Latest news with #NewfoundlandandLabradorHealthServices
CBC
04-04-2025
- Health
- CBC
Goulds man frustrated by what he says are limited cancer treatments in N.L.
Alfie Swain recalls a sombre conversation with his doctor in January. He was told his latest round of cancer treatments had stopped working. "My doctor's exact words to me were, 'We're in trouble now,'" Swain told CBC News. Swain, who lives in the Goulds area of St. John's, was diagnosed with multiple myeloma — a type of blood cancer — in August 2020, after discovering a tumour on his spine. Since that diagnosis, he's had a successful surgery to remove the tumour, and has undergone several rounds of different treatments designed to target the cancer. As Swain describes it, the results have been positive. "When I go into remission, I live an active lifestyle. I hunt and I fish, and I do my own snow and my own grass," he said. "When I'm in remission, everyday life is good." While the treatments have been effective for him, Swain, 56, says he could never be sure how long each one would last. "I have had stages of remission: two years, and the latest one I had was nine months," he said. Most myeloma treatments available in N.L. Dr. David Jones, a hematologist with Newfoundland and Labrador Health Services, says the reason there are so many treatments for myeloma, and the reason they vary in their efficacy, is actually two-fold. Firstly, multiple myeloma is the third or fourth most common cancer in Canada, meaning there's always ongoing research for finding new treatment options, and eventually a cure. The second reason is the nature of the myeloma cells themselves. "Even though we call it one [cancer], there's many clones of the disease," Jones explained. "These are cells that live in your body, and in your bone marrow particularly. So certain cells will have mutations that make them more susceptible to one type of drug versus another drug." Swain was most recently receiving bispecific T-cell engager therapy — or BiTE — which Jones described as "bad tinder" for myeloma. The BiTE antibody brings myeloma cells into closer proximity with T-cells, which are part of the body's natural immune system, killing off the cancer cells. Unfortunately for Swain, now that the BiTE Therapy has stopped working, that means he's exhausted all the targeted multiple myeloma medications available in Newfoundland and Labrador. What he's left with now are some tough decisions. One option is to move to Ottawa for an allogeneic stem cell transplant. That treatment takes stem cells from a healthy person and places them into the myeloma patient. But Swain says moving would be a disruptive and expensive process. "I'd have to sell my home, because rent up there is probably going to be three or four thousand dollars a month for a three-bedroom place," he said, adding that he would have to take both of his children out of post-secondary school to move to Ottawa with him and his wife. His doctors also told him about a treatment available in Halifax, which would require regular travel back and forth, potentially every couple of weeks, to receive injections. Swain says he has trouble understanding the rationale of having to fly thousands of kilometres to another province for what essentially boils down to getting a needle. "I can't see why, if it's just a needle or a drug, why they can't send it to Newfoundland. There are perfectly qualified doctors and nurses in that cancer centre [in St. John's]," he said. Jones, who is also the medical director of the cellular therapy and transplant program, says multiple myeloma patients in Newfoundland and Labrador have access to the majority of targeted treatments available across the country. However, there are some exceptions. For example, he says he submitted a proposal to this province's health authority to bring the allogeneic treatment here. "We did try to have an allogeneic program in the province, I did put forward a proposal, but it was not thought to be a good idea at the time by the powers at hand," Jones said, adding that setting up such a program locally would require a lot of resources. As for Swain having to travel to Nova Scotia for an injection, Jones believes that particular treatment is a research trial, as opposed to a nationally approved therapy, which is governed by different regulations and therefore not as simple as sending a medication here to be administered. "You can't just say send me the drug and I'll give it, because it has to be given in that research centre of whoever the principal investigator is," he explained. For the time being, Swain has started chemotherapy to keep his multiple myeloma in check, which Jones calls a "machine gun" approach to treating cancer that can lead to more side effects, versus a "sniper" treatment designed specifically to attack myeloma cells. Swain is also in regular contact with his doctors to keep an eye on any new medications or clinical trials on the horizon. But even when new treatments are developed and approved for use in Canada, there's no guarantee if or when they'll be made available in Newfoundland and Labrador. For Swain, whose quality of life could be significantly impacted by those decisions, that's a deeply frustrating situation to be in. "I just can't understand why Newfoundland is always so left out. We're isolated out here on an island. We have a brand new cancer centre, qualified people, and we just can't get the help we need."
CBC
27-03-2025
- Health
- CBC
Thousands of health-care products under the microscope as N.L. examines U.S.-procured items
Newfoundland and Labrador Health Services says everything it buys is under the microscope as it looks for alternatives to U.S. products, but adds it can't come at the cost of affecting patients. Tony Williams, the senior director of supply chain for NLHS, says thousands of items are housed inside the health authority's new 85,000-sq. ft warehouse in St. John's — which he says serves as the backbone of the health system. "We're doing that deep dive now to say, 'What's under the covers, what actually is manufactured in the States versus Canadian.' So that's the work we're doing now," Williams said in a recent interview. "We want to make sure that any transition from a U.S. product to something else, hopefully Canadian, ... [that] the health-care provider is OK with that. We want to make sure that that achieves those high standards." In March, Health Minister John Haggie said the province is reviewing its procurement of American medical goods. Williams said that's easier said than done given the volume of products — and how those products are sourced. For example, the warehouse stores multiple products from the same company, but some shipments come from Canada and others come from the U.S. as they are sourced by the contractor. More than 200 expiring contracts with U.S. suppliers are under review, Williams said. And while there are local solutions on the table, quantity is a key facet of any dealing. "There's a lot of competence here to make health-care products, [but] we want to make sure that they can also provide in the quantities that we need for the health system," he said. "Our number one concern in all this is patient care." However, there are some American products that can't be avoided, like imaging machines and parts for orthopedic surgeries like hip and knee replacements. Christine Donaldson, president of Health Pro Canada, which bulk buys for more than 2,000 health facilities across Canada, said about a third of their contracts have ties to the U.S. That accounts for 38 per cent of medical devices imported into Canada in 2022, which represents a cost of $5.2 billion. "[The] U.S. has been our strongest trading partner for many, many years. And to unravel that would, you know, take a long time to get into all those details," Donaldson said. "While we definitely stand with the government that ... U.S. tariffs can't go answered, it is really [something] we are exploring as far as how much we can, you know, work with Canadian partners." Donaldson said Health Pro Canada is advocating to ensure the trade war doesn't increase cost for those seeking medical care or open the door to supply chain shortages. Part of that work ensures medical equipment isn't part of retaliatory tariffs placed by Canada on the U.S., she said. "Canadians' health-care system must be protected from those unintended consequences…. Ultimately, the patient at the end of that will suffer."
CBC
26-03-2025
- Health
- CBC
Plans for robot-assisted surgery will forever change procedures in N.L., surgeons say
Tools will allow for surgical precision not before seen in N.L., docs say Image | Surgeon operating with robot system Caption: The Health Care Foundation, a Newfoundland and Labrador non-profit, is more than halfway to its $8 million fundraising goal to introduce the da Vinci XI surgical robot system into operating rooms. (Saint John Regional Hospital Foundation) Plans to introduce robot-assisted surgery tools to Newfoundland and Labrador's health-care system were unveiled to the public on Wednesday, and the Health Care Foundation says it's already over halfway toward its fundraising goal to make it a reality. Health Care Foundation president and CEO Paul Snow said $4.8 million of a needed $8 million has already been raised since December. It would be used to bring the da Vinci Xi surgical robot system into operating rooms. "Today marks the beginning of a very bold, new chapter in surgical care in Newfoundland and Labrador," Snow said Wednesday. "Our ongoing collaboration with Newfoundland and Labrador Health Services, the government of Newfoundland and Labrador and the many generous individuals, organizations, groups, family and friends that are committed to advancing care is what makes this progress possible." NLHS eastern zone COO Ron Johnson said the technology will change surgery in the province, allowing for minimally invasive surgery to be done in ways not possible before. "It's going to give shorter recovery times for very, very invasive surgery — Something now that you would have to leave this province to get otherwise," Johnson said. "It's going to benefit us. It's going to be shorter lengths of stay, meaning more people will be able to get more surgeries." Surgeons in the province are eager to get their hands on the tool, according to Dr. Angela Bussey. A training unit is currently at the Health Sciences Centre, and the hope is that the system can be integrated soon. "We're going to be able to create a situation in the [operating room] where surgeons are comfortable doing life-saving, complex procedures. And we've not been able to do that in this way to date," Bussey said. "Envision the deepest, darkest place that you could go, and put a grain of sand there or a little piece of corn. [Then] be like, 'Get that for me.' You could never do it with your hands. But with the da Vinci, you can do that. And think about that being a very small amount of cancer or other disease that someone needs to get rid of. And we're able to do that." Bussey said it will also serve as a key training tool for surgeons, as the machine's multiple screens will allow surgeons to observe procedures while they are being performed by another surgeon. She added it can also serve as a key recruitment and retention tool, as cutting-edge technology is brought to Newfoundland and Labrador. Joannie Neveu, a gynecology oncologist, said it will be a game changer. "We use the robot as a surgical equipment that is going to be, basically, the extension of what we can do," she said. "There's also less complication, right? Less bleeding and better recovery. The patient can go back to work or back to their life quicker."
CBC
20-03-2025
- Health
- CBC
Looking for a psychological assessment in N.L.? Be prepared to wait
Karleena Squires had to wait three years or spend nearly $3,000 to get an assessment for attention-deficit hyperactivity disorder (ADHD). Squires, who was 32 at the time of her diagnosis, chose to spend the money. "I decided that if I was going to wait a long time, it would probably be best to go private," she told CBC News. There is a growing demand for autism spectrum disorder referrals and ADHD psychodiagnostic assessments, according to Newfoundland and Labrador Health Services. Wait times for psychological evaluations vary across the province. For adults, they can range from 18 months to five years. For children, wait times range between 12 to 27 months, depending on the type of assessment and location. Squires, who is now 35, says her diagnosis wasn't on her radar until her TikTok feed started to feel too personal. "I started seeing more and more videos of women around my age getting late diagnoses for ADHD, and they started explaining their symptoms. I felt like it was a checklist," Squires said. Those symptoms include choice paralysis, hyperfixations on topics or hobbies, forgetfulness, impulsivity and procrastination. "I grew up thinking ADHD was, you know, bouncing in your seat, unable to pay attention, but it's so much more than that," Squires said. NLHS told CBC News that waitlists are only maintained in some parts of the province. Where waitlists do not apply, individuals are prioritized based on clinical need and resource availability of the province's registered psychologists and psychiatrists. Acting Health Minister John Haggie told CBC News he doesn't think the wait times for psychological evaluations provided by NLHS are accurate. "Until we get accurate data, I think it would be unwise to speculate too much," he said. "Quite frankly, our problem is we have a challenge recruiting and retaining psychologists within NLHS." But, not all mental health physicians diagnose adults with ADHD or autism. Kay Snow and Angie Follett both received autism diagnosis — or confirmation, as Follett describes it — as adults. Snow has been on the public waitlist for three years. Following the advice of her doctor, they received her autism diagnosis through the private system. "I'm just waiting to see how long it takes," Snow said. "He said to me, 'If you wait publicly, that's years and years, you'll never get in. You have to go private, especially if you think that you're going to lose your job.'" Follett received her diagnosis through a public research program conducted by a psychologist at Memorial University. Meanwhile, she says, her husband has been waitlisted for five years. "I got to be a guinea pig, but I got lucky. I didn't have to fork over a lot of money, and my process was nowhere near as difficult as what a lot of other people experience," Follett said. "I managed to get one, and my husband didn't." If her husband pursues a psychological evaluation privately, the couple will have to pay upwards of $3,200, she said. "I don't know where it's going to come from," Follett said. Follett wants the province to cover the expenses of private health-care if it has to rely on the private system. "Political will is going to be a really, really big thing to get this stuff moving, and I don't get the sense that the people who are currently in power really understand how desperate this is," she said. Haggie said NLHS has considered funding private providers to deal with backlogs and waitlists. He said it's been done with ophthalmologists and cataracts. "If we need to buy in expertise or skills to help with waitlists, we've done it before, and I'm perfectly prepared to have those discussions with psychologists and psychiatrists," he said.
CBC
26-02-2025
- Health
- CBC
Coastal Labrador hospital with only virtual doctor has father worried for his son's life
A hospital along Labrador's southern coast now only has access to a virtual doctor, and it has residents worried about possible fatal consequences as they wait for a permanent doctor to be hired. Newfoundland and Labrador Health Services said that effective immediately on Feb. 14, on-site emergency and primary-care coverage would be available through virtual services at the Labrador South Health Centre in Forteau. Dorman Fowler told CBC his son, Silone Fowler, is quadriplegic and living in L'anse au Loup. He says his son needs to see a doctor every few weeks and it can turn urgent whenever a tube that drains his bladder gets blocked. "We need something done and we need something done now — not next year," Fowler told CBC Radio's Labrador Morning. He said his son regularly requires life-saving care at the hospital and an emergency can happen with very little notice. "When [the tube] blocks, we don't have time for medevac. We don't have time for basically anything. Only just get directly to the hospital in Forteau and the tube needs to be changed right away," said Fowler. "If not, he can go into an anomic attack it's called, where his blood pressure goes through the roof, sky high. And it could cause a heart attack, stroke or even death." Fowler says nurses can't perform that kind of work, and says he's scared something is going to happen. "We need this addressed right now," said Fowler. Recruiting a doctor Labrador-Grenfell Zone vice-president and acting chief operating officer Joanne Pelley said when people go to the hospital there's on-site staff who do the assessment and consult with a virtual physician. The virtual doctor works with the health-care providers on the ground. If needed, a patient could also be transferred to another facility, said Pelley. If the weather made it impossible to transfer a patient, she said they would then stay on location. "They would be cared for by the staff at that facility, which is often a registered nurse or a regional registered nurse, and they would have that virtual support until it was safe access or transport," said Pelley. Vice-president of medical services Dr. Gena Budgen says the health authority has been "quite successful" with recruiting physicians. She said around 200 doctors have been recruited since the province's four health authorities amalgamated in April 2023. "Our recruitment and our retention program is quite strong and we are quite proud of the strides that we've made. Newfoundland and Labrador is a very attractive place to work for physicians and we have a lot to offer in this beautiful province," said Budgen. Bugden says NLHS is actively looking to fill a physician position in Forteau. "Virtual emergency rooms have been quite successful, not only the emergency rooms but the primary-care offerings as well augmented our in-person service," she said. Bugden says she knows there are still some situations that require a doctor be on-site, but there are others that can be done well in a virtual manner. "Our intention is to still continue to look for a long-term recruitment prospect for the Forteau centre. And as well we're looking at more short-term and long-term locum opportunities," she said. Residents unhappy Forteau Mayor Dean Flynn says going without a doctor on the ground is a problem for the region. "We've been very concerned about what we feel is a degradation of services at our Labrador straits health centre," said Flynn. He says he's been in touch with Health Minister John Hogan, region MHA Lisa Dempster and representatives with the NLHS Labrador-Grenfell zone. Residents, Flynn says, are unhappy with the move. "Virtual care is not adequate. If we have a serious accident in that area, we're not going to be able to handle it," he said. Flynn wants there to be a memorandum or understanding with a hospital in Quebec — about 30 minutes away but with five doctors — to regularly see patients from Labrador. He says he's worried that a lack of a doctor will add further stress to the nurses working in Forteau and that will make them eventually leave. "They're very good nurses but they're not trained to deal with multiple victims," he said. NLHS told Flynn the earliest a doctor would be hired is July.
