Let’s Talk About “Unnecessary” Tests

Ford’s government recently proposed a series of cuts to what is covered by OHIP in the provincial budget. As justification for him depriving the population of Ontario of adequate healthcare, in particular those who happen to be poor, on social assistance including disability, or underage, were the claims that a significant portion of tests are unnecessary. He went on to claim that less than 4% of family doctors are responsible for ordering over 40% said tests, in a demonstration of how statistics and a lack of understanding can be used to obfuscate the truth.

Let’s start with the latter claim. While it may seem strange that such a small percentage of family doctors may be responsible for so many tests, it’s less surprising to those of us who deal with chronic illnesses.

Not All Family Doctors

Continue reading “Let’s Talk About “Unnecessary” Tests”

Let’s Talk About “Unnecessary” Tests
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Dear Doctors: Even if you Disapprove, You Need to Educate Yourself

Dear Doctors,

I understand. Marijuana, for all that it has been legalized, is still a controversial topic when it comes to its uses in medicine. It wasn’t that long ago that medical professionals feared reprisal for prescribing it, either from government bodies, law enforcement, or insurance companies. Despite all the mounting evidence suggesting its benefit in treating various conditions and its relative safety, it’s hard to overcome the conditioning of several years that viewed it as an illicit substance.

Even if you disagree with the use of marijuana, however, it is important that you educate yourself about it from reliable sources, and not just about the negatives either.

Why?

Because regardless of how you feel about it, I guarantee that you have patients who either use it or are exposed to it regularly. Ignoring for the moment the problems surrounding making your disapproval obvious making it more difficult for your patients to discuss their health, use, symptoms of concern, and so on; not being educated about marijuana on a medical level puts your patients at risk. Continue reading “Dear Doctors: Even if you Disapprove, You Need to Educate Yourself”

Dear Doctors: Even if you Disapprove, You Need to Educate Yourself

April has been a pretty ridiculous month

It started even a bit before April.

After publishing my last article about Ganjahnista’s, shit really started to hit the fan.

I went to visit my medical dispensary and found out that despite a COURT ORDER ordering that medical dispensaries be allowed to stay open until the court could rule on whether they provided a necessary service to patients in accessing their medication, Police had started raiding and shutting them down. They claim, contrary to the truth, that in light of legalization that it meant the court order no longer applied. This is patently false since the court order was specifically in anticipation of the court case, and stands as long as the court case stands.

The fact the police are outright lying or so completely unaware of the law, that one wonders how they expect to enforce it, is done at the behest of conservative pressure. Have to make sure the government pot shops don’t have any competition, especially when they’re trying to get away with charging $500 an Ounce. Their illegal crackdown jeopardizes the H.O.P.E project previously mentioned, and even in just the 24 hours since it started happening, there were reports of a rise in overdoses and ambulances responding to calls all over the city.

I’ve since found out that despite being open for years with city approval, the Police have also shut down Ganjahnista’s. Not only is this another patient safe space gone, but I had also JUST arranged to have some of my artwork on display there on consignment so that’s all gone now possibly.

Continue reading “April has been a pretty ridiculous month”

April has been a pretty ridiculous month

Medical Records, Digital Technology, and Empowering Patients

One of the interesting side effects of living with a first-year university student in what is essentially pre-med, is that occasionally I get asked input on issues related to the medical system. One such topic that came up was digital technology in medicine and it’s impacts on patient health and care.

Hey, wait, I’ve got something for this.

Immediately my mind went to the MyChart system that the Ottawa Hospital used back when I lived there.

The MyChart system is basically an online portal that allows patients who register for it to access their chart online. It’s not complete, but it contains notes on any tests run in the hospital network. The part that was most useful for me however, was the fact that it let me access up-to-date blood test results when I was in the hospital.

One of the realities of being a neurodivergent woman with a chronic illness, is that I have to navigate a prejudiced medical system. It’s not uncommon for certain symptoms to be taken less seriously when they present in women, a part of the medical systems pathologizing of either having a uterus or being a woman. These symptoms can include among them, abdominal pain and iron deficiency, two major aspects of Crohn’s Disease.

In addition, frequent hospitalizations that result in being given pain medication means there is always a risk of being mistakenly perceived as a drug seeker.

All these things put together make hospital visits not only very stressful but inconsistent with regards to quality of care and treatment. The worry of course is for something serious like a blockage, fistula, or abscess being missed because the doctor assumes you have a low pain tolerance or thinks you’re trying to score. Not to mention being in severe pain is both unpleasant and also not good for your health. Continue reading “Medical Records, Digital Technology, and Empowering Patients”

Medical Records, Digital Technology, and Empowering Patients

War on Patients

For all the various experiences I’ve had as a disabled person, a long distance move is a relatively new one. I’m lucky in a lot of ways because the place I’ve moved to isn’t completely new. Although it has been 13 years since I’ve lived here, my parents have been here that whole time. As a result, I have access to certain resources that I wouldn’t have otherwise had. Among these resources is faster access to a family doctor – the same one that has served my family since I was a kid.

I’m lucky because that’s not the case for most people. There is currently a pretty significant shortage of Family Doctors or General Practicioners as they’re sometimes called. Your GP is meant to be the point person of your medical care. They’re responsible for managing the big picture of your overall health – receiving updates from all your specialists, all test results, providing referrals to specialists, and in many cases managing the vast majority of your prescriptions.

As part of my move, I had to transfer my prescriptions from Ottawa to here. Since I was using the same chain of pharmacies, I didn’t much foresee a problem. That’s because I didn’t know about a law that prevents pharmacies from transferring prescriptions that are categorized as narcotics. It’s part of the ongoing war on patients masquerading as the various wars on drugs. The problem is that narcotics are the recognized treatment for a variety of different conditions including ADHD. If I needed a refill of my medication, in this case Vyvanse, I would need to find a family doctor and get a brand new prescription.

Continue reading “War on Patients”

War on Patients

How Can Pain Cause Weight Gain?  

For years the assumption has been that “obesity” leads to pain. Many patients have had the experience of looking for explanations of pain issues, only to have the problem never investigated and told to lose weight instead. Then years later, find out that their pain was actually the result of an underlying issue, made worse through a lack of early treatment. You might have seen a comic or visual joke involving a visibly injured patient and the doctor saying “have you tried losing weight?”

In my book, Young, Sick, and Invisible, I discuss how this same trope was directly responsible for my own autoimmune conditions being ignored long enough to cause long term and severe disability and damage.

In a recent post, I had responded to an intentionally insulting comment with a long explanation of how their assumptions about my use of a mobility aid and my weight was influenced by a series of misunderstanding about obesity, pain, and disability. Included among this explanation was the statement that “obesity” or rather weight gain, can often be a symptom of chronic pain rather than it’s cause.

In response to this statement I received a question, and while the phrasing made it clear the comment wasn’t actually a legitimate inquiry but another chance for the commentor to engage in fat shaming, the underlying question sparked my interest.

Heavily edited, the question was this:  

“I understand how obesity can contribute to pain by putting stress on joints, but I don’t understand how the opposite can happen. Can you Please explain it to me and help me understand? How does Pain cause Weight Gain?”  

To begin, the concept of “obesity” is widely misunderstood and is oppressive in and of itself. As a knowledgeable friend recently explained it –  The word is based on the Body Mass Index scale (BMI) where the ratio of height and weight was determined and everyone who scored within certain parameters was considered as having a healthy BMI while anyone whose BMI was above this range was deemed obese. A person who had very little body fat, but was very muscled, especially in relation to their height, would be classified as obese. In fact, since muscle tends to weigh more than fat, a body builder is more likely to be classified as obese than what most people consider to be representative of an “obese” person.

The concept that obesity is synonymous with fatness is a misunderstanding that has become accepted as a standard, and is used by doctors to excuse their own medical negligence when it’s the result of internalized biases regarding fatness.

What’s more, more and more evidence suggests that body fat percentage is not actually a reliable indicator of an individuals health, nor is there actually a reliable standard as to what fat percentage can be considered healthy and which is unhealthy. That rather fat distribution and percentage is really just a variation in body type much the same way that shape, height, etc. are.

The attempt to pathologize fatness ultimately makes as much sense as claiming that a certain eye colour is an indicator of overall health. Contrary to popular belief, just being fat is not in itself unhealthy.  A fat person can be just as healthy as someone who is considered slender. What is unhealthy is when there is a sudden significant increase or decrease of body fat percentage outside of regular growth and development. In the specific case of an increase in body fat levels, what is unhealthy is when it is spurred by malnutrition, stress, and immobility which in addition to spurring weight gain also have a measurable negative impact on blood pressure, blood sugar, and arterial plaque. Even in this case, it’s not the weight gain in particular that is of actual medical concern, but rather the specific effects on those measured stats.

The medically accepted myth that fatness all by itself is unhealthy is another example of the fallacy that correlation signifies causation. Additionally, this accepted fallacy has had significant impacts on our social understanding of body size and health. 

A more accurate way to look at the connection between a high body percentage and pain would be that it can contribute to pain when an underlying problem exists, and when the specific individuals natural body fat percentage is significantly lower than what it is now. There are many people out there who are fat, who not only experience no pain whatsoever, but also have perfectly healthy stats.

In fact, the social convention of proper weight is so distorted, that the little abdominal bulge many women spend years trying to eliminate, is actually not the result of fat but is actually their internal organs pressing up against their abdominal wall.

Weight on it’s own, doesn’t cause pain. Rather, in an event that someone has an underlying condition that may cause pain, carrying more weight than their body naturally would under optimal conditions, can put additional stress on the injury site and make pain more intense. The impetus for the pain however, is still the initial underlying injury or condition.

What many ignore is that pain and its related symptoms can actually be the cause of accelerated weight gain and that the best way to address both is to treat the underlying cause of pain and to treat the pain itself.

How can this be?

Continue reading “How Can Pain Cause Weight Gain?  “

How Can Pain Cause Weight Gain?  

I Can’t Move On, It’s Not Over Yet

I cant move on, it's not over yet imposed over a blurry picture of a frozen winter landscape
The type of writing I do, the type of people I connect with, I tend to come into contact with a lot of people who are struggling with medical systems. Because of my own experience navigating these same systems, as well as because of the way some of my areas of privilege align – and sometimes not even privilege but just random chance that turned out well, I have also been finding myself more and more acting as a patient advocate for people.

This can mean helping someone find a doctor, helping them come up with questions to ask or ways of phrasing things, making phone calls from location to location, and sometimes even showing up to physically advocate for someone.

There are many people who I have been able to help in some small way and it was enough for them to be able to move out of trouble enough not to need me anymore. There is one core group of people, however, who no matter how hard I advocate, what strings I try to pull, what privileges I bring down to bear, I never seem to manage to get through to their primary caregivers enough for them to start receiving the help they need. Continue reading “I Can’t Move On, It’s Not Over Yet”

I Can’t Move On, It’s Not Over Yet

What Are the Chances?

CN: Discussion of Statistics in relations to disability, other social issues, sexual assault, and abuse.

There are times when I am talking to someone about my life- about the fact that I’m scared of new proposed laws making it harder for me to survive in Ontario, or about how I’m one particularly unlucky day away from being homeless – when I get the feeling like the person I’m talking to thinks I’m exaggerating. They get this look on their faces that makes it clear they’re just humoring me by not pointing out how ridiculous I’m being. Meanwhile, I’m already minimizing how severe my situation is out of fear of being accused of exaggerating. Worse still, my circumstances are relatively minor compared to that of many of my friends and readers. 

When they don’t automatically dismiss what I’m saying as being hyperbole, the people I speak with assume that my case is rare – an exception. A circumstance not worthy of planning against because it’s unlikely to happen again. And yet? Every day I meet someone new in the same type of situation I find myself in. It’s become so textbook, some people look at me as though I’m performing magic when I manage to guess the ridiculous circumstances they find themselves in or repeat almost verbatim what they’ve heard from doctors, therapists, or other people.

It’s a matter of framing, of perspective.

To someone in the mainstream, what is happening to me must be the result of either something I did wrong, or something extremely rare, or impossible. It seems like the probability of all the things going wrong that go wrong happening seem impossible.

What are the chances that every relationship you’ve been in is abusive?

What are the chances that so many of your doctors end up incompetent? That so many doctors end up holding biased opinions?

What are the chances that everyone around you is so terrible? Doesn’t it seem more likely that you are the problem? Statistically speaking that is?

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What Are the Chances?

GUEST POST: Why It’s Hard to Reveal My Disability to Strangers

By Kella Hanna-Wayne

A dancer on a dark background with title of post in white

CN: ableism, chronic pain

With every new person I meet, I have to gauge just how much to tell them about my disability. I try to be as open as possible about my health issues because I want to reinforce the idea that people who look like me- young, relatively fit, no noticeable limitations- can also be disabled. But being open about my disability means opening myself to potential scrutiny of my body, my diet, my medications, my exercise routine. Any decision I make about my physical health becomes fair game for intrusive questions. Until I get to know a person better, I have to assume they will default to treating me as if my health history is in the public domain.

Continue reading “GUEST POST: Why It’s Hard to Reveal My Disability to Strangers”

GUEST POST: Why It’s Hard to Reveal My Disability to Strangers