Tag Archives: Saskatoon Health Region

Things I Think I Know

Well I survived my appointment with the surgeon with all of my limbs still attached.  A lot of you were asking questions so here is what I know.

  1. The treatment with the wound clinic has been ineffective (I knew that… all they did was change a bandage and lecture me most days for things out outside of my control).
  2. The test results show that the infection is taking a serious toll on my entire body.  Part of the body is fighting on, other parts have given up.  It does explain why I go to work, come home and nap until the next morning.  It also explains why I haven’t been that social this year, I am so tired all of the time.
  3. Part of that is that I am probably now a Type I diabetic.  I know this is warped but there has been so many other serious things, this doesn’t seem to be a priority for anyone. The infection drives up my blood sugars which exhausts me.  Part of the problem is that to figure out what to do with the diabetes, the infection needs to be brought back under control. 
  4. Treatment is going to be long and unsurprisingly, expensive.  The treatment the surgeon wants to try isn’t covered under healthcare in Saskatchewan.  Some basic research yesterday shows that it is in other provinces but not here.  That makes sense because it works and is faster than what we cover in Saskatchewan.   I can’t remember if I file this under lean or the New Saskatchewan.  Either way it’s ridiculous because…
  5. Everyone I deal with at the Saskatoon Health Region seems shocked and bothered that I am still working and not laying at home on my bed waiting to die.  Believe me, every single morning I was wake up and say, “I feel like death” and “I just want to stay in bed” but staying in bed causes a lot of pain while being up and about does not.  So I try to get an appointment where I can get treatment and then go to work.  I get told, “well the seniors like those early morning time slots”.  I understand that being retired is hectic but seriously?  I try to get treatment after work and am told, “We don’t offer that treatment in the evenings.”  The best is when I am scheduled for a treatment and am told when I get there, “Oh, we only do that in the morning and at a different facility.”  Or they don’t call me but insist they did.  Or I show up at appointments and am told that I cancelled it.   It is not a lot of fun dealing with CPAS and it is even harder when you are trying to keep working….
  6. I get asked all of the time if they are going to take my leg.  I don’t know yet.  Some doctors are more optimistic then others.  What we do know now is that antibiotics aren’t killing the infection.   When I am on antibiotics, the infection is at bay but as I saw this week, the infection literally moves up my leg in 24 hours after I am off it (I am back on them now).   I also am told that there will be surgeries in my near future and there will be a lot of them.
  7. So that killed the hope of hiking to Grey Owl’s Cabin in August.  I know this is stupid but that makes me incredibly sad.  You have no idea how badly I wanted to take that trip with Wendy, Mark, and Oliver.   The new treatments were going to start today.  Since we had planned to leave for Calgary at 6:00 a.m. on Thursday, those treatments are starting next week when I get back.   Wendy and I had talked about her taking the kids to Calgary herself if I needed to stay behind but I am hopped up on antibiotics that will keep me going until I get back.  Without them, I was told I would have been hospitalized in Calgary which is why I was nervous about going.  As the doctor said, I have a long and hard road ahead of me, a vacation right now is a good thing.
  8. I appreciate the advice that EVERYONE is giving me and that is that I go to the Mayo Clinic.  Umm, I have about $200,000 equity in my house.  Wendy and I have looked at re-mortgaging to do this but to go down, it would take every bit of money we have and then what happens if it doesn’t work?  I bring up the costs for just a week of treatment and people’s jaw drop.  Let me be blunt, the Mayo Clinic is for the wealthy.  Wendy and I are very middle class.  Throughout this I am realizing that people see the Mayo Clinic as their last hope.  If everything else goes bad, there is always the Mayo Clinic and “those” doctors can help you.  They may be able to do so but only at a tremendous cost that most of us can’t afford.

Why We Don’t Like Stories in Which the Mentally Ill Heroine Recovers

Basically people who recover undermine how psychiatry is practiced now.

The story of modern psychiatry, for many, is triumphant one. The quick-and-dirty history goes like this: Human ingenuity and scientific advances led us from the dark ages of hydrotherapy and solitary confinement to cognitive-behavioral therapy and expertly prescribed medications. While we used to believe the mentally ill were unwell as a result of wayward behavior or demonic possession, we now know that psychic anguish is the result of brain chemistry and nurture, and we’re working harder to analyze the former. We moved, in other words, from mental illness as a moral failure to mental illness as a medical condition.

But if you zoom in on the late 1940s through the early ’60s, a different battle is being waged—a battle between those who believed mental illness was biologically located in the brain, and those who thought mental illness was a matter of emotional disturbance. Back then, those intent upon transforming psychiatry into a reputable science (as opposed to a touchy-feely art) worked tirelessly to develop new methods of medical intervention for the mentally ill. The best-known method was “psychosurgery” (aka lobotomy), which was introduced by neurologist Egas Moniz in 1936. In 1949, Moniz won the Nobel Prize for his work on psychosurgery, and by 1951, the operation had been performed close to 20,000 times.1
Contrast this obsession with the physical brain—slicing it, shocking it, or tranquilizing it—with the ethos held by Chestnut Lodge, the elite private institution where Joanne Greenberg began treatment in 1948. The clinicians at Chestnut Lodge fervently believed that no patient, however psychotic, was impervious to psychotherapy. The champion of this viewpoint was the Lodge’s most famous employee, the gifted psychoanalyst Frieda Fromm-Reichmann. Fromm-Reichmann was Greenberg’s primary analyst and, in both the novel and in real life, led her from insanity to wellness. In the book, Fromm-Reichmann is “Dr. Fried,” and Greenberg so positively depicted the humble German that for years she received letters from struggling fans desperate to track down Dr. Fried and undergo analysis with her. 

Fromm-Reichmann immediately recognized something special in her teenaged patient: Greenberg was quick-witted, well-read, and seemed to retain an appetite for life that many of the doctor’s older, chronically ill patients had lost long ago. Greenberg’s symptoms were often referred to as “florid”—interpretable, extravagant, and suffused with meaning, like a story. When Joanne was struggling, Fromm-Reichmann openly empathized. When she began to retreat, the doctor begged to follow. “Take me along with you,” Dr. Fried tells Deborah during a session. She insisted to her young patient that they must pose a united front. “I believe that you and I,” Greenberg has her say in Rose Garden, “can beat this thing.” And, together, that’s just what they did.

This narrative is a little too pat for our contemporary sensibilities. Perhaps that’s why the book is not as well known as, say, Sylvia Plath’s The Bell Jar. (The Bell Jar still sells briskly; the fiftieth-anniversary paperback edition is ranked 1,730 on Amazon, compared to Rose Garden’s 21,792.2) But Rose Garden does not appeal for another reason: It’s easier to think of the psychiatry of yore as entirely backward and as the poetic casualties of it—Plath, Arbus, Sexton—as victims of that ignorance. Their tragic stories, paradoxically, make us feel more secure in the march of psychiatric progress.

The demise of these women—and the subsequent autopsy of past mental healthcare failures that their paper trails encourages—permits us to rest serenely in the knowledge that the world is moving steadily toward a more scientific, humane psychiatry. But, one has to wonder if this is entirely the case. Frieda Fromm-Reichmann spent four years with Joanne Greenberg; she hiked up to the Disturbed Ward to see patients when they were lying limp in restraints. Now, psychiatrists evaluate patients for 45 minutes before diagnosing them and sending them off to fill prescriptions, and many patients go months between appointments. Efficiency is the goal here; medication the cure, meaningful human connection a distant second priority. It is increasingly rare to find a psychiatrist who also performs talk therapy, despite its many proven benefits.

This might be an even greater tragedy with regard to treatment of schizophrenia, where holistic treatment—that is, one that recognizes both the medical and the emotional components and allows for feedback between the two—might hold particular promise. According to Dr. Allen J. Frances of Duke Medical School and the author of Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, “Cognitive therapy and social skills therapy are very valuable in treating schizophrenia, but they are rarely available.” And the idea of “complete recovery” is downplayed.

If you are a regular reader of this blog, you know that my wife Wendy has struggled with depression for most of her life.   As she has written about before, like many others, she was sexually abused for an extended period growing up and it took a toll on her as she has grown older. It has never gone away and returns with a vengeance each and every summer and causes chaos and pain around here until fall.

This is the process we have to go through to get help.

She needs to go to her family doctor who prescribes depression medication and then writes a referral to the psychiatrist.  Since that is a year to two year wait, she goes back to her family doctor who ups her medication, ups it again, ups it again and then realizes it doesn’t work.  So then she is weaned off her medication and then the doctor does it again.  If that doesn’t work.  Repeat.

Finally she gets to see the psychiatrist (18 months later), she walks in, explains her situation, he tells her she has PTSD and then gives her a prescription for a stronger medication.  Out in 10 minutes.  

That medication may or may not work.  If not, she can go back and is back out in five minutes with a new prescription.  If it does work, it works for about 8 months and then when she tries to go back, she is told that her file is closed.  She needs another referral (and a year wait).

That is what is covered by Saskatchewan Health.  What she really needs is talk therapy as well which is not covered by Saskatchewan Health and runs over $100 a session.   Since it isn’t part of her health care or any kind of continuum of care, the therapist and psychiatrist don’t talk which means that once summer went spent thousands on therapy that did nothing because Wendy’s medication was off.

What we are told is that Wendy’s condition will be with her for the rest of her life and she just needs to keep taking her medication.  In some ways that may be correct but the reality is that it doesn’t have to be as bad as it is or as costly if we spent the resources to treat mental illness like we do other illnesses.  I think that is what makes people so uncomfortable, we know we can do better but do not because of a shortage of psychiatrists and clinical psychologists in our system.  Heck we don’t even benchmark mental illness treatment in Saskatchewan.  How do we hope to get better when we don’t define success?

It’s been a frustrating process to see Wendy struggle like this.  Her public presence like many is far different then her private one and I have been more than willing to move to get her treatment.  We have explored selling the house and our stuff and moving south to the United States but the equity in our house won’t touch long term treatment costs.  So like a lot of families and people who struggle with depression, we stay and try our best to work in the cycle of madness and fight the assumption that mental illness can’t he cured.

Video: Reduce the lead time for Mental Health and Addictions patients in RUH Emergency


The Saskatoon Health Region is being driven by Lean Management.  Like any management theory it has a website, newsletters and even some videos.  While the video production quality is horrible, here is a video on how the Saskatoon Health Region is trying to improve intake and evaluation for Mental Health & Addiction Services at RUH.

Expansion of services for 33rd Street Methadone Clinic

From the StarPhoenix

When staff at the 33rd Street pharmacy learned that lack of transportation hampered many of their 250 clients from seeing addictions counsellors, they approached the Saskatoon Health Region, offering to renovate and build a state-of-the-art methadone dispensing and distribution system.

“Because people have to come here to pick up their medication, the idea came up – ‘Is there any way we can help these people access services?'” Carlson said.

The health region agreed to lease the 800-square-foot clinic, which will have a counselling space, a doctor’s office and examination room, and a children’s play area.

It is expected to open around the end of April, said Tracy Muggli, director of mental health and addictions services for the health region.

I think this is a good step for the Health Region, Mayfair, and of course those that use the services.


Well Wendy, Oliver, and I caught H1N1 (for those of you who are following on Twitter this is redundant).  Oliver and Mark had been vaccinated and while Mark was fine, Oliver was not.  Wendy and I also got horrific secondary infections along with it which made us even sicker.  All I can say is that you need to go and get the vaccination as I can really understand how people die from it.  Wendy and I were in incredible pain, had trouble breathing, ran really, really high fevers and still days later are not feeling well.  After seeing my doctor, he said it was going to be a long time until I felt normal again.

Stop the Spread of H1N1 We aren’t sure who brought it home.  Wendy works with the public and I work in a homeless shelter which was asked to house homeless people who have H1N1.  While I don’t expect Safeway employees to get the vaccination first, I was a little disgusted that none of our staff were given the chance to get H1N1 vaccinations by the same health district that was sending people infected with the disease to us to be taken care of.  I know how big the Saskatoon Health Region is but you would have thought in some of the pandemic planning that is done, shelter provider staff would have been seen as a high risk people group to catch the disease.  It’s weird as these patients are refused services by hotels and motels and yet the expectations is that shelter staff will take care of them, despite the fact that most our housing is congregate housing in dorms.  On my to-do list is to figure out a way that the next time this happens, our shelter and other housing providers get a little more care and support.

It wasn’t a lot of fun being that sick.  Fevers of 105 get on my nerves quickly.  It also wasn’t fun seeing Wendy that sick and especially seeing Oliver get that sick again (it’s been a bad year for the little guy).  A couple of quick thanks though.  Mark was kept home so he didn’t infect the half of his school whose parents decided not to vaccinate their kids and he was a lot of help taking care of Oliver while Wendy and I were bed ridden.  Also as Wendy was tweeting some of our suffering to Twitter (and then to Facebook), we got a call from Brenda England who gave some wonderful advice and that was to get the Tamiflu as soon as possible.  Finally, Gloria phoned up and asked if she could bring by some food.  Wendy called her back and gave her a list.  I am not sure what she brought but there was fresh grapes on that list and on a day when I felt beyond horrible, those grapes tasted amazing.