Reference to Doctor especially in Calgary, Edmonton, Vancouver, Victoria?

[Cinquefoil]

Hi all. I'm US nursing student, set to become a Canadian nursing student as soon as I go through immigrations, because my Canadian husband recently moved back up to Canada because his health worsened quite a bit.

Unfortunately, his health condition has been a big mystery to every one of the six or seven docs who have tried to diagnose him over the past five years. And now he has free health care again since he's been in Canada over 3 months, but he's in a remote area that only has specialists rotate through once every three months (where his family is). He is considering moving elsewhere in Canada to get better medical attention, but where?

I was wondering if I could get a referral to a Canadian doc who, in your experience, is great at addressing ambiguous possibly autoimmune diagnoses and treatments as well as heart issues? My husband has had a high ANA test for years, as well as a host of problems with his joints, energy, and skin. However, all tests specific to lupus scleroderma etc. have been negative. Now in addition to all his other problems he has A-Fib, pain in his chest, and shortness of breath. He's only 32.

It would also be great if the doc also had a certain kind of personality. My husband is pretty charming and good at relating to all types of people normally, but when he's stressed out (and he's stressed out about his health), he does better being around people who have gentle, humorous, interested, listening bedside manners.

So, that's the situation in general. I'm willing to email more specific symptom information on request, outside the public thread. Any references you have would be wonderful!

[NotReady4PrimeTime, RN]

Umm... the band office and the band health office or nursing station are different things. The band office is like city hall in any other sort of community; they deal with civic administration. The nursing station is the clinic or hospital in the community; they're usually staffed by nurses around the clock and have physicians on site on a rotating basis except for the larger communities where they'd have a more comprehensive health centre. The nursing station is the first contact in the system for Fisrt Nations residents. They act as the primary care practitioner in the community and as a liaison between the community and the acute and tertiary care facilities in the city. As an example, let's say Mary Crowchild lives on a remote First Nations reserve; she isn't feeling well and goes to the nursing station. The nurse takes her history and does some basic examinations. Mary's blood sugar is almost double the desirable so Mary goes back every couple of days to have it monitored until a pattern of hyperglycemia is proven. Mary is then referred by the nurse to a GP in the nearest large town. The GP and staff provide Mary with the initial care for her Type II diabetes and when she returns to the nursing station for followup the nurse there will have her records from the GP's office and knows the treatment plan. S/he provides primary care to Mary and between them they get Mary's blood sugar back to normal. Some time later Mary's urine output drops off and she starts becoming edematous, especially around her ankles. She goes back tothe nursing station where the nurse does some basic tests to discover that Mary's kidneys have become compromised. Mary receives a referral to a nephrologist in the city; the federal government provides transportation to the city and accommodations for Mary and a supporting person so that she can have a renal workup. Mary's kidneys are damaged but not to the point where she needs dialysis. So she returns home with a low protein, low potassium diet with instructions for ongoing followup in the city. So that's how the band health office or nursing station can help your husband find a referral to a specialist while the band office where your mother-in-law works can't.

First Nations health care is not restricted to "First Nations' health facilities". They receive care at whichever health care facility has the services they need and the bill goes to Ottawa. Many of the patients I care for at work are Aboriginal; a lot of them come from the far north. Our hospital has a wonderful Aboriginal Services department; the social workers there work in conjunction with our unit-based social worker to ensure that whatever supports the patient and family need are arranged for and that there is someone who "speaks their language" (even if it's English!) who can help them find their way through the health care maze. We have sweetgrass ceremonies for patients in their rooms (the only hospital system I know of that allows this) and we have a sweat lodge on the grounds. We also will provide for customary or cultural dietary needs.

Now what your husband needs is the initial referral so that he can start making connections and get a diagnosis. Having a name for his problem will help him a lot! It's possible that his autoimmune condition has nothing to do with his heart problem, but without an adequate assessment knowing that isn't possible. And nobody will stop him from looking for a better fit with his GP, so if he has family in a bigger community, maybe he should be paying them a visit. Then while he's there he could just "get sick" and go to a medicentre where they'll say, "Gee, I don't know why you're sick like this, so let's refer you to someone who can figure it out!"

[grad2014]

Hi Cinquefoil. Are you still looking for a rheumatologist for your husband? I'm in BC and am a medical receptionist. There's a particular name that I do hear good things about. This doctor is located in the lower mainland. I just joined because I saw your question and this is probably "unprofessional" to be posting like this, but I thought I could help and I would be willing to give you a specific name. And although it's not preferred, you can try "cold calling" various rheumatology offices and try to feel out what kind of personality the doctor has through the receptionist. There are too many times when patients, or even I, go to the doctor and am/are not pleased at all with the medical attention, or lack of, and patient care (in terms of actually listening and compromising with the pt about what he/she/I want to do) provided. People definitely have to be compatible with their doctors. Good luck on your search. If you'd like to contact me, just send me a private msg. I haven't been on the site long enough so I'm not allowed to send any private msgs otherwise I just would've.

[sirI, MSN, APRN, NP]

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