Tag Archives: physiotherapy

Workers Compensation: A Fallacy

There are probably many people reading this who know someone or have themselves experienced a workplace injury and WCB’s attitude toward compensating the worker. In fact, the Workers Compensation Board changed their name to WorkSafe BC, to reflect the greater scope of their reach and because they’re known for not compensating workers, or cutting compensation off arbitrarily.

This could all be hearsay but I do have direct experience. I have had to file twice in my life. The first time was for a repetitive stress injury to the soft tissue of my hand (my fingers and hand swelled) due to writing so much in quintuplicate for the movie industry (with one period that consisted of about 30 hours straight). In this first case, WCB did cover treatments but only until they thought I should be better. A known fact about the human body is that people heal at different rates and many other factors come into play. So I had to somehow manage to get better, without affording the therapy while still working.

The second time was perhaps harder to pinpoint but indicates the arbitrary decision making of case workers. I was working inside underneath three air conditioner vents. I have a couple of conditions, the major one being chronic myofascial pain syndrome (MFS). It is similar to fibromyalgia but more treatable. I can be fine for a long time and then experience a relapse brought on by certain conditions. Then I will proceed into a chronic pain cycle, which can take years to get hrough. I can function but am often in pain all the time.

Myofascial pain can be triggered by various events, some of which are: stress, cold, injury. This means, at the onset a person can try to work through the pain with exercise, which can backfire, causing more trigger point cascades. A trigger point is an area on the body that when pressed refers pain to other areas. People with myofascial pain and fibromyalgia have specific spots on their bodies which will be major trigger points. Each person may not demonstrate pain in all of them but may in most of them. A trigger point is often a hard knot. I’m not a medical expert but from what I’ve read it involves muscle tissue and fascia (the thin membrane that covers muscles [like you see on chicken]). A trigger point cascade can occur where one trigger point starts a progression of spasms and knotting that create other trigger points.

At my worst, I was trying to work out and increased the problem unknowingly. I had trigger point cascades down my arms and back, to the point where I could barely hold a fork or chew. That was an extreme episode that I don’t wish to visit again. Overall, my muscles will spasm and knot up and will forget how to release. I had ten years of chronic pain before the combination of the right muscle relaxant (many painkillers and analgesics don’t always work on this type of pain), a massage therapist who understood how to work with trigger points, and about four months of very warm weather which took me out of the chronic stage.

As I’ve mentioned, stress, injury or cold can trigger myofascial pain. Other conditions can be associated with it, such as Reynaud’s syndrome. Reynaud’s is also called red, white and blue because it will be brought on by cold and the vessels in the extremities (fingers and toes) will constrict, causing the limbs to go from red to white to blue as the blood flow is suppressed. People with this condition will experience sharp, knifelike pain and numbness. I have found, when I experience Reynauds, that the only way to bring circulation back to the extremities is to bring up my core temperature.

I have given these two examples here to wind back to workers compensation. The three air conditioner vents that I was sitting under blew a lot of cold air onto my back. I’m more susceptible to cold, but was the only person in my area who was under three vents (no one was under more than one). Because the muscles tightened up, when I moved suddenly, sitting at my desk, I threw out my back. I was a contract worker so I couldn’t really take time off but I filed a claim. I went to the chiropractor a couple of times but couldn’t afford more than that.

Recognizing that this could be another chronic pain onset, I wanted WCB to cover therapy for a couple of weeks. In all, if I had had treatment right away I could have put off the chronic pain. It would have taken probably a month at most, consisting of chiropractic to adjust my back, and massage to keep the muscles from tightening up and pulling my back out again (believe me, I live with this often, muscles pulling my ribs out while I sleep).

My case worker was on holidays so I talked to someone else first. When the case worker came back, he didn’t even talk to me but denied the claim straight out. I wrote back citing the specialist that had originally diagnosed me. I was willing to be examined, get letters from the specialists about the condition and other documentation if needed. I said that the cold of the air conditioning was the problem and the case worker wrote back and said that cold never hurt anyone. Never. Cold.

I wonder what those people feel who suffer frostbite and hypothermia and die of exposure? One of the best ways to get through myofascial pain is to apply heat, along with therapy. This case worker didn’t consult any medical expert but made his own uninformed arbitrary decision. I would have had to go to a new level to fight this, to get the therapy that was now some time from the onset of the injury. And what else causes myofascial pain? Stress. Having already taken ICBC (our provincial car insurance company) to small claims court for not covering the therapy costs of the injury that originally began my relationship with myofascial pain, I knew how stressful that process was (I won, BTW). I didn’t do it and have spent several years getting out of another bout of chronic pain. And of course all the subsequent visits to my doctor for muscle relaxants (trying to find some that work), the few visits to the therapists, and days I take off work when the pain is too much, or for doctor appointments puts more strain on our health care and system. In the long run, it costs way more than what the initial treatments would have been.

This is just one example of how workers compensation is a fallacy. I have heard far worse stories. And I have only touched the tip of the iceberg on what myofascial pain is all about. It is a more accepted condition these days, very hard to diagnose and many doctors pooh pooh it still.  Wikipedia has a very short entry. http://en.wikipedia.org/wiki/Myofascial_pain_syndrome  And should you have a workplace injury that brings on this condition, you can expect workers compensation to not compensate, to not help you get better, and like many other injured workers, leave you out in the cold.

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Gordon Campbell’s Record

We’re moving closer to a provincial election and the super plasticky premier Gordon Campbell and his cronies will be putting on their best faces, making more promises and hiding their earlier dirty work. Unfortunately they’ll probably get in again because people have notoriously short memories. So here are a few things to do with health care that we can thank Gordon Campbell for.

  • Raising the cost of medical services by 50%. And remember, BC and Alberta are the only provinces that pay for what Canadians call “universal health care” that’s free everywhere else. Ask your MLA why we have to pay.
  • Broke contracts with health science professionals, nurses, health support workers and community social service workers. That was in his first four years and even though it went tot he courts and the Campbell government was found in the wrong, what did that do for those people who had to wait four years to get a ruling?
  • Because those contracts were broken and things like cleaning hospitals was given to the lowest bidder, which did not guarantee that workers knew how to work with biohazardous waste, many people lost their lives and livelihoods do to increased infections (some of this is to blame on health cleanliness standards too).
  • Raised Pharmacare deductibles for the poor on MSP premium assistance from $600 to $800 a year.
  • Delisted podiatry, eye exams, chiropractic, physiotherapy, and massage services. This means they are no longer covered or subsidized under health care. As people age what two areas tend to need work: eyes and feet. But who needs those, right? I have a condition that requires massage or chiropractic to stop chronic pain, and when I cannot receive timely care because of the cost, I end up seeing my doctor and specialists and in no way does this cut the costs to the health system.
  • Privatized MSP billings to Maximus, an American company, making private BC records subject to disclosure under the US Patriot Act. This company was also fined twice and has not save people money.
  • Eliminated the provincial mental health advocate.

Everyone may have forgotten these things (and the many more listed below) with the huge economic downfall scare. However, the poorer we all become the less likely we are to be able to pay for any healthcare needs, and we’ll all just suffer a bit more. I never trusted Campbell and I still don’t. A premier that will tear up legally binding contracts is bound to do more dirt to the people.

This site lists 77 reasons, and that only up to 2005 on what Campbell’s government has done for us. http://www.pej.org/html/modules.php?op=modload&name=News&file=article&sid=2551&mode=thread&order=0&thold=0

http://www.bcndp.ca/node/1054

http://www.vancouversun.com/news/todays-paper/Campbell+record+reform+falls+short+ambitious+agenda/1238924/story.html

http://howbadtherecord.blogspot.com/2009_03_01_archive.html

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Depression: The Invisible Battle

In the last decade there have been more books on depression and people talking openly. Although I think there can be a point of over-saturation, we’re not there yet and more dialogue on depression will people help recognize and understand it better. There are still too many people who live under the black cloud of despair or more tragically, kill themselves out of depression.

I speak not from an outsider’s point of view but from the intimate perspective of having suffered mild depression to full-blown clinical depression. The first time was probably in my twenties when my boyfriend of three years and I broke up. I moved to Vancouver and lived for another three years in a somewhat different personality. It was a bit kamikaze, reckless, unhappy and angry. I ended up going to my doctor who sent me to a psychiatrist. He determined that I was working my way out of the depression by that point and didn’t put me on meds. That’s pretty rare for psychiatrists who are married to the pharma industry. Psychologists aren’t covered in Canada’s medicare but psychiatrists are.

Perhaps I dipped into depression a few times after that but it was when I was dealing with my eating disorder that I was first put on anti-depressants. I can’t say they changed my mood or state of mind but eventually it seems my brain chemistry balanced out and I stopped the binging and quit the meds.

In 2001 I had gone through a few things and had a boyfriend, but I was pretty poor and nothing seemed to be going right for me, My health was deteriorating, partly caused by a repetitive stress injury in the movie industry and now I was poor. Everything built up. I was freelancing but not full time so I’d go and work, then come home and crawl into bed. I forced myself to eat a bowl of soup a day. I couldn’t deal with anything: answering the phone, changing a doctor’s appointment, coming up with answers to questions. I cocooned for months. And then September 11th happened and that added to the fear and gloom. My elbow was also hurting and no amount of physiotherapy was helping. After many sessions the physiotherapist said she couldn’t help anymore.

I went to my doctor with this symptom and she mentioned depression. I didn’t want to see a psychiatrist because I don’t think they do much (the last one when I had the eating disorder, didn’t) and I didn’t want to go on anti-depressants because they’re hard on teeth and can cause increased cavities (less salivation occurs and bacteria builds up). I also argued that I had reasons to be depressed and listed them. My doctor said, true you can be depressed and have good reasons but it’s not about the reasons but how you cope. In essence, I wasn’t coping very well at all.

My doctor gave me a questionnaire to fill out and bring back. Of all the questions the only one I didn’t have a dire answer to was the one about suicide. I’ve never been suicidal, not even when depressed. My doctor took one look at my answers and said, “You’re going on medication.” So I did and luckily she got me a compassionate prescription, which is free through the pharmaceutical companies because there was no way I could afford it and I would have stopped buying them, if I had to pay.

Since that time I try to gauge where I’m at, watch my moods and feelings. But depression is a tricky thing. It doesn’t always manifest the same way every time. Sometimes you can function but you can’t eat. Sometimes you’re just in physical pain that won’t go away. Sometimes you are fine during the day and plummet every evening. Sometimes you can’t eat, or you eat too much, can’t sleep or sleep too much. For me, it’s never been quite the same so it gets hard to know for sure.

I sometimes have to look back over a period of a year and see if I have shifted much. I try to catch it before it gets as bad as 2001. I don’t like being in that space and everything is far too dark. I tend not to read or watch the news because the concentration and the repetition of the bad and horrid gets to me. Even the radio can be too much but I do like to know what’s going on in the world.

Depression is not a physical ailment but it can become one. It can make people as sick as any disease and kill them. Understanding what a person may be going through will help people heal. Calling them crazy and whacked, which we all do, may describe their current state but it won’t help them get better. Depression is a disease with varying symptoms, and understanding will help those who have it and those who have to be around it.

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Healthscare: the Undermining of Our Free Health

I’ve already said that if the government is so worried about the funding for our health care, then part of the solution is preventative medicine. This means you can’t deny people services when they’re in an acute stage. The longer one waits for treatment, the more it costs the health system as the problem becomes chronic, sometimes with life lasting problems.

At the same time, each provincial government seems to have the impunity to whittle away our health care any way they want, without the federal government saying anything. In BC, we used to get 12 covered visits for chiropractic, physiotherapy and massage therapy each. I suffer from soft tissue problems which often take the combination of massage and chiropractic to stop my bones from being pulled out of alignment by my over-tight muscles. The BC government somehow didn’t believe that these therapies helped people so they took them away. Then you were allowed ten visits total and only if on subsidized medical.

Subsidized? But surely health care is free in Canada. Well, some provinces are freer than others. Alberta and BC pay a monthly premium (in which you are harassed, ignored and strong-armed into these payments–to be elucidated on later). BC residents pay $54 a month. Oh, and let’s see what we lost when the Liberal (liberal?!!) government decided to bleed us, but not for our health.

  1. Premiums doubled (we’ve always had to pay)
  2. Massage, physio and chiro went to no free visits (or only 10 combined if you were subsidized)
  3. Podiatrists were dropped (what happens to people’s feet as they get older)
  4. Optometrists were dropped (what happens to eyes as people get older)

Optometrists seem to be covered if you have a health problem but a check-up is not. Glasses and/or contacts have never been covered. Likewise, somehow dental health has never been covered. As someone who has no medical/dental plan, the cost of even the basic dental health is out of reach for many people. I’ll be paying out over $2000 for one crown and one root canal. Feet problems? Well I may have to put those off. Back problems. I suffer longer, use more painkillers which do not work and worry about the problems that become worse with time, where I must visit the doctor more often, get more prescriptions and seek more specialists.

Over the years of the mismanagement of MSP (Medical Services Plan) I have written letters and asked why we pay when other provinces do not. To this day I have never received any communication from MSP except for the automaton bills, which are erratic at best. I’ll devote a piece just to the unfair billing practises of MSP.

And now we’re looking at bill c-51 about to be passed where you and I will not be able to buy vitamin C, echinacea or anything else we want over the counter. We’ll need prescriptions and that will cost more. My last prescription: the drug was $6.50, the dispensing fee was $8.30. What will this mean? Pharmaceutical companies and drugstores will get richer, we’ll put greater strain on the health care system by either having to see our doctor for a prescription or by ignoring and taking no vitamins.

Granted there is a lot of self-medication and taking supplements that don’t do anything but really, will I need a doctor’s permission to take vitamin C and iron. Write your member of parliament if you’re concerned about any of this.

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