Category: Health Issues

The Wonders of Cataract Surgery

In recent weeks I have experienced the wonders of cataract surgery extended to correct myopia. Like so many I know, several dates with the ophthalmologist, two remarkably short visits for surgery at the highly efficient Kensington Eye Institute,  a rigorous regime of multiple eye drops every day, and voilà: almost instantly, I can drive without glasses.

It is amazing what I now see. Street signs appear as if in large font primary print. Left-hand turn prohibitions are now legible. I now notice how the traffic is proceeding (or not), three or four street lights ahead. I can drive down Don Mills Road which is unfamiliar to me and still scan the signs of all the passing plazas looking for the one remaining Tilley store in Toronto. My command of the road and navigating the passing environment has never been better. It’s clearly time to get my driver’s license, which requires that I wear glasses, changed.

Apart from the luminosity of what I see, the detail I now notice makes me realize how much I missed before. I never appreciated, for example, that there were old-fashioned triple street lights lining the sidewalks along Bay Street beside the Manulife Building. Or that many downtown buildings have elaborate murals at the skyline. Or that the wooden fretwork on the chancel at Trinity-St. Paul’s Jeanne Lamon Hall is as elaborate as it is. Or that the fur on the tail of my black cat has a textured pattern that I didn’t know existed.

Of course, there is a downside to this new-found visual acuity. I now see cobwebs on the ceilings, plaster which needs repair, paint to be redone, and many other defects of an old house which I blissfully avoided up until now. Clearly, replacing my eyes will entail new costs for home repairs.

Having the eye surgery has been a learning experience. With one eye fixed, and the other not, I took one lens out of my glasses (the first one I’d had surgery on) and assumed that using the glasses with the other, I could read and work on the computer. Alas, that was not the case. With one eye corrected and the other not, I could read if I held whatever I was reading up close, but the distortion between the eyes made working on the computer very difficult.

Now that both eyes are fixed to improve my distance vision, I must adjust to the need for reading glasses. Before I wore glasses all the time and never thought twice about it. Now, reading labels in the grocery store, the program at the theatre, menus in a restaurant, and even the Globe and Mail is impossible without reading glasses. No big deal, you say. Everyone needs reading glasses once they hit forty. Maybe.

But there are strategies to consider. Some people carry their reading glasses on a cord around their neck. My husband, who had this surgery a couple of years ago, has at least a dozen pairs of reading glasses he bought cheaply at the local pharmacy. But he is always looking for them, never seems to have them when and where he wants them, and they are always breaking.

I’ve decided that it will work best for me if I invest in a couple of decent pairs of better fitting generic reading glasses which I can leave permanently located beside the computer and another in the kitchen where I typically read the newspaper. A friend also advised me to wait until the second eye is totally healed and then invest in a good pair of reading glasses which are bifocals (with plain glass on top) to carry around with me in my purse. I have also learned that, with an optometrist’s prescription, my favourite optical shop on College Street can likely fit bifocal lenses into one or more of my old glasses frames, and that the frame of my old prescription sunglasses could be recycled for reading glasses.

Cataract surgery (and the related opportunity to correct other vision defects at the same time) is one of the miracles of modern medicine. Commonplace, but oh so effective in improving our quality of life and public safety.

 

 

 

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Midwives and Maternity Care: The Wave of the Future

Our niece and her husband from Vancouver, who are now living in Toronto, had their first baby in late December. When I met the little one in February, I learned how pregnancy and birthing have changed since my day. My niece had a wonderful experience using midwives, an option now available to pregnant women and their partners.

Midwives? I have heard about midwives, but certainly didn’t know what they did. Now I appreciate that they have a marvellous role in health care for women that hopefully will increase in the future.

Last spring when my niece and her husband wanted to start their family, they needed to find a family doctor. She used the Ontario Health Care Connect program to find the names of doctors taking new referrals. There weren’t many but, three months later, she found one in a clinic five minutes from their home in Toronto’s east end. Once she became pregnant, the family doctor advised her that she could give care for only up to ten weeks. Thereafter, health care to do with the pregnancy would be provided by either an obstetrician or a midwife, both funded by OHIP. The doctor recommended a midwife as they do home visits and provide ongoing support.

Referred to The Midwives Clinic of East York, my niece learned about their services. They would see her every month until twenty-eight weeks, every two weeks until the 35th week, and then weekly. They offered several options for the actual birth: with a midwife at home, with a midwife at the Toronto Birth Centre on Dundas in Regent Park, or with a midwife in the local hospital, in this case the Michael Garron Hospital (formerly Toronto East General). After delivery, the midwife would visit every two days for the first ten days, see her at the clinic every two weeks until the baby was six weeks old and then they would transfer her back to the family doctor. If there were problems at any time, she would be transferred to an obstetrician. My niece was introduced to two midwives who would give continuity of care throughout the pregnancy and make sure that one or the other would be available when the time came to deliver.

Her pregnancy went well. The only issue was that the baby was late, six days after her due date. When my niece’s waters broke late one evening, she called the midwife, who asked questions to make sure that everything was okay, and told them to call back when her contractions started. Once they did, the midwife was at the house 45-60 minutes later, did an exam to see how far she was dilated, and then stayed with her for another hour of labour. She then left her to continue labour into the morning, but was available by telephone for updates throughout. Ultimately, the midwife instructed them to meet her at the hospital. Now sufficiently dilated for admission, my niece was given an epidural, the baby transitioned into the proper position and at 1:38 in the afternoon, the baby was born. Two midwives attended the delivery, one to attend to the baby, the other for the mother. The baby’s father was present throughout. The only contact my niece had with any doctor was with the anesthesiologist who administered the epidural she requested. Post-delivery, the midwife was at their home to help with the baby.

My niece loved the process, felt very supported, and never rushed. She had assumed that midwives would push the home birth experience but found that they never did. Her midwife delivered seven babies that same week and was, to quote my niece, ” incredibly knowledgeable.” At all times, my niece considered herself well-informed and knew that she had the power to make the decisions that were best for her.

I had not appreciated that midwives have been a self-governing regulated health profession in Ontario for over twenty-four years. They are subject to standards, guidelines and risk-screening protocols set by the College of Midwives of Ontario. According to the Association of Ontario Midwives, as of 2016, there were 839 midwives in the province, 89 midwifery practices, 77 communities where midwives provide care, 93 hospitals where midwives have privileges, and three community-based midwifery-led birth centres. Canadian Association of Midwives statistics show that from April 1, 2015 to March 31, 2016, there were 21,224 midwifery-led births in the province, 15.2% of the total births.

That same year, there were 8,987 midwife-led births (21% of the total) in British Columbia, 3,400 (3.9% of the total) in Quebec, 2,815 (4.9% of the total) in Alberta, 1,110 (6.4% of the total) in Manitoba, 132 (15.4% of the total) in Nunavut, 87 (12.7% of the total) in the Northwest Territories. and 247 (2.18%) in Nova Scotia. In Yukon, New Brunswick, Prince Edward Island and Newfoundland, there were none. These figures come from the latest statistics of midwifery data available on the internet

Seven universities across Canada: the Université de Quebec at Trois Rivières, Laurentian, Ryerson, McMaster, the University College of the North in Northern Manitoba, Mount Royal University in Calgary and the University of British Columbia, offer Four-year Bachelor of Health Sciences degrees in Midwifery. In addition, Ryerson offers a part-time degree program that is completed in five to six years, and an eight-semester post-Baccalaureate program for health professionals with earlier maternity care experience. Apparently, eighty new midwives graduate from Ontario programs every year.

It is ironic that, although women helping women with pregnancy and birthing occurred historically, midwifery is now one of the new professions which did not exist in Canada before. As with new technology, new approaches to providing health services need new knowledge and new skill sets.

Having midwives as an essential part of the health care team makes so much sense. Their ongoing support and specialized expertise can only enhance women’s pregnancy and birthing experiences. Given that their role providing maternity care in other countries is well-established, it is surprising that midwives are not in greater demand in Canada. Perhaps Canada’s health care systems across the country need to show greater leadership. Maybe more midwifery training programs are needed. Maybe people like me need to catch up on what is actually going on in the field. Undoubtedly, this is the wave of the future.

 

 

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ETHEL’S TOQUES

How do you see yourself at 96 years of age? On Monday, my sister and I visited an old family friend who is truly aged, has many medical issues, and needs full-time caregiving support. She now lives with her daughter and son-in-law in their expansive Markham home which accommodates her walker, has a stair-lift climbing the staircase to the second floor bedrooms and, on the main floor, a kitchen table looking out to a backyard busy with birds at the feeder, bushy black squirrels and even the occasional fox.

When we arrive, Ethel is in the family room watching the Olympics on the television. She rises to greet us. Her freshly made up face lit up with a radiant smile, her white hair immaculately coiffed, and wearing a stylish black checked jacket, she looks twenty years younger than her age. Before long, she opened up a plastic bag and gave us each a soft, hand-crafted woollen toque, navy blue with a white pompom, which she had made for us. We were thrilled.

Ethel has been making toques for about ten years. She saw a woman at Eglinton Square in Scarborough working on a round plastic frame called The Quickie Loom. Intrigued, she bought one right away and took it home to show her husband, Vic. Before long, they had two frames, one for toques and one for scarves, which both made for family and friends. One year they made forty toques and gave them to a church which distributed them to street people. So far this year, Ethel has made more than a dozen, two for us and the others which also have been collected and given to people in need.

When we asked, she was eager to show us how she makes the toques. The trick is using an inexpensive frame called The Quickie Loom which can be bought at a craft shop such as Michaels or even Walmart. She uses Bernat Roving acrylic and wool (hat weight), which she also buys at Walmart.

Several videos on YouTube provide simple instructions for what is called loom knitting. Ethel begins with a slip knot placed on an anchor peg on the plastic frame. She wraps the strand of wool around each peg on the frame to make one row of loops, and then continues the same thing to create a second row. Once she has laid down two rows, she uses a pick to hook the bottom strand over the one above. She repeats the process of hooping and hooking, two rows at a time, until she has completed sixty rows for a large size toque and forty rows for a medium. As she loops and hooks the wool on the frame, the toque forms itself.

It’s easy. She can make one in an evening while she is watching television. And she didn’t have to be a knitter.

Looms come in many sizes with increasing numbers of pegs to make toques and scarves for dolls, babies, toddlers, and adults. There are YouTube instructions for making different types of hats; unisex slouchy beanies, pussy-hats, a rib-stitch hat, and also scarves. There are instructions for changing colours, making pompoms, and adding a flower to the hat. For the toques she made for Kath and I, Ethel added white pompoms. Making those pompoms for the first time required the ingenuity of all three adults in the household, but now she has the hang of it.

Loom knitting hats is easy for children. Ethel told me that when her pastor’s young daughter was diagnosed with cancer, Ethel gave a Quickie Loom and some wool to both her and her sister, to make hats for themselves. She told them that when they showed her the hats they’d made, she would give each of them $5.00. Two days later, on Sunday morning, they met her at church with big grins on their faces, and their finished hats on their heads. Ethel was delighted to depart with the $10.00. The girls went on to make dozens of hats for their friends and for the church.

Happy Valentine’s Day, everyone. 

***** Photos with thanks to Keith Carbert *****

 

 

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Mastering the Technology of a New Car

Our fifteen-year-old clunker, a 2002 Nissan Sentra with only 118,000 kilometres on it, finally ran into the ground on the July long weekend. There was a terrible racket from underneath the car that turned out to be a heat shield dragging on the pavement. A minor repair maybe, but we had long ago agreed that we would not put another cent into it. I called the Kidney Foundation and a few days later, they towed it away, providing me with a $300 charitable donations receipt.

We mined Phil Edmonston’s Lemon-aid New and Used Cars and discovered a new class of vehicle which we did not know existed. It’s a CUV, a crossover utility vehicle, which is smaller than an SUV and apparently very popular. That the seats of the car are higher off the ground is a huge advantage for seniors with mobility issues, and apparently there are now all sorts of safety features that will prevent crashes. We considered only two vehicles: the Nissan Rogue and the Toyota RAV4. Ultimately, we settled on the Toyota because I wanted a hybrid.

I made an appointment on the internet to test drive a RAV4 hybrid first thing Tuesday morning. The local Toyota dealership was only a short distance away by streetcar. When we arrived, the young sales rep showed us the exact model we were interested in and, within an hour, we became owners of a new RAV4 hybrid he would deliver to our home two days later. On delivery, the sales rep spent an hour and a half explaining how the car worked, and then left us with the car and two thick manuals. Undoubtedly, this was the most expeditious car purchase we have ever made.

Buying is easy. Learning how to use it more difficult. Three and a half months later, the car is still a continuing revelation. Keyless, the car door opens when we approach, so long as we have the fancy fob (worth $800 if lost) in pocket or purse. It took me several days to realize that, locking it, requires two taps on the door handle that will activate a light on the mirror to tell me that the car is actually locked. And although it is clear that one has to depress the brake before pushing the ignition button, the car is so quiet that we have on occasion forgotten to turn it off. Once, several hours after we last used it, a neighbour knocked on our front door to tell us that our car parked on the street still seemed to be running. Even yesterday when I was outside the car, the lights were still on and the door would not lock, and I couldn’t figure out why. Only then did it come to me that I had forgotten to depress the ignition button.

Then there is the gear shift lever. Whenever we put it into reverse, the camera appears on the master console screen with yellow and red lines showing where our car is in relation to cars behind it. The yellow line is apparently the trajectory of our car. The red line is the point at which I would actually hit the car behind. Gauging how those lines reflect the reality of the space required for parallel parking has been a challenge. But I’m getting the hang of it, finally. It even beeps a warning if someone or something should cross my path behind.

The warning beeps, and the flashing lights, are marvellous. So long as the various safety features are turned on, the lights on the mirrors will flash when a car, or sometimes even a bicycle in a bicycle lane, is passing in my blind spot. Or when I am drifting out of my lane on the freeway. If the beeps or lights come on, I now know to pay attention. Something is wrong; my job is to figure out what.

For all the wonderful safety features of this new car, the Master Console Screen is terribly distracting. It will take us forever to understand all its features, but already we are learning. We have more or less mastered the Audio; endless radio choices, SiriusXM if we knew why we should subscribe to it, and my entire music collection accessible by merely inserting a computer stick into the USB port below. And, just to make sure that we are fully informed, the screen identifies each program and each piece of music we hear.

As for the Apps, the Navigation feature has already proven invaluable. Tap in an address and a map and a friendly voice will give directions. Maybe even several options, with times and distances, for how to get there. How we are to evaluate the routes, we doen’t yet know. But we’ve already learned several things:

  1. The system will not allow us to tap in a new destination when the car is moving. Apparently that is a safety feature to prevent distracting the driver.
  2. The directions for the downtown core must be taken with a grain of salt. Often we know better than the system how to get from our home to the Gardiner expressway, for example. To its credit, the system adjusts to the route we actually choose to go.
  3. On the highway, the directions are usually right and we second guess the system at our peril.
  4. I must become more tolerant when the voice mispronounces local street names. The fact that AI is not perfect, I should consider some consolation.

The Telephone App is a light-year improvement over the dashboard cradle which used to hold my iPhone in the Sentra. So long as the smart phone is in my purse, it apparently connects by Bluetooth to the console screen. Phone numbers magically appear on the screen. Those numbers we use regularly are now installed for instant access by touch. And I’ve discovered a button on the steering wheel which I can push to activate a personal assistant who will call someone else on my Contacts list or find coffee shops, gas stations and restaurants nearby. All I need to do is think up something for the assistant to do and, voilà, the call is made or the results appear on the screen. Talking so easily on the telephone in the car is a new treat for me and I love it. As for the computer searches for nearby restaurants, I have to steel myself not to look at the results while driving alone. That would be dangerous.

Learning not to be distracted by the Master Console Screen is a major challenge. At first, we were endlessly fascinated by the colourful image which shows the flow of power in our hybrid from the gas engine and the battery, and back again. Trying to figure out what conditions cause the operation to change, and how that affects gas mileage, was an initial preoccupation which we have given up. I now just rely on the gas gauge showing the mileage to the next fill-up. It appears somewhere in the second set of information windows behind the steering wheel itself. Those are controlled by a toggle on the steering wheel which has multiple functions that I am gradually learning how and when to use. I wish I could just read the manual and assimilate all its info, flat-out. Alas, that’s not my learning style.

Last week, my husband looked up how to turn on the heated steering wheel and the heated seats which were supposed to be in this car. In the past, he scoffed at such amenities. Not any more. He likes the heated seat, even in warm fall temperatures. He says the warmth reduces the pain in his back. And the heated steering wheel? All the better to assuage arthritis in aching fingers and wrists. Who would have guessed that our new car, as well as being a fabulous new computer (perhaps more properly a mirror for my computer), was also going to be a new mode for therapy?

This could be the last new car we ever buy. Just as well. Learning how to use all its features may well take us a decade.

 

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Nordic Pole Walking

Are you looking for the perfect high intensity, low impact exercise? We may have found it. Yesterday my husband and I had a lesson in Nordic Pole Walking. We both came away wildly enthusiastic. Even my normally cynical husband readily admitted that this may be the way to go.

His return from Vancouver has been Act Three in the saga of the broken kneecap. After a good recovery in Vancouver and an easy flight home, only a few days later, he was suddenly suffering excruciating pain in the leg opposite to that which had been broken. Although the pain was intermittent, when it occurred he was forced to walk almost doubled over, at half his height, leaning on his cane. We had no idea what was happening.

A friend referred us to the Insideout Physiotherapy and Wellness Group in downtown Toronto and, less than ten days later, he appears on his way to recovery. Among the diverse techniques physiotherapist Jennifer Howey used was to recommend that he take up Nordic Pole Walking.

Developed by the Finns in the 1990s to train their cross-country ski team during the summer, the technique makes perfect sense. It’s walking naturally with a kick. Using the specially designed walking poles with the proper technique transforms a lower-body exercise into a gentle full-body workout which includes the upper arms, back, shoulders and neck. That doubles the impact of the walking without adding to any apparent increase in exertion.

We have used poles for hiking and backpacking for years. There, they are invaluable in distributing the body weight, helping with balance, and adding a third and a fourth leg to ease crossing difficult terrain. These poles are different. They are shorter, have rubber boot tips which are shaped to add propulsion, and a glove which adds pressure to the push without straining the fingers. They are designed to get all the muscles of the body moving while walking naturally.

For my husband, the poles are a huge advantage. Giving what is perceived to be a gentle exercise, they help with balance and force him to stand upright and look ahead. Use of the poles reduces stress on the knees and hips. It is early yet, but we can see the benefits the poling will provide.

It didn’t take me long to realize that Nordic Pole Walking could be equally useful for me. Apparently, it is highly recommended for managing diabetes, blood pressure and weight control. In Europe, 20% of Finns now use these walking poles, as do millions in Germany where health insurance companies subsidize pole walking courses and equipment.

Jennifer and her partner, Peter Burrill, the Insideout Nordic Pole Walking Program Coordinator, are big promoters of the technique. They use it for their patients, offer Nordic walking workshops and special events, conduct clinical studies and even helped design the Nordixx pole they recommend. Walking around the trees and up the allies of Toronto’s iconic Yorkville Park and along Bloor Street in our lesson yesterday, Peter had specific suggestions to ensure we were using the correct technique. My husband walked better than he has in weeks and I could feel the difference. The proof, of course, will be in how we follow up.

For more detailed information about Nordic Pole Walking, the health benefits, the nature of the equipment (relatively inexpensive and remarkably light-weight), and demonstrations of the correct technique, check out the Insideout webpage.

My husband and I are clearly slow to catching on to new trends. Mike Snider reported in the Globe and Mail six years ago that occupational therapist Mandy Shintani launched Urban Poling in Vancouver in 2003, and has certified more than 1,000 instructors across the country. Nordixx maintains a webpage which allows you to locate the closest instructor in your area.  

 

 

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The Blessings of a Broken Kneecap

My husband went to extraordinary trouble to bring us the blessings of an extended stay in Vancouver. Now that his care (and mine) is in place, he is exercising every day, taking charge of planning and cooking our evening meals. and using his walker to shop for groceries and visit local eateries. He appears to be making good progress. For all the tribulations, our extended stay in Vancouver is bringing us many unexpected benefits. Just to list a few.

  1. The rain which depressed even me February through mid-April has now stopped, the sun is shining, and the cherry and plum trees, magnolias, and early rhodos are in unbelievably beautiful bloom. At their peak, they are breath-taking. I never would have guessed that our local community here was endowed with such a splendid display.
  2. Living here, grounded, without any possibility of touring elsewhere, has caused us to use the resources and the merchants of the local community as never before. It’s been an eye-opening “welcome wagon” of new experiences.

  3. We live next door to the West Vancouver Memorial Library, but have hardly used it in the past. This week, the Library Foundation streamed, live and free of charge, the 2017 TED Talks which other people paid big bucks to hear at the downtown Vancouver site or in selected theatres. I happened upon a session on “Mind, Meaning” at 8:30 a.m. on Wednesday morning, and was awestruck by what I heard and saw. Lots of material for posts there.

  4. I have now spent much time with the WVML Information Librarian. When I asked for a couple of books that were out locally, she told me that they were available at the Vancouver Public Library downtown, and that I could pick them up there and return them here. She also did a computer search of recent Globe and Mail book reviews to find an essayist whom I wanted to read but whose name I had forgotten. Once she had identified the author, she put me on a waitlist for both her books which are now on order. Undoubtedly, these same services are available at the Toronto Public Library. I just have never used them before. My loss.

  5. The proprietor of the local Kerrisdale Camera Shop referred me to Advanced Digital Training in North Vancouver where I have had two simply superb private lessons on how to operate the mirrorless compact camera I bought a couple of years ago.  Utterly intimidated by the complexity of what is effectively a very sophisticated computer, I have hardly used the camera all this time. Peter Levey at ADT is an enthusiastic and gifted teacher who has made my camera accessible. Next week, he is going to show me how to organize and manage my photo files, something that I should have learned years ago but never did. Finding Peter, and working with him, has been a real coup.

  6. Last night, my husband and I went for turkey dinner and all the trimmings at the spacious Garden Side Café at the Seniors’ (over 55) Centre nearby. Run by volunteers, the café serves breakfast and lunch every day, and full hot dinners twice a week, at a very modest cost. My husband, who has avoided the Seniors’ Centre until now, even conceded that it was a good meal, that the company was congenial, and that the dinner menu for May looks more interesting than he would have expected.

  7. Walking on the Seawalk, the people I run into at about the same time each day are beginning to become friends. As my Sixth Floor Caregiver friend has told me, these early morning walks come with all sorts of benefits, apart from the exercise itself. Among other things, I suspect that these new friends will bring some great stories to inspire future posts.

  8. Last week, one of the texts for the writing program I am starting this summer arrived unexpectedly early. This single book is a revelation which already is making the rewrite of my first book go better and faster. With a regular routine and few distractions, my writing is on a roll. I now think it likely that my forthcoming book will be published this year after all, thanks in no small measure to my husband’s broken kneecap.

  9. As a couple, we have been slow to think of ourselves as “seniors,” an illusion now shattered. We are coming to realize that dealing with the medical issues inevitable with aging requires proactive thought and a modicum of grace. Achieving that, or not, may well be a measure of character, part of “growing up.” Those people who have met the challenges of medical issues all their lives set an example. They are the experts in how to relate to and benefit from the health care system. We’d do well to emulate their courage, resilience and their joie de vivre, no matter what comes. Maybe this is one of the secrets to successful aging. And to successful living?

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Lessons Learned from a Kneecapping

Three weeks ago my husband suffered a kneecapping. His injury was not a malicious wounding as the I.R.A. and the mafia historically imposed on those who’d earned their ire. No. His was an ordinary, run-of-the-mill broken kneecap sustained from a simple fall on the hard cement sidewalk near our local grocery store. Nothing could have been more prosaic. The results, however, have been a life lesson for both of us.

When he fell, he also hit his head and nose on the cement, splattering blood all over and alarming the shocked onlookers gathered around him to help. An ambulance took him to the Lions Gate Hospital in North Vancouver. Two hours later, he was released. The good news was that he had no concussion and no broken nose; the bad news was that his kneecap was broken and he had to wear a velcro leg stabilizer to keep his leg perfectly straight until it could be seen by an orthopaedic surgeon. Six days later, he saw the surgeon who ordered day surgery for the next day.

That Friday, he was last on the list to have his knee cap wired, stapled, pinned and stitched together, as only surgeons can do, and was told to keep the leg straight in the velcro stabilizer for six weeks. When we left the day surgery unit, it was 9:30 at night, the lights in the ward were low, all the beds but that of my husband were empty, the intravenous poles were herded together for the next day, and two staff (nurses or aides, we had no idea) were behind the desk. When they finally pronounced him fit to leave, they rolled him down to the car in a wheelchair, he pulled himself and his prone mended leg into the back seat as best he could, and we headed home.

We left the hospital as proverbial babes in the woods. The hospital provided a set of crutches, a prescription for painkillers (which only made us recall with horror a previous very negative experience with side-effects of high-powered opioids), and instructions to schedule a post-op with the surgeon two weeks hence. We had planned a return to Toronto by that time; obviously that was not going to happen. We had no idea what would happen, nor what we would be required to manage.

The past two weeks have been a crash course in “Basic Care 101.” Part A: for the caregiver, and Part B: for the care receiver. Although we did not know it at the time, our first big mistake was leaving the hospital (probably due to the late hour) without any referral to an Occupational Therapist, Home Care Assessor, or to the Red Cross (which apparently loans all sorts of medical equipment to people recovering from hospital stays, all on referral from the hospital or a doctor). We had no family doctor on the west coast, and no referral for that, either. We had to manage as best we could, by trial and error, as the situation evolved.

We soon ditched the crutches and rented a walker, bought a raised toilet seat, and set about to make my husband as comfortable as possible. In a totally understandable post-surgical stupor, strategically sedated with painkillers, he developed bedsores, a bad sign we thought. The remedy? “Keep them clean,” and “Cover them with Mepore pads,” said the pharmacist who sold me a half-dozen dressings. A friend brought some Tegaderm film she had used to good effect for her long-deceased mother years ago. The bed sores healed as my husband became more mobile.

In the meantime, an 89-year-old neighbour who lives on the sixth floor and who has been a full-time caregiver for her wheelchair-bound husband for the past three and a half years, gave me the telephone number (604-215-4700) of a publicly accessible nurse whom she assured me is “always helpful… even in the middle of the night.” That we had a phone number to reach some medical help if necessary was immensely reassuring.

Our biggest mistake was our failure to buy or rent a “Bed Assist” that would help my hubby get up from his bed and onto his walker. Who would have guessed that it would be so difficult? First, I was the ballast as he grabbed the walker to pull himself up. That was difficult and hardly confidence-building. Then, we tried arranging cushions beside him in various configurations to act as risers. That was better, but a nuisance. Ultimately, our next-door neighbour, well into her nineties, who uses a walker, demonstrated on her own bed how she uses her upper arms, wrists and fists to push herself up and how she places her head to get the necessary momentum. If she can do it with such agility, so can my hubby. After two weeks, we finally rented a “Bed Assist,” a curved bedside bar attached to two long metal anchors that go between the mattress and the box spring. Problem solved, at least in the bedroom. Getting off cushions piled on the chesterfield in the living room still requires some care. Getting out of the back seat of the car, using the seat belt and the door for leverage, requires the strongest possible strength in the upper arms. Where are those strong shoulder muscles and biceps when you need them?

At first, we were in a state of shock, overwhelmed by our frequent miscommunications, my husband’s justifiable fear of falling again, my expectation (which he didn’t initially discourage) that I needed to do everything, and our clear incompetence. Neither of us was sleeping at night, except with heavy-duty sleeping pills which were running out. When our dishwasher was overflowing with suds just as the new cleaning woman arrived (because I had used the wrong detergent), that was the last straw. The mistake reflected my state of mind. 

It seemed as if this event was a foretaste of the future. Would this mean we’d have to sell our Toronto house (if only to get rid of the steps)? Or give up our Vancouver cottage (because our primary health care providers are in Ontario)? Must I abandon my writing, just when I’m on the verge of learning what the craft is all about? Apart from the love and devotion caregiving requires, the professional skills involved and the constant attention are bloody hard. I know the statistic that caregivers often succumb before the person they care for. Being a caregiver is a high-risk occupation. 

All that has now changed. A friend who is a professional social worker invited me for coffee, gave me space to vent and shared some practical referrals she could recommend from experience. I have now visited the walk-in clinic she suggested, and had excellent service for my own needs. The doctor sent me to a local LifeLabs where I can get access to the test results myself on the internet. We saw the surgeon for a post-op on Wednesday and, as well as having the staples removed and proclaiming the knee nicely on its way to healing, he gave us all that we asked. We had a long list: renewals of sleeping pills, written orders for physiotherapy, a referral to the Red Cross for medical equipment, and a date for the next visit.

The physiotherapist from local community health came Thursday, showed us how to manage the brace, what exercises to do, which furniture adaptations and equipment additions would work best, how to install new shower heads… altogether a most helpful consultation. On Friday, we secured from the Red Cross Loan Program a shower stool and a tub transfer bench, two possible means to get proper showers. That same day, we plugged into a Home Care Service for a personal service worker or attendant who can help my husband with his bathing routine. And my hubby never even complained. Truth be told, we both came to exactly the same conclusion about our mutual needs at the same time.

Our neighbours, who are nearly twenty years our senior, carry on their caregiving and their personal health challenges with relentless good humour and energy. Who are we to complain?

My hubby is feeling better; he wants to get some exercise, and resume cooking. He has ample time to browse the cookbooks (one of his favourite past-times), can push his walker around the grocery store as he does his shopping, and can manage cooking in the small confines of our galley kitchen. Already he has bought dozens of exotic spices so he can cook from the Jerusalem cookbook a friend gave us. On Thursday, he actually walked all the way home from the grocery store pushing his walker and paying very careful attention to the contours of the sidewalk. The physiotherapist had told us about the practical consequences of neuropathy in the feet, something which may account for his fall and which we should have known before. This successful spurt left him in great good humour. I have resumed writing, taken up walking again and returned to the gym. Friday morning, at 6:00 a.m., I met my Caregiver neighbour on the Seawalk. We are now bosom buddies.

It will be at least another month before we return to Toronto, but the new norm seems manageable after all. And with the sun finally coming out in Vancouver, and the cherry blossoms, early rhododendrons, ornamental tulips in the latest fashion colours, bright yellow and spritely white daffodils, who could want for anything more?

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“Spa in the Sky”

Have you ever felt run off your feet? Busy, busy, busy? Totally occupied with a thousand things, all of which you want to do, but which all too quickly fill your days?

That’s been me the past few weeks. October seems to have been so busy a month: family dinners, the renewal of the opera and concert season, multiple medical appointments, working out at the gym, runners to cheer for, guests to entertain, a quick trip to Vancouver, people to visit, Thanksgiving, Hallowe’en, home repairs, organizing our upcoming vacation, doing some writing, getting the garden ready for winter. The list goes on. And on top of that, the persistent dreadful drone of the American election.

At the #6DegreesTO event in Toronto in September, I picked up the most marvellous little book by Pico Iyer, one of the “Framers” invited to talk about Inclusion. Iyer is a well-known essayist and travel writer born in Britain and now based in Japan and California. He writes regularly for Harper’s, The New York Times and The New York Review of Books. His book is The Art of Stillness: Adventures in Going Nowhere (2014, TEDBook, Simon & Schuster).

His description of Leonard Cohen at the Mount Baldy Zen Center in the San Gabriel Mountains near Los Angeles immediately engaged my attention. I had no idea that Cohen had spent 40 years meditating with the abbot there, or that his monastery name is Jikan which means “the silence between two thoughts.” Apparently, Cohen practices the silence of meditation as avidly as he crafts his poetry and his songs.

Iyer invites his readers to “take this book… as an invitation to the adventure of going nowhere.” He describes how he left his dream life as a writer in Manhattan and around the world to live in a tiny single room in the back streets of Kyoto. “Going nowhere… isn’t about turning your back on the world; it’s about stepping away now and then so that you can see the world more clearly and love it more deeply.” When so much of our lives are lived in our heads, perspective comes not from what we do or where we have been but from how we reflect on it. A real change in life can come from changing “the way I look at it.”

Iyer writes about how freeing up the mind to “play” fosters creativity. He gives the example of Google’s headquarters where employees spend a fifth of their time lounging in tree houses, jumping on trampolines, or practicing yoga. Every building on the campus of General Mills in Minneapolis has a meditation room. Apparently one-third of American companies offer “stress-reduction programs” to their employees. And then there is the institution of the Sabbath, the traditional day of rest, which has existed for a reason and which we increasingly erode to our detriment.

He writes of his meeting with Matthieu Ricard who is known as “the happiest man in the world” and who has written that “Simplifying one’s life to extract its quintessence is the most rewarding of all the pursuits I have undertaken.” When Iyer asked him how he deals with jet lag, when he is in such demand all over the world, Ricard replied, “For me, a flight is just a brief retreat in the sky. There’s nothing I can do, so it’s really quite liberating. There’s nowhere else I can be. So I just sit and watch the clouds and the blue sky. Everything is still and everything is moving. It’s beautiful.” Iyer relates how he met a young woman on a flight from Frankfurt to Los Angeles who sat down and just sat there, “apparently at peace” throughout the entire flight. When Iyer finally spoke with her she said she was a social worker from Berlin en route to a vacation in Hawaii. “Her job was exhausting… (and) she liked to use the flight over to begin to get all the stress out of her system so that she could arrive on the islands in as clear a state as possible, ready to enjoy her days of rest.” I think I will try that the next time I fly. 

It is a beautiful little book, with stunning photographs taken by Icelandic/Canadian photographer Eydis S. Luna Einarsdóttir who lives in Vancouver and travels every year to Iceland. This book is a companion piece to a 14-minute TED TALK by Pico Iyer. Also check out the TED TALK by Matthieu Ricard “The habit of happiness.”

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Fit Fellas

One morning recently I was at the West Vancouver Seniors’ Activity Centre (for those fifty-five and older) to renew my membership. As I did, a horde of men of a certain age, all dressed in black t-shirts, streamed in the front door. Dozens and dozens and dozens of them. I was utterly amazed. Who were they?

“These are the Fit Fellas,” I was told, “and they are here for their coffee and cinnamon buns.” When I followed them into the large cafeteria, it was full of these men. Apparently Fit Fellas was started 41 years ago as a twice-a-week fitness class for eight older men. It has grown to 195 members who meet up to eight times a week for a fitness class “just for guys.” Led by four qualified volunteer trainers, they do aerobics, strength training, coordination, balance, stretching, all mixed with “plenty of laughter” and optional social events. The youngest is 62 years of age, the oldest 97 years, with an average age of around 76. Their membership is full, and there is a waiting list to join. Over 45% of the members have participated regularly for over ten years and 70% for over five years.

Their routine is to meet each morning from 7:50 to 8:50 at the West Vancouver Community Centre gym (two or three days a week, as they wish) and then adjourn to the cafeteria for coffee and refreshments. Anyone celebrating a birthday buys cinnamon buns for the group. They keep in touch by email and a quarterly newsletter, volunteer in various community groups and events, and take part together in other sports, competitions, pub nights, and fund-raising activities. As much as the exercise, their goal is to have fun and build friendships.

Their success has attracted the attention of the Department of Gerontology at Simon Fraser and the School of Kinesiology at the University of British Columbia. They have been the subject of Masters theses, academic conferences across North America, and community workshops on the Lower Mainland. UBC Professor Mark Beauchamp claims, “There is no other program similar to or as successful as theirs,” anywhere else.

In “an effort to develop a framework for use by others,” The Canadian Institute for Health Research funded a two-year study conducted by UBC, in partnership with the Vancouver YMCA, for targeted studies on the Fit Fellas model. The Group-based physical activity for Older Adults (GOAL) Trial involved close to 600 females and males over 65, participating three times a week, free of charge, in single-gender and both-gender classes conducted at three YMCA locations. Data collection ended  in August 2015. The aims of the study were to assess how older adults stick with their physical activity over three months and six months, and whether group cohesion and enjoyment affected their adhesion.

That very morning, Dr. Beauchamp presented a plaque to Fit Fellas and a $500 honorarium to the West Vancouver Seniors’ Centre for their support of the research.

The statistics on physical activity by older adults are sobering. According to Statistics Canada, by 2036, 25% of Canadians will be over 65 years of age. At present, 50% of provincial and territorial healthy spending is on older adult care. Although a clear link has been found between physical activity, improved functional capacity, and reduced risk of chronic disease, only 13% of Canadians over 65 engage in the recommended 150 minutes of moderate to vigorous physical activity per week.

Fit Fellas is a model to watch. Check out the great Fit Fellas You Tube Video, their Facebook page and the promotional video for the GOAL Trial.  It’s a blast. 

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An Interlude on Amherst Island

For thirty years, the all-women’s law firm where I practiced as a lawyer has treasured our Annual Firm Retreat. For two brief days, the existing partners join with those who have moved on or retired to relax, reconnect and recharge our batteries. Until this year, the retreat was held at the beloved country home of one of the partners, a sprawling property at Sturgeon Point near Fenelon Falls, which provided an idyllic setting beside the Kawartha Lakes. That property was sold last year, and we had to find another that would help wean us off what we had come to cherish.

The alternative this year was a trip to Amherst Island. Amherst Island is in northeastern Lake Ontario, west of the islands around Kingston and east of the more populous Prince Edward County. Although the size of Manhattan, the island has a permanent population of only 380 people, and is totally attractive to outsiders for its low-key, laid-back country charm.

We stayed at The Lodge on Amherst Island, a most comfortable self-catering former fishing camp turned guest house, with an extraordinarily well-equipped kitchen, expansive common rooms, well-appointed sleeping quarters, and beautiful grounds by the water. Owned by Molly Stroyman of Toronto, and often used for art shows, writers’ retreats and musical events, The Lodge was ideal for our purposes. Our lavish breakfasts we enjoyed while basking in the eastern sun flowing into the family room beside the kitchen. Dinners in the screened multipurpose room gave us the sunsets in the west.

The twenty-minute ferry ride from Millhaven on the mainland transports visitors to another world, where the pace is slower, the wildlife prolific, and the vistas of Lake Ontario pounding over the limestone of the south shore stunning. The prime economic life of the island is farming, raising dairy cattle and especially sheep. There are said to be 3,000-plus sheep on the island, not including the 1,400 lambs produced each spring. Topsy Farms, on the west end of the island, allows visitors to feed the newborn lambs, and to shop for quality products made from wool and sheepskin. Feeding newborn lambs is totally engaging, but hardly conducive to putting lamb on the menu.

The only hamlet on the island is Stella, close to the ferry. The General Store (seeking new management) is beside the Post Office; there are three churches, a public school, a couple of cafés, The Weasel and Easel selling crafts and local art works in the historic Neilson Store Museum, a radio station and the remnants of a blacksmith shop. Activities on the island include the Canada Day Parade, a Farmers Market during the summer, the Presbyterian Church Garden Party the last Saturday of July, a Book Sale in August, and numerous community dinners and teas held throughout the year. Besides The Lodge, there are four bed and breakfasts on the Island. In the past, I have stayed at premises offered by the Foot Flats Farm, and can vouch for the comfort and hospitality we enjoyed there.

Thanks to photographer Helen Feldmann for the wonderful photos.

 

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Watchful for Wanderers

“On Sunday, I rescued a woman,” my friend, Bob Dann, reported in the midst of our bi-weekly personal training session. He was standing at Yonge and Queen last Sunday morning at 8:30 a.m., waiting to cheer on relatives doing the Sporting Life 10k Run. He felt a persistent tug on his t-shirt and turned to find a little Asian woman wanting his attention.

Bob didn’t want to miss his relatives, but felt he must help. So he turned to the woman. She was well-groomed, appropriately dressed, carrying a purse, and obviously not homeless. English was not her first language but she said she was lost and cold. She had no idea where she was or where she was to go. Bob thought to look in her purse. Before he did, he had the wit to tell the Race Marshall standing nearby what the problem was and what he was doing. All the better to avoid any accusations of nefarious actions on his part.

In her purse, he found two wallets, one with no money in it, the other with a large amount of cash. He found a laminated card with her name, address and telephone number. When he called the number on the card, it was out of service. Further searching of her bag revealed another laminated card with several names, telephone numbers and their relationship to her. He called her son whom he learned lived in North Toronto.

Her son was very alarmed to learn about his mother’s condition. He told Bob that she lived in the east end and her routine was to go out for a walk in her area every day. He suspected that she had become disoriented by the race. He was willing to come and get her but, as a practical matter, his getting downtown and parking would take a long time. Bob suggested that, as she did have money on her, he would put her in a cab with instructions to take her home.

Bob planned to wait until there was a break in the runners to help her find a cab. When there wasn’t a break soon, he manoeuvred her across Yonge Street through the runners, walked with her east on Queen, and hailed a cab on Victoria. He put her in a cab, gave the driver her address, and said that she had money to pay the fare. Bob trusted that the cab driver would deliver her to her home correctly.

Later that day, her son texted Bob to thank him for rescuing his mother. She was 95 years old, and in transition from being very independent to a secured living situation. Pending placement, she was staying in her home and doing her daily walk. Fortunately, she was able to ask for help, someone like Bob responded, and in her purse was the information he needed to get her home. Without the laminated cards with contact information, he could not have done so.

This reminded me of a similar experience which happened to my mother and father. My mother had suffered a stroke, lost her short-term memory, and became prone to wandering. My father was her primary caregiver. Always, when she left the house, she went with him. One day, he had been gardening in the backyard, came into the house, and found Mum missing. He looked everywhere and couldn’t find her. He was panic-stricken and didn’t know what to do. Should he call the police? Should he call my brother, a busy family doctor who would be seeing patients? Maybe she just went for a walk around the block, and would soon return.

He waited, increasingly anxious as the time went by. Then the telephone rang. It was friends from the church. They reported that they were at the Lougheed Mall on the North Road when they saw Mum shopping by herself. The mall is 4.5 kilometres away from my parents’ home, a seven to ten minute drive by car. When they didn’t see Dad with her, the friends knew something was wrong, and phoned the house. They speculated that my mother had gone to the corner near her home and caught the eastbound bus which ends its route at the Lougheed Mall. Dad retrieved her, utterly relieved, and totally grateful to the friends who assisted.

There was an upside to this event. It showed that Mum still retained her capacity to get herself to the bus stop, get on a bus, pay a fare, and find her way into the mall from the bus terminus. The downside was that this was a new development. It had never occurred to my father that she would or could do what she did. New precautions were now required.

As an aside, I should add that great personal trainers, among other things, provide their clients with material for their blogs.

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Don’t Miss the Play “You Will Remember Me”

Theatre reviewers have raved about the play by Quebec playwright, Franςois Archambault, entitled “You Will Remember Me,” now playing at the Tarragon MainStage in Toronto. It was labelled “a pleasing family drama” by Karen Fricker in the Star, which explores “the reality of dementia and uses it as a metaphor,” says J. Kelly Nestruck in the Globe and, after discussion with “Canadian theatre legend” R. H. Thomson, “a play about identity” by Mike Crisolago in EverythingZoomer.com. I was able to snag a last-minute ticket last week and found that the play is all the critics said, and more.

Given its subject, the play is surprisingly light-hearted. Edouard Beauchemin (R.H. Thomson) is a well-known Quebec history professor, public intellectual and nationalist who is in his sixties and beset with Alzheimer’s. Although he can recite historical facts, ad infinitum, and rage on about his favourite bugbear, he can’t remember whom he is talking to or why. He remains vigorous and occasionally brilliant, but cannot be left alone. His long-suffering wife, Madelaine (Nancy Palk), needs a break and decides to leave him with their daughter Isabelle (Kimwun Perehinec) and her new partner Patrick (Mark McGrinder). Isabelle is preoccupied with the demands of her career as a journalist. Patrick, temporarily unemployed, volunteers to pick up the ball. But he has his own agenda which includes his teenage daughter Bérénice (Michela Cannon). All the actors are superb.

To quote Karen Fricker (March 11, 2016), “Edouard is the latest incarnation of an iconic Québecois cultural figure: the charismatic, incorrigible, skirt-chasing male academic… whose ambiguities and excesses comment on the national situation.” The national situation in Quebec has changed since Edouard supported René Lévesque and the Quiet Revolution, years ago; young people today know next to nothing about the revolutionary struggle of which he was a part. The bane of Edouard’s current existence is the all-pervasive influence of social media which, in his view, has “dumbed down” contemporary intelligence. All this is suggested by sparkling dialogue and interesting plot developments. But he who scorns modern technology finds it has uses after all.

And who is it that best helps Edouard deal with his changing identity? His wife has left. His daughter is impatient and rarely connects. It’s “the strangers” in his “blended family” who step into the breach. Patrick and Bérénice discover that the trick is to live in the moment, and that the reality of the moment may, but need not, reflect the truth in the past. On the contrary, relationships can be enhanced, and secrets revealed, by the strength of the creative imagination.

My mother, after surgery for an aneurysm at 75 years of age, suffered a post-operative stroke which destroyed her short-term memory. Although not suffering from Alzheimer’s, she was demented for the remaining 12 years of her life. My experience visiting her and her fellow residents in the secure unit of a long-term care facility for six years was that “the creative imagination” was the key to successful emotional interactions between us. On many occasions, by knowing just a little of what remained in the long-term memory, I found it possible to connect in the present. Who knows whether what we talked about was true or not; it didn’t matter. What was important was to confirm each other as people connected in the moment. That the play portrayed that process left me awestruck. That it did so with such good humour and such pathos in a mere 90 minutes makes it totally compelling.

I would recommend the play to anyone who has been, or will be, touched with dementia. As the reviewers all said, it offers much food for thought and it’s a play you will not forget. Developed for Montreal’s Théâtre La Licorne in 2014 as Tu te souviendras de moi, it had its début in the English translation by Bobby Theodore as part of the Enbridge playRites festival of new Canadian plays in Calgary that same year. It played at The Cultch Historic Theatre in Vancouver last November. This co-production between Studio 180 and the Tarragon Theatre is its Toronto English-language début and runs until Sunday April 10th.

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Meetup Walking Groups

When I first came to Toronto as a graduate student, I found the city exciting but lonely. My fellow students met weekly for short seminars and then scattered. Hart House excluded women, unless accompanied by a man. Massey College did not admit female students.  I met a law student and we decided to share a flat near the Danforth. Apart from my new housemate and my landlady, I knew no one else, did not know the city, and spent a dismal year.

Today, newcomers to both Vancouver and Toronto needn’t despair. Meetup groups exist in both cities to bring people together around specific interests. It could be hiking, music, photography, local area groups, young mothers’ groups; options are broad and enticing, all described on the internet. Some Meetup groups are free; others have a small fee, to pay the facilitator and cover costs.

Meetup groups are not just for newcomers or young people. Anyone can take part. It occurred to me that the West End YMCA Walking Club, which meets Sunday mornings at the College Street West End YMCA, is like a Meetup group, although not structured the same way. Lori Myers, a dedicated and knowledgeable fan of Toronto, facilitates this particular group, maintains the webpage, and leads the walks. Participants can join in whenever they want, just by showing up at 9:00 a.m. The walks provide good exercise, interesting conversation, and great camaraderie. An internet search of “walking groups in Toronto” lists many other options in the city, including a power walking group, and groups that walk in malls.

I have a friend on the west coast who joined her local Meetup Walking Group in Maple Ridge in the Fraser Valley. Her membership is free of charge and gives access to all the other Meetup groups in the entire Lower Mainland. She receives notice of upcoming hikes by email and need only pre-register in advance by internet for each hike. She now hikes two or three times each week with different groups, each time exploring new areas of the city that she does not know, in the company of others.

Last month, I joined the Vancouver Walking Meetup group and, with my friend, explored the south end of Pacific Spirit Park near the University of British Columbia. A forest of trees, some old growth, intertwined with paths, Pacific Spirit Park has lots to offer. It is, however, a large area, and, even with a map, people may not feel comfortable exploring the park alone. The Meetup group is an ideal solution. An experienced guide with particular knowledge of the area led a small group of only fifteen or so hikers for two hours one Sunday morning. It was a perfect introduction to a wilderness area in the heart of the city which I had long wanted to visit and never had done.

The Sunday we went, it was raining hard. Hardly ideal hiking weather. But the trees in the woods shielded us from the rain, and the trails are well maintained so that footing is not a problem. The trees and the greenery are lush, and so aromatic. In the breaks in the weather, we stopped to dwell on the ferns, underbrush, hollowed out logs, evergreens, and pools of water. After two hours in the out-of-doors, we revel in our physical well-being and in the revival of our senses. Altogether a most delightful experience.

 

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“Zen and the Art of Body Maintenance”

Nothing marks the aging process more than “maintenance.” If it’s not one thing, it’s another. Everyone has some medical issue which requires attention.

The most basic of all “maintenance” tests are blood tests and urine samples, as set out in the family doctor’s requisition. In the old days, a visit to the local lab inevitably meant a long wait. Many routine tests required fasting, and there was always a crush of people waiting at the door of the lab when it opened in the morning. Nothing to do but to join the queue, and fall back onto various time-passing strategies: the morning newspaper, checking email, getting some extra shut-eye, or perhaps catching CP24, or some “health education” program showing on the monitor in the corner. It always seemed forever before my name or number was called.

Cooling your heels at the lab is no longer a necessity. Now that fasting requirements are less rigid, patients have the option of going for their tests later in the day. Even so, chairs at the local lab, both inside the clinic and out in the hall, are typically filled with people waiting patiently for their turn at the tourniquet. The lab still seems to be the busiest place in town.

What gives? People don’t seem to realize that LifeLabs at least has initiated a computerized appointment booking system. You can register on the internet, find the available appointment times at the lab closest to you, and book your appointment for a specific time. Last week, I made an appointment with only two hours advance notice. Confirmed appointment number in hand, I walked into the lab, identified myself to the staff on the desk and within but a few minutes of my time, was called for my tests. I jumped the queue by what would undoubtedly have been at least an hour’s wait.

It’s a wonderful service which has worked for me now several times and is grossly under-utilized. All those people waiting in the lab who saw me go ahead must have been somewhat miffed. But they could do the same. Posters on the walls advertise the booking service, and registration on the internet is easy. The attendant at the lab told me that people are not using it because they don’t have computers, or are reluctant to have their kids use the computer to book for them. I have since learned that several of my perfectly computer-literate friends did not know such a service was available. Maybe the labs they use don’t offer pre-booked appointments. Quite frankly, lab loyalty is a waste of time. If other companies are not competitive with LifeLabs, who wouldn’t go to the most patient-friendly service available?

Equally interesting, LifeLabs now offers what they say is “secure online access to your lab test results through your computer or mobile device.” They say that they will provide the lab results in raw form, and an analytical tool (graph program) to monitor test results over time. The results are designed not to preclude discussion with family doctors but to help patients become more actively involved in managing their own health. Apparently, since 2010, over 600,000 people in British Columbia have accessed their health records using a similar system.

At the moment, LifeLabs accounts for booking appointments are not yet joined to their “My Results” system, and patients must set up another account on the LifeLabs results webpage. I registered a new account as I was instructed to do but, despite several tries, was unable to get my results. Apparently, they are still working out the bugs of extending the system to Ontario. Get your “lab visit number” from the lab attendant when you get your tests done and see if you have better luck.

Like doctors’ offices sending prescriptions directly to your local pharmacy, it is gratifying to see the health care system using modern technology to streamline the system and make it more accessible to patients. Now, it is up to us to take advantage of what is available.

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Costa Rica #4: Touring the Northwest Beaches

Seen one beach, seen them all? Not so in Costa Rica. The ones we saw were all different. The interior I-21, which runs from south of Nicola to Santa Cruz and then to Liberia, is the spine from which numerous side roads head west to different beach areas. These main roads are paved, but access roads to many more remote beaches are not, and a 4WD is necessary to negotiate gravel and dirt roads, some surprisingly rough.

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The vast Playa Grande is across the estuary from Tamarindo and, apart from the surfers offshore, has practically no one on it. Crocodiles and caymans are said to live in the estuary and, as the beach and its hinterland are part of the protected Parque Nacional Marino las Baulas (Leatherback Turtle Marine National Park), development adjacent to the beach is prohibited. According to Lonely Planet, the area is one of the world’s prime nesting beaches for these leatherback turtles, which can live for 50 years and weigh up to 400 kilograms. Apparently, they come ashore at night to lay their eggs, which later hatch on the beach, and then go out to sea. We didn’t see any, but friends have.

Thirteen kilometres south is Avellana, a broad white sand expanse of remote beach with high waves and good breaks for advanced surfers. It was here, and at nearby Playa Negra, that Bruce Brown filmed his classic surfer film, Endless Summer 2, in 1994. Apart from the excellent surfing, the leading attraction is Lola’s bar and bistro, named after a succession of porcine mascots. It is an idyllic spot in the sand under the palms, great for good food and leisurely lounging. Those who don’t surf spend their time at Lola’s.

We made several trips north. Not far from Tamarindo is Playa Flamingo, Playa Potrero and, at the end of a more remote road that rises high above the coast, Playa Danta. Flamingo has a broad protected bay ideal for yachts, and another white sand beach along the open sea. On the beach, locals stretch colourful materials between the trees to stake out their space, I guess, and get a little shade. The sand at Potrero, dark coloured and apparently rich in marine life, attracts vultures and pelicans dive-bombing into the water for their food. Danta is a charming beach in a narrow little bay. Apart from the sand, flat rock shelves extend out of the water. Lucio recommends the area for snorkelling. At the moment, the bay is used almost exclusively by locals. There is, however, a huge high-rise development being built just inland from the beach. Once finished, this little local paradise will be inundated by occupants of the new resort, a classic example of the conflict between the natural beauty of Costa Rica and ongoing development for tourism.

On another trip further north, we spent some time at Playa Hermosa, considered one of the quieter and more beautiful bays in the area. Hermosa Bay is utterly delightful, a narrow semi-circle of water and grey sand with tall trees providing ample shade along the shoreline. There is no surf here, only water splashing into the bay. The scene seemed so inviting that I decided to wade in. Within minutes, a huge wave over my head surged in, totally swept me off my feet, and, before I knew it, my glasses were swept away. Silly “gringo.” I should have gone wading at the far end of beach where the “tico” children were swimming and playing on a more protected shelf of sand.

Losing my glasses meant that I could not drive. I had brought a spare pair which were at the apartment. But that prescription is 20 years out of date, so driving with those spare glasses was not possible. When I returned to Vancouver, I immediately saw an optometrist to get new glasses. She found cataracts I never knew I had. Now, I am waiting for an appointment with an ophthalmologist and, likely, cataract surgery. There is an ophthalmologist here in Vancouver who could see me in early March and do the surgery in late May. I’ve been seeking options back in Toronto. Who would have thought that a vacation in Costa Rica would lead to interprovincial negotiations between Canada’s health care systems? Moral of the story? Pay attention where you enter the sea in Costa Rica. And always travel with an extra, up-to-date, pair of glasses.

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