely more on, “love thy neighbour as thyself” and provide the world with free and equal access to all information about the vaccine?

As major stakeholders who have contributed great amounts of money, space, training and other resources to the research facilities of these universities, we have a right, in fact, an obligation, to demand just that.

Crosscut is a service of Cascade Public Media, a nonprofit, public media organization. Visit crosscut.com/membership to support independent journalism.

 

 

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Seniors advocates call for longer and more frequent visits to care homes

Seniors advocates call for longer and more frequent visits to care homes

Decafnation file photo

Seniors advocates call for longer and more frequent visits to care homes

By George Le Masurier

The COVID virus has negatively impacted many lives, from those out of work to parents struggling to find child care when schools were closed to business owners who shuttered their doors. But none more than our seniors who have been locked away in assisted living and long-term care facilities.

And while the pandemic’s mortality rate has been higher among seniors than other age groups, life and death have not been their only struggle.

Over the last nine months, 151 seniors in British Columbia died from the COVID virus, but 4,500 seniors also died from other causes. And almost all of them died alone.

MP Rachel Blaney

In an online meeting, last week about seniors advocacy arranged and hosted by North Island-Powell River MP Rachel Blaney, more than 80 participants heard BC Seniors Advocate Isobel Mackenzie call to lift the restrictions that have prevented family member visitations.

“You have to ask, what is the purpose here?” Mackenzie said.

In a report also released last week, Mackenzie said that a survey of 13,000 care facility residents about their experiences during the pandemic showed seniors would have preferred to see their families and taken the risk of contracting the virus.

Before the pandemic, most seniors were visited by family members for an hour or more several times per week and some daily. These family visitors performed essential care for residents, such as grooming, assistance with feeding and staying mobile.

But that all came to a halt as the virus spread quickly through long-term care and assisted living facilities in the early stages of the pandemic. During the first four months, family members could not visit their loved ones at all.

Under current visitation policies, the majority of family visits are only once a week or less, and more than half are for less than 30 minutes. And recreation activities at the homes had also ground to a halt and even now remain limited.

“When we initiated visit restrictions back in March, most of us, myself included, supported the measure,” Mackenzie said about her survey and report. “However, I did not foresee that nine months later we would be where we are today, with prolonged separations for some family members and only brief impersonal visits for many more.”

Mackenzie said the restrictions have created a nine-month suspension of individual liberties.

But she and Laura Tamblyn Watts, the CEO of Canage, a national seniors advocacy organization, also noted that the measures taken by BC Health Officer Dr. Bonnie Henry in early March improved the province’s outcomes, which they agreed were the best in Canada. Ontario and Quebec had 10-times the infection and death rate as BC.

 

NATIONAL STANDARDS NEEDED

Noting that BC had the best response to COVID, MP Blaney said that shows that Canada needs a national strategy for seniors.

Blaney worked on a 2018 committee report as the NDP Critic for Seniors Issues at the time that made 29 recommendations, including reviewing Guaranteed Income Supplement rates and creating a National Seniors Strategy, most of which have not been acted upon by the federal government.

“Recognizing that the provinces and territories are responsible for delivering many aspects of support and care for seniors, a properly resourced National Seniors Strategy would provide national standards, and a platform for sharing best-practices,” she told Decafnation after the online meeting. “We know we have an ageing population. It’s crazy that we don’t have a national plan and vision for providing our seniors with the dignity and care we all deserve.”

Seniors Advocate Mackenzie said the federal government has to champion a Canada-wide coordinated approach. She said other countries with a system similar to ours, such as Australia, have a strong national regulator.

Mackenzie suggested that governments could attach strings to seniors program funding as an incentive for the owners of private care homes to “do the right things”

“It’s the way we fund them (that’s the problem),” she said. “We should say, spend these dollars on X and spend these dollars on Y, instead of handing them an envelope of money.”

For example, Mackenzie said, some funding should be specified to pay the care staff more, not just to hire more staff.

A wide variety of other topics were covered during the two-hour meeting, most of which have been discussed previously.

“We have a growing population of seniors across Canada, but especially in our riding,” Blaney told Decafnation. “In 2017, I did a series of town halls around our riding to hear from seniors and many of the issues they raised are the same ones that are getting national attention now because of the pandemic.

“As we heard (during the online meeting), some great work is being done to show a path forward. Now we need to follow it.”

 

 

 

 

 

 

SURVEY SHOWS SENIORS NEED MORE VISITS

Before the pandemic, 55% of families were visiting long-term care and assisted living residents for an hour or more several times per week and even daily;

Prior to COVID-19, the majority of visitors were performing essential care for residents, such as personal care, grooming, assistance with feeding and mobilization;

Most family members were not aware of the possibility of essential visits during the first four months of visit restrictions, and almost half of the people who did apply for an essential visit were refused;

Under the current visitation policy, the majority of visits are only once a week or less, and half the visits in long-term care are 30 minutes or less;

30% of current visits are outside only;

Currently, 65% of visits are observed by staff for some or all of the time;

Only 21% of visits are in the privacy of the resident’s room (75% of long-term care residents and almost 100% of assisted living residents live in private rooms);

70% of visitors are not allowed to touch their loved one;

Most visitors are washing their hands, wearing a mask, having their temperature checked, and answering health questions prior to each visit; and

Most family members and residents support some visit restrictions during the pandemic, although they believe visits should be more frequent and that at least one more visitor for each resident should be permitted.

— BC Seniors Advocate office

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Shirley and Paul Brown share how the CRH pathologist shortage impacted their lives

Shirley and Paul Brown share how the CRH pathologist shortage impacted their lives

Shirley and Dr. Paul Brown  |  Submitted photo

Shirley and Paul Brown share how the CRH pathologist shortage impacted their lives

By George Le Masurier

Ever since the Vancouver Island Health Authority started reducing pathologist services at Comox Valley and Campbell River hospitals in 2013, North Island citizens have endured longer wait times for their biopsy and other lab results.

Many have complained. And health care professionals and some local government officials have added their voices to the need to restore full laboratory services to the North Island hospitals.

But VIHA, sometimes called Island Health, has denied that reduced pathologist services have created delays in test results.

Now, a well-known Campbell River physician and his wife have come forward with their personal story about how Island Health’s policies have impacted their lives.

MORE: Patients suffer from reduced pathologist services

Dr. Paul Brown, a Campbell River family doctor for 40 years, has launched a series of complaints to Island Health, the College of Physicians and Surgeons, the BC Health Ministry and local officials regarding a significant delay in a cancer diagnosis that caused his wife anxiety and altered her cancer treatment plan.

Brown told Decafnation this week that his wife, Shirley, had a routine surgical procedure on Dec. 9 at CRH to remove an ovarian cyst.

Five weeks later, the pathology report was still unavailable. Shirley was anxious to learn the outcome of her surgery.

Because Brown knew the system, he called the pathology department at Campbell River Hospital and discovered the problem. There was only one pathologist working during the time that Shirley’s samples were being processed.

The pathologist had not yet reviewed the slides and had not made a diagnosis. He was prompted to review her slides and consult with his colleague who had just returned from holiday.

Two days later, Shirley learned that she had cancer.

It took another 10 days for a specialist pathologist in Victoria to confirm the diagnosis. Shirley saw an oncologist at the Victoria Cancer Clinic two months after her surgery.

 

PATHOLOGIST SHORTAGE

The hospital has two full-time pathologists, but when Island Health unilaterally transferred all clinical pathologist services to a private corporation in Victoria, called the Vancouver Island Clinical Pathology Consulting Corporation, CRH lost funding to hire a needed third pathologist.

Currently, CRH’s two pathologists must cover each other’s shifts, vacation time, sick time and other required absences. That means that for a third of the year, up to 18 weeks, CRH may have only one pathologist on duty.

The delay in receiving the confirmed diagnosis moved the oncologists to start chemotherapy before the recommended surgery to stage the cancer and remove any visible tumour. Shirley completed chemotherapy in June.

At the end of July, she had surgery to complete staging and to remove visible cancer. A small deposit of cancer was found at her second surgery and more chemotherapy has been prescribed.

If the pathology report had been delivered in the recommended time frame, she would likely have had surgery first, followed by chemotherapy a couple of weeks later.

It is impossible to predict the outcome of that scenario but the treatment plan would have been completed much sooner, and Shirley would have experienced much less anxiety by knowing the stage of her cancer.

 

DISINGENUOUS REPLY FROM ISLAND HEALTH

Seven months ago, Brown initially complained to Island Health’s Patient Care Quality Office and he’s still waiting for a response. Every 20 days or so, he receives an email saying they are still working on the file.

He has also contacted North Island MLA Claire Trevena, Health Minister Adrian Dix and his deputy minister. He has not received a reply from any of them.

It’s an understatement to say the Browns are “frustrated by the lack of engagement by elected officials.”

Brown did get a reply to a letter he sent to Dr. Robertson, Island Health’s executive director of lab and pathology, on March 16 of this year. In this letter, Brown described what he considered were the troubling aspects of his wife’s case, including the delay in getting a diagnosis.

“I cannot express the anguish that this delay in diagnosis has caused us … (and it has) left me with concerns regarding the safety of the current delivery of lab and pathology services at CRG,” Brown wrote to Robertson.

In a reply dated May 20, Robertson denied any knowledge that having one pathologist on duty presented a problem.

Brown replied to Robertson on May 25 to refute this claim.

“The fact that you, as you have asserted in your letter, were unaware of concern regarding delays in surgical turnaround times when one of the pathologists was on holiday is incorrect,” Brown wrote.

Brown’s reply refers to several meetings that Roberston attended where the concerns were openly discussed, including the July 22, 2019 Campbell River City Council meeting and the April 11, 2019 meeting of the Comox Strathcona Regional Hospital Board.

Brown told Robertson that to profess no knowledge of the concerns was “disingenuous to say the least.”

 

 

 

 

 

 

 

 

INFO TO KNOW ABOUT OVARIAN CANCER

 

Symptoms
Early-stage ovarian cancer rarely causes any symptoms. Advanced-stage ovarian cancer may cause few and nonspecific symptoms that are often mistaken for more common benign conditions.

Signs and symptoms of ovarian cancer may include:
Abdominal bloating or swelling
Quickly feeling full when eating
Weight loss
Discomfort in the pelvis area
Changes in bowel habits, such as constipation
A frequent need to urinate

When to see a doctor
Make an appointment with your doctor if you have any signs or symptoms that worry you.
If you have a family history of ovarian cancer or breast cancer, talk to your doctor about your risk of ovarian cancer. Your doctor may refer you to a genetic counsellor to discuss testing for certain gene mutations that increase your risk of breast and ovarian cancers.

— www.mayoclinic.org

 

 

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Last two CVH pathologists resign angry and exasperated by Island Health tactics

Last two CVH pathologists resign angry and exasperated by Island Health tactics

Dr. Chris Bellamy, a well-known pathologist who practiced in the Comox Valley for 31 years  |  submitted photo

Last two CVH pathologists resign angry and exasperated by Island Health tactics

By George Le Masurier

For the past 31 years, Dr. Chris Bellamy has been a stabilizing figure in the Comox Valley hospitals’ medical laboratories. The mild-mannered pathologist earned the respect of his colleagues by working days and often nights to provide timely and accurate diagnoses for physicians and patients.

His stellar reputation extended beyond the Comox Valley. His peers around the province recruited him to serve on professional boards and committees, including one that revisited pathologist workload models and studied how they should be used in pathologists contracts provincially.

He mentored a wide array of medical technicians and laboratory assistants and provided them with the real-life education that can only be learned on the job.

When Bellamy first came to St. Joseph’s General Hospital in 1989, he was the Comox Valley’s only pathologist. As a general pathologist he did both the clinical and anatomical streams of the medical specialty. 

As the community’s population grew and the hospital’s workload increased, Bellamy was joined by Dr. Wayne Donn in 1999 and Dr. Stefania Giobbe in 2015, also general pathologists. The three doctors covered for each other’s vacation time and shared the after-hours calls and weekend work.

But this rosy scenario took a dark turn about seven years ago when the Vancouver Island Health Authority (sometimes called Island Health) unilaterally started to implement a plan to eliminate general pathologists on the North Island.

MORE: The issue in a nutshell

In the future, VIHA planned to provide only anatomical pathology services on-site and turn all clinical pathology over to a private corporation of doctors in Victoria, called the Vancouver Island Clinical Pathology Consulting Corporation.

Island Health started this change in 2013, but only at the Campbell River Hospital, where complaints of long wait times for results — some as long as six weeks for a cancer diagnosis — began almost immediately. 

The Comox Valley pathologists who worked at St. Joseph’s General Hospital, which was not under Island Health’s control, had different contracts that allowed them to practice general pathology and that remained in place through the opening of the new Comox Valley Hospital.

Island Health couldn’t take clinical pathology away from Bellamy, Donn and Giobbe, but it could encourage and pressure them to leave.

And it could refuse, after Dr. Giobbe went on extended medical leave in 2018, to provide any support to ease the workload. In response to requests from Bellamy and Donn for help, Island Health’s answer was to send the work to Victoria.

So it all came to an acrimonious end on June 21 when Bellamy and Donn jointly resigned. They gave two months notice.

“I was just exasperated and angry,” Bellamy told Decafnation. “I really felt forced out. VIHA was relentless in their pressure.”

“Politicians need to have their feet held to the fire”

According to sources within the Comox Valley Hospital, the Island Health announcement of Bellamy’s and Donn’s resignations did not thank the doctors for their years of service.

“And it was sent to the smallest audience possible,” the source said.

Bellamy said he feels sad for patients and staff, “who are bearing the brunt of what’s happening here.”

Their absence for the past two months has caused chaos at the CVH laboratory where most laboratory work is now shipped to Victoria. This has created longer wait times and has provoked some emotional patients to turn up at the lab, desperate for their biopsy results.

Since the pathologists resigned in August, Island Health has been unable to recruit any doctors willing to practice only anatomical pathology at the Comox Valley Hospital. The jobs remain vacant.

 

VICTORIA WAVES OFF CONCERNS

Dr. Chris Bellamy has been warning Island Health executives and North Island politicians about the dangers of shipping biopsy samples to Victoria to no avail. Now, he’s joining the call for a full external review of the situation.

Bellamy, Giobbe and Dr. Aref Tabarsi, a Campbell River general pathologist, met with Comox Valley MLA Ronna-Rae Leonard on Aug. 11, 2017, just prior to the opening of the new Comox Valley Hospital. North Island MLA Claire Trevena was also invited but did not attend.

MORE: 2020 candidates address the issue

The doctors’ goal was to save microbiology and other lab services from being moved from CVH to Victoria. They explained how even minutes counted in making a diagnosis. For example, they said in serious infections, such as meningitis, mortality rates nearly double if the diagnosis takes longer than an hour.

But Leonard said she would not interfere in what she perceived as an Island Health operational issue.

“If politicians don’t want to interfere in the daily operations of VIHA that can impact patient care and safety, then who is accountable?” Bellamy told Decafnation.

Bellamy now believes that an independent review is necessary because there is no accountability within Island Health for the delivery of lab services.

“You can’t point to any one person and say they are responsible,” he said. “It’s a matrix organizational structure, a latticework of managers who all point the finger of responsibility in another direction.”

Bellamy made further attempts to retain lab services on the North Island at meetings with Island Health and VICPCC doctors in 2019 and as late as March of this year. None were successful.

By summer, “it was game over,” for Bellamy and Donn. “From then on, it was just a matter of how to extricate ourselves from the situation,” he said.

 

BEYOND PATIENT CONCERNS

With Bellamy and Donn gone, the North Island now has no on-site clinical pathologist services. All of that work is now shipped to Victoria, mostly by courier.

That change has raised more concerns than long wait times and impacts on patient treatment plans. There are allegations of conflict of interest within Island Health.

Island Health signed it’s first multi-million dollar two-year contract with VICPCC in 2014. It signed a second two-year contract in 2017 under a non-disclosure agreement.

In the meeting with MLA Leonard in 2017, Bellamy, Tabarsi and Giobbe questioned the priority of these contracts.

“It is scandalous that a public body like Island Health would use taxpayer money to sign a multi-million contract with a private, for-profit corporation under a non-disclosure agreement,” the doctors wrote in their presentation to Leonard.

MORE: Medical centralization risks to public

And they alleged conflict of interest in how the contracts were awarded.

“Island Health allows some of the senior VICPCC shareholders to hold key administrative positions … including department and division heads who then dictate changes in service delivery to the detriment of the patients of the North Island and to their own financial benefit,” according to the presentation.

Island Health maintains there was no conflict of interest and has relied on a ruling by the College of Physicians and Surgeons, whose function is to protect the public.

Bellamy says Island Health has wrongly interpreted the College’s ruling.

“The College didn’t say there wasn’t any conflict, only that there was no conflict that had conclusively resulted in patient harm,” he said. “There was no absolute proof that patient care had been compromised because at the time no citizen had formally complained to the college.”

Since then, however, a citizen has made a formal complaint to the College, and there have been complaints to Island Health’s Patient Quality Care Office.

 

WHAT’S NEXT

Dr. Donn has already taken another job in the Fraser Valley. Dr. Giobbe remains on medical leave.

Dr. Bellamy is taking time to decide whether to go back to work in another capacity or to retire. Regardless of what his future holds, Bellamy says he wants to see this issue finally resolved.

“Politicians need to have their feet held to the fire,” he said. “The Comox Valley Hospital laboratory service is no longer good value for money and Island Health won’t change without public pressure.”

 

 

 

 

 

 

 

 

 

 

MEDICAL TERMS USED IN THIS ARTICLE

Anatomical pathology deals with tissue biopsies, such as biopsies from breast, colon, skin and liver.

Clinical pathology deals with body fluids such as blood, urine and spinal fluid, and includes three areas of specialization:

Microbiology deals with the identification of infectious organisms.

General pathologists are medical specialists who study an additional five years in all areas of pathology.

Clinical pathologists are medical specialists who study the same additional five years but in only one of the areas of specialization.

 

 

 

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Comox Valley Hospital loses another medical service: how the candidates respond

Comox Valley Hospital loses another medical service: how the candidates respond

The Comox Valley Hospital  |  Decafnation file photo

Comox Valley Hospital loses another medical service: how the candidates respond

By George Le Masurier

The Comox Valley Hospital no longer has any on-site pathologists. Dr. Chris Bellamy and Dr. Wayne Donn both resigned on June 21, exasperated by Island Health’s refusal to adequately staff its North Island medical laboratories. Their last day was Aug. 21.

Their absence for the past two months has caused chaos at the CVH laboratory and lengthened the time that patients wait to receive test results. This has provoked some emotional patients to turn up at the lab, desperate for their biopsy results.

While this is a new reality at the Comox Valley Hospital, the reduction in on-site pathology services at the Campbell River Hospital has impacted the North Island for several years. It’s part of Island Health’s plan to centralize some medical services in Victoria.

But despite pleas for help from family doctors and other health care workers, individuals and groups such as the Citizens for Quality Health Care and the Comox Strathcona Regional Hospital District board and other North Island municipal governments, neither Island Health or the NDP provincial government have responded with any relief.

And while the North Island’s concerns have focused on patient care, there are also allegations of conflict of interest within Island Health and the claim that taxpayers are no longer receiving the services they were promised and continue to pay for.

Decafnation asked each of the provincial candidates in the Courtenay-Comox riding to address this issue (with no limit on length). Here are their unedited responses (in the order they were received):

 

GILLIAN ANDERSON — BC Green Party

While I am unaware of all of the factors involved with this decision, in principle, I am in favour of health care being delivered in patients’ home communities as much as possible. This strengthens our local healthcare system and creates jobs. When patients and families are waiting longer for test results, there is added worry and stress. What is the price of additional sleepless nights waiting for a result?

As the MLA for Courtenay-Comox, I would listen to the concerns of individuals across the riding and I would work towards a solution that addresses all of the issues involved.

 

 

 

BRENNAN DAY — BC Liberal Party

I took the time to consult with Dr. Bellamy on this issue, and what I heard was extremely concerning.

When St. Josephs was running, our community had a full-service laboratory, providing both anatomical and clinical pathology services; they had the autonomy to hire staff and general pathology was the priority with a focus on patient care here in the Comox Valley

During the planning phase of the new hospital, the pathology department was designed to be full service, in keeping with the St Josephs model, which was working well. The costing and design of the new hospital had this budgeted. At some point in the consultation process, Island Health pushed for microbiology to be removed from the hospital and centralized in Victoria, an experiment that had been tried in Campbell River previously with a resulting marked increase in turnaround times of results.

During the hospital planning process, the head of microbiology for Island Health lobbied the VIHA hospital planning committee for removal of microbiology services to Victoria while being a shareholder in a private company providing these services and therefore having a financial interest in the decision; the fact that this scandalous move was not more broadly reported is shameful as it has directly impacted the quality of healthcare here in the North Island.

Once the plan to centralize services in Victoria had been rammed through by VIHA, the taxpayers in the Comox Valley were stuck with the same tax bill, but considerably less local services and longer wait times. VIHA is currently in the process of transferring more clinical lab services from Comox Valley hospital to the private company in Victoria with further erosion of local services.

This is unacceptable.

Our current MLA was contacted multiple times by concerned physicians, nurses, and techs, but their concerns fell on deaf ears and no action was taken to advocate on behalf of the Comox Valley.

An independent external review must immediately be undertaken to analyze the decisions made by VIHA, as the costs have not been reduced by this decision, only the service we are receiving.

We need to build compassion back into the healthcare we are paying for in the Comox Valley, which was so well done by St Josephs for decades, and look hard at whether the VIHA regional governance model is really working, or if it is simply an organization with a bloated middle and little to no accountability to the taxpayers of the Island.

Our community and those affected by long wait times for serious diagnosis through this system are being ignored. I will make sure I advocate loudly to put compassion back into local healthcare, and ensure we are getting the services we deserve.

 

RONNA-RAE LEONARD — BC New Democrat Party

The challenge of privatized services is ensuring profit does not override the protection of the public interest. The previous BC Liberal government facilitated the privatization of many services that people rely on, from hospitals to hospital services, from long term care to home care, and so much more. There have been many negative consequences that the John Horgan government turned its attention toward, to bring the public interest back into the forefront.

We repealed the BC Liberal’s Bill 29 and Bill 94 and then introduced Bill 47 to remove the major financial incentives of contract flipping for companies which created an underpaid and unstable healthcare workforce and deprived seniors of a proper standard of care. We brought back community homecare to direct government services when homecare services became compromised. We brought the contracts for laundry and food services at the Comox and Campbell River Hospital back into the public system.

The quality of care and timeliness of service is also at the root of the concerns over pathology service. The BCNDP is committed to providing the care people need where and when they need it. A commitment to a 10-year cancer care plan demonstrates the closer to home commitment for the North Island, with a new Cancer Centre in Nanaimo.

The pathology services contract was awarded under the BC Liberals and was extended for one more year. It will be reviewed after that. We absolutely agree that lab services should be maintained in Courtenay and Campbell River, that’s why we’re hiring more people now. We’ve accomplished much, but there is still so much more to do. We can’t afford to go back to the BC Liberals.

 

 

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OCT. 24 PROVINCIAL ELECTION INFORMATION

The 2020 provincial election takes place on Oct. 24.

Advance voting is underway at various locations today in Comox, Courtenay and Merville and tomorrow in Black Creek, Comox and Courtenay.

Candidates in the Courtenay-Comox riding are incumbent Ronna-Rae Leonard (NDP), Gillian Anderson (BC Greens) and Brennan Day (BC Liberals).

In the last election (2017), 66.89 percent of the riding’s 43,671 registered voters cast a ballot. The results were:

NDP Ronna-Rae Leonard received 10,886 votes or 37.36%

BC Liberal Jim Benninger — 10,697 votes or 36.72%

Green Ernie Sellentin — 5,351 votes or 18.37%

Leah McCulloch — 2,201 votes or 7.55%

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