Healthcare in Ontario

 Quarterly PSA test

Thursday, August 4th, JB had to have his quarterly PSA test. He has to go to our local LifeLabs, a for-profit. That said, it is all free under our provincial healthcare system.

Lifelabs LP is located in Toronto, ON, Canada and is part of the Medical & Diagnostic Laboratories Industry. Lifelabs LP has 3,000 total employees across all of its locations and generates $977.91 million in sales (USD). There are 340 companies in the Lifelabs LP corporate family.

Joseph Brian had prostate cancer surgery in 2014, but they didn't get it all. If the test is good, he'll get his antigen Lupron injection next week to prevent it from growing. So far, so good.

He goes in for 8:10, and there is a new nurse. She gets the butterfly needle, which he always needs with his small veins. She fetches it. "Which arm?" she asks. 

"Any one," he replies. Left first, then right, but it doesn't work. He says if it was drilling for oil it'd be a dry hole. There was another nurse who was always called upon awhile back, and JB called him the closer. He was great! He has moved on. 

"OK, how about my hands," he asks? (It's not his first rodeo!)

First nurse gets 2nd nurse, who has more confidence, but didn't pass the Miss Manners test. Very abrupt. She checks his arms, checks his hands. "When was the last time you were here?" (What does that matter?!) 

Sometimes they try a hand warmer, he suggests helpfully. Nurse #2 filled a glove with hot water, gives it to JB, to put between the back of his hands. It was too hot, so they put a paper towel between his them. Nurse #2 tries, again in a half hour.  Success. The poor man. He came home for a rest.

💉💉💉💉💉💉💉💉💉💉💉💉💉💉💉💉💉💉💉💉💉💉💉

Friday, August 5th

This is his PSA result since his surgery in 2014. JB can go online and check it – usually within 24 hours. During the beginning of this process, they would require another face-to-face appointment, and the doctor to interpret the results. Thankfully, those days waiting with baited breath are gone. The results are good. We have a deep breath for another 3 months.

😷 😷 😷 😷 😷 😷 😷 😷 😷 😷 😷 😷 😷 😷 😷 😷 😷 😷 😷

Nursing in Ontario

We are so short nurses in Ontario (30,000 - they say). I fear our provincial government has nary a clue. Nurses have suffered so much on the front lines during COVID. Our personal support workers (PSWs) who assist them, are in short supply, as well. It's the nurses who supervise the PSWs. Emergency rooms are closing. Places like LifeLabs is competing for nurses. 

The nursing association did a survey and says that 1 in 2 nurses are considering quitting. Then, 60% say their mental health has deteriorated. This sounds accurate, as many of us NOT on frontlines, have many issues due to the pandemic. I found, when my principal was bullying me in 2005, that I am still having the same reactions to stress these many years later.

Our premier decided to create Bill 124 [Bill 124 Royal Assent (PDF)] to limit pay increases to public sector workers to 1%. It is disrespectful. This doesn't reward them in for hanging in, and it means that staff are moving to find better paying jobs. Nurses work long, difficult hours. They are called in to work when other nurses fall ill. One ICU nurse, interviewed on CTV news, said that she did 28 shifts in a row doing overtime. It is affecting critical care response teams. 

"According to the Ontario Nurses' Association (ONA), about 25 hospitals in Ontario were forced to scale back sections of their facilities on the previous long weekend due to staff shortages.This marks the first time in weeks that Ford has taken questions amid an  ongoing staffing crisis in the health-care sector and contract negotiations with education workers.

Burnout and illness among health workers, compounded by an influx of people seeking treatment that was put off earlier in the COVID-19 pandemic, has forced some hospitals to limit services and temporarily close their emergency departments."

Many nurses have left the front line jobs. When a facility cannot get a registered nurse (RN) who supervises nurses, they call in temps from for-profit agencies. There were 25 emergency rooms that closed last week, due to a nursing shortage. The average wait, according to nurses, is 10 hours in an ER waiting for a bed.  

The Nursing staffing system in Ontario is broken. 
ONA pay scale vs. the $110/h private agencies charge hospitals to fill RN vacancies
Hospitals are paying 2-3x more for a transient workforce
To save money and create a sustainable system, appropriately compensate full time work pic.twitter.com/QpsWeBvSso

— Michael Warner (@drmwarner) August 3, 2022

Where is our provincial health minister? Assuring us that all is well and stating that 9/10 patients are getting appropriate care. 

@fordnation the government claims they cannot afford to give equity to a female dominated profession but yet they are UNDER SPENT in health care by over 1.8 billion dollars. @ontarionurses @NurseWithSign @NursesWant

— Cathryn ONA, RN (@CathrynOna) August 6, 2022

Where is our premier?  At a $1300 entry fee golf tournament. He's having a great summer. Finally emerged from his summer vacation to assure us that emergency wait times are fine.

The process of cancer treatment in a time of COVID

PART LXXVIII: Thursday, Nov. 26 

JB has quarterly injections, taking a PSA test prior to each one. This is our life. He was due last week for his PSA test. He went in to LifeLabs early, before 7:30 am. when they open. There was another client there, someone who had been fasting. The door finally opened, but they said they were only working by appointment, which she made for them. 

They gave him an appointment for the afternoon. I wonder what the other poor man did all morning, fasting, as he was. JB's appointment was for 1 p.m. No fasting required. In he went. 

It took three stabs, and two technicians, to get the blood they needed. It is rather stressful and tiring. He has small veins.

I've complained about LifeLabs before: Prostate cancer in a time of COVID–19. We aren't the only ones complaining, either:

‘Really relieved': LifeLabs acts after concerns raised about lack of seating, long waits at Smiths Falls location

Friday

Next, you wait a couple of days to read the results online. The test was on Thursday, and Friday only the one count was in for the testosterone, not the PSA portion. JB emailed Friday. Nothing all weekend. 

Monday, Nov. 30

Monday morning, still no change in the online data. I was sure they didn't work weekends. He phoned, and it rang once, and it hung up. They don't take messages. He tried twice in the morning, once in the afternoon. NADA. No answer. They simply are not answering phones at the lab.

JB gets requisitions for these tests from his doctors. He's got one for this month and another for March, the next time he needs to do this again. Neither doctor's office (our local GP nor the urologist/surgeon in Ottawa) were taking calls due to COVID keeping them busy. How can he get another requisition sheet, signed by a doctor? (I wondered about the ER.) 

Now, in Canada, all this is free. The various testing labs are for-profit, the tests, however, are free with OHIP. 

Lifelabs LP is located in Toronto, ON, Canada and is part of the Medical & Diagnostic Laboratories Industry. Lifelabs LP has 3,000 total employees across all of its locations and generates $977.91 million in sales (USD). There are 340 companies in the Lifelabs LP corporate family.

Now what? 

I posted it on Social Media, with the @LifeLabs handle. Life Labs replied. 

At 8:26 a.m. they replied on line after I DM'd my phone number. The manager phoned us and she took JB's Healthcard number, wanting to talk to JB confirm it is him. She apologized twice for the mistake. Guess so. Pulling up his file, she found they did the testosterone test (no change), but not the PSA test. They can't send it back to redo it from the blood they took, but they can use the original requisition for another test. (So she said.)

She got back to us, with a time of 11:45 a.m. for the test. Bearing in mind, after I told her we were unable to contact our GP to get another requisition for the test, she said the lab could use the old one. She'd phoned the local lab manager, and made an appointment. 

2005 - out on the back deck 
watching football

Off he went for the appointment. JB had cleverly copied his requisition sheet for March. Good thing. They couldn't find his original for the previous test. This time, they had to call in G., and he got the blood in one shot.

Both of us are a bit shaky. JB kept checking the website. By Tuesday evening, they had posted his file, but not the numbers. Deep breath. Off to bed. It is so frustrating. Unless we know the PSA count, he can't have the Lupron next week.

Wednesday, Dec. 2

Dishes done, breakfast had, we were good to go. JB logged into his account. Finally, the results are in, and they are good, no change. It was a challenge. Next week it'll be his injection. At least he won't have to have that in the GP's parking lot in the falling snow! [Lupron injection, April 9]

You can see where he began getting Lupron treatments in 2017. 

He is wearing his Santa hat these days. 

Prostate cancer in a time of COVID–19

OK, let me vent, as I am wont to do! This is our life. Last month JB had a COVID–19 test. It was quite the deal. (BTW – I worked 20 minutes on this post at 6 a.m., and 'New Blogger' wouldn't save it. Ticked me off, I tell you.) This month he needed a PSA test.

This has been our quarterly adventure, for several years:

a) book a PSA test (mid-June)

b) check the PSA test results online (a day or so later)

c) if all is well: order the injection from our pharmacy (10 days before the injection date)

c) arrange for the injection either at the GPs office or our local ER (July).

It has to be this order of operations. If anything has changed, indicated by the PSA test results, then it is possibly an appointment in Ottawa, and an examination of the treatment plan. These are the test results so far. I graphed them. It begins at 0 where JB had surgery. His PSA should have been zero, but they didn't get it all with the robotic surgery. After his PSA tests rose enough, we began a course of quarterly Lupron injections. His PSA tests dropped dramatically to >0.008.

The Winter injection was done in the GP's parking lot, full PPE gear, in a snowstorm. This one won't be so bad!

PSA Test

The spring project is to get hubby's quarterly PSA test, prior to his quarterly injection/cancer treatment, an injection. I tried online. It did NOT go well. I tried 5 times. I could not book an appointment online.

 

JB phoned, and there was a message, "Due to extreme volumes we are not answering phones at this time."  He decided to just show up and hope for the best.

PSA Test June 16 

Now, we don't pay anything for tests that are on the OHIP list. Yet, LifeLabs is a for-profit company, collecting our tax dollars, to provide these services. They were woefully understaffed, with only two women. They said it was due to COVID–19. Presumably, staff have it, as well. 

9:15 a.m. – He left to try a line up. There were about 6 people inside the Lab with 9:30 appointments. The process is slow. Most of the customers had masks on, and were seniors. There was a 45 min wait, with 10 people outside lined up in the sun. JB made the suggestion to move the line up to shade! All followed. (He used to be a manager!)

What irks us is that they haven't even hired a receptionist, to relieve the pressure on the two nurses. Only two of them dealing with 15 - 20 patients an hour.

They closed up at 11 a.m. for lunch, taking in the one person left who'd had an appointment. By then, there were more people in line. 

In the meantime, I managed two phone calls demanding I pay up, or I will be prosecuted. Thankfully, we pay all our charge cards every month. I knew it was a scam. The second robo call voice finished with, "Have a blessed day." I sat and snorted, while Josee sniggered, as well. 

[spam call #1 if you are curious!]

By 11:15 the test was done and he was home. Both arms, he has small veins.

Phase one is complete. We now wait to see the results online. In the meantime, we put it out of our minds until the next step.

UPDATE: This morning we checked online, and his PSA is stable at >0.008. This means that the Lupron is still working, keeping the prostate cancer at bay. We are good.

Next stage: Lupron injection.