CORPORATE PROFILE – Contents · 2013-08-22 · 2 Contents 4 6 8 10 CORPORATE PROFILES 2 5...

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Contents

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CORPORATE PROFILES

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Provital Health & Wellness

Copeman Healthcare Centre

EFW Radiology9

11 Canada Diagnostic Centres

Lingering effectsA Calgary clinic takes an individualized approach to the treatment of concussions.

Hidden feesDespite what Canadians think, the country’s free health care comes at a cost.

14 Wait notAt 85, a vibrant Calgary senior wasn’t prepared to wait for knee- replacement surgery.

Team workA Calgary woman, diagnosed with Stage 3 breast cancer, finds the multi-disciplinary approach to her treatment reassuring.

Making timeThe attention a private clinic gives a Calgary dentist and his family is well worth the investment.

12 Big pictureOptimal health starts with good nutrition and exercise along with mental and emotional well-being.

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Quality controlA referral to a private health-care facility in the U.S. has a recently retired LPN enjoying her life again.

Renewed energySolutions to the lack of energy she experienced have given a Calgary woman the strength to run her first 5 K.

Proactive approach Activity and diet are key factors in reducing the risks of developing diabetes.

Shoulder checkRotator cuff injuries can be common in people over age 50. A Cal-gary doctor offers suggestions for treatment and ways to avoid injury.

FEATURES

Amount Alberta spends on health care every day.

Health funding allocations for 2013–2014,

www.health.alberta.ca/about/health-funding.html

$47 million

Amount a family a four pays annually for free health care in Canada, about 10 per cent of pre-tax income.

Fraser Institute

$11,400

By the numbers

is a special publication of the Calgary Herald Publication date: Saturday, Aug. 24, 2013

Special Projects Co-ordinator: Jennifer Worley, 403-235-7119

[email protected]

Advertising inquiries: 403-235-7168

Cover and cover story illustrations: Jennifer Worley

Cost increase of health care since 2002. This compares with a 22.4% Consumer Price Index increase and a 37.2% increase in the average Canadian income for the same period.

Fraser Institute

59.8%

Amount a family of four pays for health care when an additional 30 per cent is added for private spending for drugs, dental and other services not covered by government insurance.

Canadian Institute for Health Information

$14,800

Average Alberta wait times for various procedures, a full three weeks longer than the

national average of 17.7 weeks.Waiting Your Turn, Wait Times for Health Care in Canada,

Fraser Institute

20.7 weeks

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Landmark Collaborative Health

Preventous Collaborative Health

YOUR GUIDE TO PRIVATE MEDICINE

ptionsO

Left to right: Dr. Sarit Sengar, Dr. Tessa Van Rooi, Dr. Supriya Goyal and Dr. Donovan Kreutzer.

IT HAS NOW bEEN four years since doctors Donovan Kreutzer and Sarit Sen-gar open the doors of Provital Health and Wellness.

Working together since 2004 in a typical hybrid type family walk-in medical practice, it became readily apparent that the patient and physician experience was deteriorating. Operating a practice where patients wait several hours to have five minutes with the doctor resulted in an underwhelming expe-rience for the patient and led to decisions regarding medical management based on “snap judgments.”

Due to the increased congestion of prac-tice, simple administrative functions like filing papers sending out referrals to outside specialists were delayed. They knew there had to be a better way where the practice of medicine could be more efficiently implemented and where medical care could be provided within a much more nurturing environment; where the focus of medicine is not only on the problem at hand but also more broadly towards risk management and prevention.

To this end, Kreutzer and Sengar believe they have found that happy medium.

Provital Health and Wellness operates in Marda Loop. The clinic has grown with the area and not only has it become the community family medicine clinic serving local patients but its central location enables patients from all over the city easy access.

Its focus is based on a more holistic ap-proach to health care utilizing the expertise of its team of family physicians, naturopath physician, chiropractor, psychologists, dieti-tian, massage therapists, exercise kinesiolo-gists, pedorthist and pharmacist. Timely and expedient referrals are made to outside specialists as well.

“So many health concerns are interre-lated that it makes sense to collaborate and integrate care with our team of practitio-ners,” says Sengar.

Patients have access to their physicians 24/7. Initial assessment involves a complex examination and history involving all prac-titioners and the subsequent plan is tailored to the explicit needs of the patient.

It is a fluid and flexible plan that evolves as the health concerns of the patient changes.

Provital Health and Wellness is now open on Saturdays thus allowing for greater

convenience for its patients. As well, blood work is drawn on site via appointments resulting in less wait times.

Access to Provital’s team of practitio-ners, including workshops and boot camps, involve an annual fee.

Many packages are available to meet the needs of its patients. Discounted rates are available for snowbirds and students. Furthermore, Provital administration staff work diligently with patients and their insurance benefit providers to maximize claims for much of the cost of their fees, if not entirely.

“It has been an exceptionally gratifying experience being able to practice medicine like I had been trained to do in medical school” says Kreutzer.

“It is a viable option for all those who want to take a more active role in their healthcare execution.”

“All of our practitioners are here because they believe in this philosophy of collabora-tion in maximizing the administration and execution of preventative medicine” says Sengar.

“This is ultimately the forum of health-care moving forward.”

Name: Provital Health and Wellness

Location: Suite 204, 2031 33rd Ave. S.W.Calgary, AB, T2T 1Z5

Contact info:Phone: 403-685-4520 Fax: 403-685-4525 E-mail: [email protected] Web: www.provital.ca

Services: Providers of thorough and collaborative health care services to individuals, families and corporate clients. Provital provides timely, preventative & proactive health care, with the services of family physicians, naturopathic doc-tor, chiropractor, nurses, dietitian, exercise kinesiologists, psycholo-gists, massage therapists, pedor-thist and pharmacist on site — plus numerous allied specialist partners.

Provital – A new way of practicing medicine

All of our practitioners are here because

they believe in this philosophy of

collaboration in maximizing the

administration and execution of

preventative medicine. This is ultimately the forum of health care

moving forward.”Provital Physician & Co-Owner

Sarit Sengar

– CORPORATE PROFILE –

4 5

4 Options | Fall 2013

By BARBARA BALFOUR

It’s been several decades since Perry Cavanagh suffered the concussions that ended a promising future in

competitive sports. But the aftershock still lingers, he says, in the form of se-vere migraine headaches he attributes 100 per cent to the concussions he sustained in high school.

“There was no discussion in those days about concussions being cumula-tive,” says Cavanagh, former president of Hockey Calgary and the current executive director of the North East Sportsplex Society. “You went in on an ambulance, they gave you pills and sent you home. Your parents checked your eyeballs and a week later, you were rushed back onto the field.

“The second concussion I got shortly after the first one put an end to playing sports for me at the high level — I just wasn’t prepared to suffer the conse-quences.”

As the most frequent specific injury in Alberta, concussions involve a blow to the head followed by a change in consciousness, thinking or symptoms

While they can occur in a motor vehicle accident, on the ski hill or by slipping on an icy sidewalk, concus-sions also make up 15 per cent of all hockey-related injuries. A minor traumatic brain injury can become a serious health risk when proper treat-ment methods are not put in place.

At the Copeman Healthcare Centre, an enhanced, multi-disciplinary concus-sion management program focuses on personalized treatment and rehabilita-tion to fit each patient’s unique needs.

“The first thing we do is take a very full history, assessing that person in terms of severity and any preexisting conditions that make them more sus-ceptible to prolonged recovery,” says program leader and neuropsychologist Dr. Elisabeth Sherman.

Those conditions could include preexisting migraine headaches, neck injuries or weakness and even Atten-tion Deficit Hyperactivity Disorder, depression or learning disabilities that could worsen the ability to concentrate after a concussion has been sustained.

“We assess their balance, symp-toms and the level at which they have changes to their vision, reaction time

and thinking,” she says. “They will see a physician for a

neurological exam to make sure there are no hidden injuries and a physio-therapist for neck and headache issues. Then, we offer a treatment plan — for most people, the first thing is rest.”

This involves a period of no sports, work, physical or cognitive activity, a very slow and specific exercise plan of treadmill exercises that won’t trigger any symptoms and complete avoidance of electronic devices.

“Your neurons literally need a break to recover,” she explains. “Like a sprain to your ankle, where you don’t want to be running on it because you can cause permanent damage, your neurons need energy to correct what is an ion imbal-ance and clean up the damage.”

Recovery times can take anywhere from a week to three months. Some peo-ple have even come in years after their injury and have been helped greatly.

“The vast majority of people we see have taken a little longer and struggled with emotional issues such as depres-sion or loss of sleep,” says Sherman.

“We monitor their cognitive function, balance and physical capacity very closely — this is not a one time appointment.”

Cavanagh, whose four hockey-playing sons have all sustained severe concussions, says more awareness is needed across all sports.

“It’s important to see what impact concussions can have on the ability of the player to simply function in soci-ety,” he says.

“Fortunately, technology is helping – there’s an assessment tool of signs and symptoms that coaches can download on their smart phones. We had a recent deci-sion by Hockey Canada banning body-checking at peewee levels of the game.

“Those are all positive changes that can give food for thought to other sports where concussions are happening.”

Copeman Healthcare’s Dr. Elisabeth Sherman offers the fol-lowing tips on what to do if you’ve had a concussion:

1. Stop what you’re doing. Get out of the game. Don’t get

back in your car and drive. A second or more severe concussion can occur because of reduced reaction time or mental confusion.

2. Get assessed by a medical professional that day. See your family doctor, start a concussion management program or seek urgent or emergency care if symptoms are severe (e.g., repeated vomiting, seizures, increasing drowsiness).

3. Monitor your recovery for the first few days very closely. If there is any worsening of symptoms, see your treat-ment team again.

4. Rest until you are recovered. 5. Do not return to contact sports without being cleared

by a qualified health professional with experience in concussion management.

6. If your concussion symptoms are not going away, don’t give up — see a professional team specialized in concus-sion recovery.

Rest essential for concussion recovery

Neuropsychologist Dr. Elisabeth Sherman leads the concussion management program at Copeman Healthcare Centre, creating individualized treatment plans for each patient.

— Wil Andruschak photo

Concussiontreatment

THE COPEMAN HEALTHCARE CENTRE set a new standard for primary care in Alberta when it opened the doors of its Calgary Centre in October 2008.

The centre was developed to offer each client a personalized and expert team of professionals focused on all aspects of his or her health.

The state-of-the-art, centrally located 17,000-square-foot facility was expanded in 2011, and a second Alberta location opened in Edmonton in May 2012.

Copeman Healthcare has created a West-ern Canadian network of doctors, special-ized professionals and researchers to develop and implement some of the most advanced programs of screening, diagnosis, preven-tion and health management available in the world today.

According to founder and CEO Don Copeman, the company began with a simple premise — to deliver unparalleled access to medical expertise while providing each pa-tient with a highly personalized and “unhur-ried” experience.

In addition to expert doctors, the centres are staffed with a complementary team that includes psychologists, psychiatrists, neuro-psychologists, physiotherapists, registered dietitians, kinesiologists, exercise medicine specialists, nurses, health coaches and other

specialized professionals who work together for the early detection and treatment of disease.

The centre is the only one of its kind to have a program recognizing that complete wellness must address all three areas of physi-cal, psychological and brain health.

Copeman’s brain-health program is the first of its kind and is focused on early intervention for age- and disease-related cognitive decline.

Copeman Healthcare has become Canada’s leader in collaborative, team-based health care, but the services and technologies it has developed are now being shaped for imple-mentation throughout the world.

One of the centre’s greatest contributions to the field of prevention and health manage-ment is its computerized Health Management System, which is a secure, online personal health record combined with sophisticated risk assessments, health surveillance and self-management tools.

Changes in laboratory results and other diagnostic measures trigger personalized reminders about important risk factors and transmit both positive and negative trends to the patient’s health team. This advanced technology is made available to every client of the centre.

The centre offers a warm and comforting environment, as well as an atmosphere of

genuine caring that belies the size and sophis-tication of its operations.

“We are committed to a large, expert staff and the most current technology and tech-niques, but creating a very personalized and highly available service is just as important to us,” says Copeman.

“We have a simple motto, which is to treat every client like we would have our own loved ones treated. Our clients’ health teams are dedicated to them and committed to looking after every aspect of their health.”

Although the centre has numerous sub-scription programs and services, the most popular offering is LifePlus, an all-inclusive prevention and health management pro-gram. It includes a comprehensive, four-hour annual health assessment and a complete package of professional services to support a client’s individual health plan. This service costs $4,200 per adult in the first year of ser-vice and $3,200 per year thereafter, and the enrolment team works with clients to explore individual coverage as it relates to employee benefits packages and tax deductible health expenses.

In addition to the comprehensive adult health services, the centre also offers one of the most advanced programs for the preven-tion of child illnesses available in the world today.

A new standard of health care


Name: Copeman Healthcare CentreLocation: 4th floor, 628 12th Ave. S.W. Calgary, T2R 0H6

ContactCristle JaskenPhone: 403-270-CARE (2273)Email: [email protected]: www.copemanhealth-care.com

Services Advanced personal and fam-ily health care; 24/7 physician on call; integrated physi-cal, psychological and brain health; exercise medicine and physiotherapy; comprehensive health assessments; corporate wellness; registered dietitians; concussion management ser-vices; dementia and Alzheimer’s screening; stroke and brain injury rehabilitation; integrated personal training; cardiac health and rehabilitation; health coach-ing and therapeutic lifestyle change.

Copeman Healthcare has introduced a highly

personalized and service-focused approach

to personal, family and corporate healthcare

that delivers excellence in prevention and health

management. Dr. Pollie Lumby, a family physician at Copeman Healthcare Centre, Calgary.

Managing a concussion

COVER STORY

Options | Fall 2013 76 Options | Fall 2013

The price of free health careCanadians pay 10 per cent of pre-tax income for services that are considered free

Our patients are going to Montana and B.C. all the time.There, they pay for services that would be fully insured at home but being referred out of province enables them to “recover their quality of life sooner” and reduces the number of people on the waiting list here.

By BRIAN BURTON

Canada’s “free” health care costs the av-erage family of four $950 per month, whether they know it or not, accord-

ing to the Fraser Institute.That adds up to an $11,400 tax burden per

family each year — about 10 per cent of pre-tax income — for services that Canadian’s are accustomed to considering free, says Nadeem Ismail of the conservative think tank.

The institute bases its cost of family health care on average incomes and tax rates, fed-eral and provincial health-care spending and population in each province and territory in order to produce a national average. It does not calculate separate numbers for each province.

Nor is the $11,400 annual tab the total cost of health care for the average Canadian family of four. It doesn’t include private spending for drugs, dental and other services that aren’t covered by government insurance in most provinces. Canadian Institute for Health Information says these add about 30 per cent to costs, making the total per family about $14,800 per year. (Alberta is planning to introduce a new Pharmacare drug insur-ance program in January, with premiums geared to income.)

“Canada has the developed world’s most expensive universal health-care system,” Ismail says. “Health care is one of the fastest-rising expenses (Canadian) families face,” with costs increasing 59.8 per cent since 2002. He says this compares with a 22.4 per cent increase in the Consumer Price Index and a 37.2 per cent rise in average incomes.

Despite rapidly rising expenditures, health-care standards in Canada have declined sharply, the Fraser Institute contends. Wait times for various procedures have increased by 90 per cent, to a national average of 17.7 weeks in 2012 from an average 9.3 weeks in 1993, according the latest issue of Waiting Your Turn, Wait Times for Health Care in Canada. The Fraser Institute has produced the Wait Times report annually since 1991.

In Alberta, the cost of health care is higher than the national average and wait times are longer, Ismail says. The per capita cost of health care in Alberta is $4,606, while the Canada-wide average is $3,867, according to the CIHI.

Meanwhile, average Alberta wait times are

20.7 weeks, a full three weeks longer than the national average.

The provincial health-care spending speedometer looks like this: Alberta burns through $1.9 million for health care every hour. That adds up to $47 million per day. For the 2013-14 fiscal year, health-care costs will reach a total of $17.1 billion, consuming 45 per cent of the entire provincial budget, according to Alberta Finance.

Both nationally and in Alberta, the rate of growth in health-care spending is unsustain-able, Ismail says. Wait times for nearly all kinds of medical procedures have increased in every province as a way of rationing care and slowing the rate of spending.

But even at current spending rates, Canada faces a $540-billion unfunded liability for the lifetime health care of those now 18 and older, Ismail says. That means the future will hold further reductions in health-care services, cuts in other government programs or substantial tax increases to cover rising health-care costs, he says.

In Canada, health-care spending consumed 11.4 per cent of gross domestic product in 2010, compared with an average 9.5 per cent of GDP for the 34-member OECD (Orga-nization for Economic Co-operation and Development). In Western Europe, average national spending was around 10.5 per cent of GDP, while the U.S. spent 17.6 per cent of its GDP on health care.

Ismail says most European countries have lower costs and shorter wait times because they provide universal health care through a combined system of public and private health insurance, as well as public and private hos-pitals. These systems fund each facility based on the number and type of procedures it performs. Ismail points out that the highest-performing European systems also include modest user fees to discourage overuse.

By comparison, he says, Canada insists on an exclusively government-funded-and-delivered model that prohibits user fees and provides annual bulk funding per hospital. This is a formula for inefficiency because every operation a Canadian hospital performs consumes part of its fixed annual budget, while in Europe each procedure increases revenue, says Ismail. The European system also forces public and private hospitals to compete to deliver comparable care at the lowest cost.

“Improvement (in Canada) is not possible without a larger role for the private sector,” Ismail says.

Landmark Collaborative Health president Jesse Stein says she believes private clinics such as Landmark perform a complementary role to the publicly funded system.

“We remove our patients from the walk-in clinics,” Stein says of Landmark, where pa-tients pay annual fees for uninsured services such as diet and exercise consulting, physio-therapy and massage and get quick access to physicians for government-insure diagnostic services.

That reduces the wait times for her patients and the number of people waiting in line at walk-in clinics.

Stein says waiting lists in Calgary for surgeries and other medical procedures mean “our patients are going to Montana and B.C. all the time.” There, they pay for services that would be fully insured at home. But being referred out of province enables them to “recover their quality of life sooner” and reduces the number of people on the waiting list here.

Dr. Donovan Kreutzer of Provital Health and Wellness says the Fraser Institute is right to put a spotlight on Canadians’ view that health care is free — because there will always be a shortage of anything that’s free.

“I don’t know how we’re going to fund this giant monster called health care,” Kreutzer says. “The province is going to go broke.”

He says the province should begin reduc-ing costs by putting reasonable limits on the number of free visits patients are allowed to make to their family doctor before a user fee is applied.

“Have you ever waited to see a dentist? he asks. “There’s no waiting because you have to pay for it.”

“If people had to pay even a small fee for visits to the doctor, he suggested, they would use the service more judiciously.

“Right now, there’s nothing stopping you from seeing a doctor once a day,” says Kreutzer.

Eventually, the government should reduce the kinds of medical services it insures and require patients to purchase private insur-ance for the rest, he adds. Traumas, major surgeries and other vital medical services should always be covered, he says.

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By COLLEEN BIONDI

The best kind of friend is one who is there to celebrate the good times with you and support you through the tough

times. Kim Johnston, 37, and a nurse clinician at Alberta Children’s Hospital has that kind of friend in Amber, one of the licensed practical nurses employed at Provital Health & Well-ness.

Johnston had found a lump in her left breast in January 2013, just when her general prac-titioner was going on sick leave. A full range of diagnostics (ultrasound, mammogram, biopsy) was recommended.

Johnston knew about Provital through Amber and had a gut feeling she was going to need “close care and a variety of services.” She im-mediately signed on with the multi-disciplinary health-care clinic and Dr. Donovan Kreutzer, general practitioner, delivered the biopsy re-sults to her: She had Stage 3 breast cancer.

To date, she has had five sessions of chemotherapy, a lumpectomy and a month-long regime of radiation. “Everything is

going really well,” she explains. “I have had overwhelming support from family and friends who have dropped everything to help me.”

The clinic team has helped Johnston look at the bigger picture of living with cancer, navigate the care she is getting at the Tom Baker Cancer Centre and make informed choices about that care. For example, when her white blood cell count dropped as a result of taking chemotherapy, Kreutzer was able to reassure her that this was not uncommon during treatment and suggested she be diligent regarding hand washing and avoid busy, public places.

Johnston regularly visits a registered psychologist at Provital to help her cope not only with her own emotions related to cancer and its process but the “remarkable and overwhelming” response the illness is having on others.

“He has helped me deal with the fear of the unknown, with questions such as: what is this going to feel like and what am I going to experience? He has been incredibly supportive of why I am feeling

the way I am feeling at different points.” She was also referred to a naturopath in the

community who specializes in oncology. Twice per week she takes vitamin C intravenous treatments and mistletoe injections and is committed to daily supplements such as vitamin D and coenzyme Q-10.

“He has made me feel like I am participating in my own treatment and supporting my body in going through the process,” she says. “We are working with the traditional medical system but are trying to increase the efficacy of the treatments through naturopathy.”

Johnston gets all her blood work done at Provital; she doesn’t have to sit and wait anywhere. She is beginning to see an on-site massage therapist and a personal trainer. She is anxious to do more running — she has been running throughout her treatment, but now her team recommends she step that up — and get back to work.

For the Provital plan, which includes ready access to any of the clinic professionals, Johnston pays $4,000 per year out of pocket. She will claim the services on income tax and

get reimbursement for some of the costs (the massage therapist and registered psychologist, for example) from Blue Cross.

“There is no question it is worth it. It is unbelievable how supportive the team is. And they really function as a team; they talk to one another and respond to your questions immediately. The resources at Provital are very personalized.”

She credits a supportive network and the dedicated groups at the Tom Baker Cancer Centre and Provital for helping her get her life back. “It feels good to feel good again.”

‘It feels good to feel good again’Calgarian Kim Johnston has the full support of Provital’s multi-disciplinary health-care team as she receives treatment for Stage 3 breast cancer.

— Adrian Shellard photo

Johnston . . . had a gut feeling she was going to need close care and a variety of services.


PROFILE

MRIs ARE bECOMINg more acces-sible to people in the Calgary area, thanks to EFW Radiology, a specialist group of radiologists providing comprehensive diag-nostic imaging services for patients and their doctors.

EFW Radiology operates a total of 11 clinics in the Calgary area, including a com-munity clinic in High River and one in Aird-rie. EFW also provides all radiology services at the Foothills Medical Centre in Calgary.

Magnetic Resonance Imaging (MRI), is one of the private medical services that EFW offers. MRIs can detect abnormalities by producing detailed anatomical images, providing important information to aid diagnosis and treatment. EFW Radiology believes in making MRIs more accessible, in order to help patients and their doctors find answers to their medical questions.

Recently, EFW Radiology launched pri-vate MRI services that are available under a new flat-rate pricing structure, ‘One Visit, One Price.’ Patients pay one fee and receive an answer to a single medical question — no matter how many areas of their body require imaging. EFW Radiology has introduced

One Visit, One Price in order to answer patients’ questions appropriately, working in partnership with a patient’s physician.

“The difference is a flat-rate pricing structure, so that people get answers to their questions. They’re not making decisions based solely on economics,” explains EFW Radiology CEO Nairn Nerland. (Tradition-ally, he notes, clinics charge by body part, which typically results in increasing cost as multiple body parts require imaging.)

For people who are in pain or potentially ill, an MRI may be appropriate, Nairn says. With EFW Radiology’s One Visit, One Price, patients don’t have to worry about paying multiple fees for multiple body parts in order to obtain an answer to their health question.

“EFW works with the patients’ physician to utilize medically appropriate MRI.

“To our knowledge, no one in North America and certainly not in Alberta has approached MRIs the way we have, in a private community environment. It’s a flat-rate pricing structure, so you are charged one price of $600 ($850 with contrast). For that one visit, we will do as many imaging

exams on you as is medically appropriate.”This new approach is based on the model

used at the Foothills Medical Centre and at other tertiary hospitals, Nairn says. “In a hospital, you don’t make a decision based on body parts — you image as many (body parts) as necessary to find an answer to a patient’s medical problem.

“This gives people an option. In private MRI, we are establishing a new way to ap-proach this, which is in the best interests of the patient and the referring physician.

“That’s what this is really about — it’s the right thing to do. It really does address what people’s needs are. We are very proud of this — because we are trying to make things work for people better than they ever have before.

“The other thing is, we also believe this helps relieve some of the pressure from the public system in terms of the wait lists for public access to MRIs. by coming to the private world, it helps alleviate that pressure point. On a macro level, it’s good for the over-all population in Calgary who need access to an MRI.”

For more information, please visit www.efwrad.com.

Patients pay one price per visit at EFW Radiology


Name: EFW Radiology

Locations: Eleven in the Cal-gary area including a commu-nity clinic in High River and one in Airdrie.

ContactPhone: 403-541-1200Email: [email protected]: www.efwrad.com

Services MRI, general X-ray, ultrasound, mammography, bone mineral densitometry, nuclear medicine, body composition analysis, pain management, maternal fetal medicine: ultrasound, consulta-tions, first trimester screening, fetal echocardiogram, amnio-centesis test, clinical assess-ment, diagostic ultrasound, therapy prolotherapy, platelet rich plasma (PRP), tenotomy, rotator cuff lavage, peripheral nerve injection, nuclear cardiol-ogy, myocardial perfusion imag-ing and prostate biopsy.

To our knowledge, no one in North America

and certainly not in Alberta has approached MRIs the way we have

... It’s a flat-rate pricing structure. For that one

visit, we will do as many imaging exams as is

medically appropriate.

11


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By COLLEEN BIONDI

Volinder Dhesi likes the number three. He is a 33-year-old dentist, owns three professional practices and has

three small children. But he didn’t like it when one of his sons was ill and he attended a northwest Calgary medical clinic only to be seen by the doctor after a long wait for — approximately three minutes.

“We live in the best country in the world. There has got to be a better way. My faith and trust in the system was just not there,” explains Dhesi. As a result of the inconvenience and hassle, he and his family only used clinics on an as-needed basis. They avoided regular check-ups and screenings for years because it was just too much work.

About four years ago, Dhesi heard about Preventous Collaborative Health, investigated the clinic and signed on.

“They are not interested in seeing as many patients as possible. They value people’s time,” he says.

At Preventous, patients can book an appointment the same day (the clinic will make pre-school or post-school appointments for the children so they don’t miss classes). Patients are seen when the appointment is scheduled and have the time needed — 30 to 40 minutes is not unusual — to discuss the medical situation.

“I have never been rushed at Preventous.”With the annual fee, members get an

assessment with a general practitioner, a registered dietician and a kinesiologist. During the year, members can access those professionals and others, including the licensed practical nursing staff, a personal trainer and a psychologist, as frequently as they like.

Since joining Preventous, Dhesi has had regular check-ups and screenings and now sees the clinic as a vital part of his life. Recent blood work showed slightly increased sugar levels and although he is still in the normal range, the plan is to get to the lower end of normal. As a result, he is working with a dietician to reduce

his bread and rice consumption and increase his vegetable intake, adding superfoods such as quinoa.

People of East Indian descent often have difficulty absorbing vitamin D so he was assessed and was found to have a deficiency. He is stepping up his vitamin D intake via supplements. He also saw a kinesiologst for advice regarding exercises to increase flexibility and to strengthen and protect his back, a vulnerable spot for dentists who are bent over patients all day.

Professionals at Preventous emphasize health over illness and use a team approach to patient care. They are up-to-date regarding current trends in medicine, their recommendations are evidence based and they offer good, factual information, says Dhesi. “You learn a lot about yourself.”

When his two-year-old son, Jovan, developed allergies he was referred to a specialist for a treatment plan. The back-and-forth communication between the Preventous team and the specialist community has been

solid, smooth and seamless. It has meant less disruption for the family and more confidence that their needs are being looked after.

The cost for the family is $6,600 per annum, which they pay out of pocket ($3,300 each for the adults; kids are free).

“You can’t place a dollar figure on your health and wellness,” says Dhesi. “We’ve seen incredible changes in how we approach things through the support of a team that cares for us and helps us be our best. There is no downside; we’ve been really pleased with our services at Preventous.”

‘They value people’s time’Volinder Dhesi, wife Komal, sons Shaan, Jovan and daughter Mila have found the unhurried medical care they need at Preventous Collaborative Care.


There has got to be a better way. My faith and trust in the system was just not there.

PROFILE

CANADA DIAgNOSTIC CENTRES (CDC) is a leader in public and private medi-cal diagnostic imaging services in Alberta. One of the largest medical imaging provid-ers in Alberta, CDC has clinics in Calgary, Okotoks, Edmonton and Sherwood Park.

CDC is a multi-modality service provider that has recently expanded its pain manage-ment services with new imaging equipment.

CDC’s pain management therapy is a specialized service currently being offered at seven of CDC’s 14 Alberta locations. CDC continues to innovate and extend its pain management therapies, which have been designed for adults of all ages experiencing spine, joint, tendon or nerve pain.

In younger patients, these pain therapies are often used to treat sport- or work-related injuries, while in older patients, they are usu-ally used to treat conditions such as osteo-arthritis, disc degeneration or other effects of the aging process. The therapies can be particularly helpful for conditions such as chronic tendonitis, osteoarthritis, sciatica, neck and back pain and shoulder issues. The treatment can also benefit patients waiting for joint-replacement surgery.

“The advantages of what we do is that patients are getting accurately delivered and

proven medical therapies to diagnosed causes of pain,” says Dr. Robert Davies, principal radiolo-gist at CDC’s Pacific Place location in Calgary.

CDC offers pain management therapy utilizing ultrasounds or digital fluoroscopy, a form of X-ray technology. This therapy combines precise imaging diagnosis and high-tech equipment to guide the physician to the exact problem area, with advanced medical treatments that allow the physician to deliver a smaller amount of medication, more ac-curately than conventional methods.

The procedure is usually quick and causes a minimal amount of discomfort. The recovery time, which will depend on the type of treat-ment being delivered, can range from one or two days, up to a week.

In many cases, these therapies are as or more effective than traditional surgical treat-ments, says Davies.

“Depending on where the procedure is done and the underlying problem, some pa-tients will have complete pain relief that can last for months or even years.”

While image-guided pain management is an emerging field of medicine in Canada, it is well established in the U.S. and Europe.

“These are well researched treatments, delivered by medical doctors to the highest stan-

dards, and they are extremely safe,” says Davies. A certain proportion of patients will get bet-

ter with traditional rehabilitation methods such as physiotherapy, Davies notes, “but for those patients who aren’t getting better after a few weeks, the next step is to come and see us.”

Patients who are interested in this treatment should see their family doctor for a referral. Most treatments are covered by Alberta Health Care and some private options are available.

CDC holds regular educational seminars for family physicians and other health-care providers to explain the research behind these emerging pain management therapies, and the techniques used to deliver them.

“It’s an emerging field in Alberta and we are trying hard to educate our colleagues in different areas of medicine that this is an op-tion for some of their patients,” Davies says.

In addition to image-guided pain manage-ment therapy, CDC provides MRI and CT services, ultrasounds, X-rays, mammography and bone density scans. Private MRI and CT scans include preventative health scans, such as full body, joint, lung and heart scans and vir-tual colonoscopies. CDC also offers pediatric and adolescent X-ray and ultrasound exams.

For more information, please visit www.CanadaDiagnostics.ca.

CDC’s new pain management therapies bring welcome relief to ailing patients


Name: Canada Diagnostic Centres

Locations: Nine in Calgary and Okotoks, six in Edmonton

Private MRI & CTCDC Chinook1-6020 1A St. S.W.Calgary, AB T2H 0G3Phone: 403-212-58551-877-420-4CDC (4232)

Email: [email protected]

Web: CanadaDiagnostics.caServices:Diagnostic medical imaging, magnetic resonance imaging (MRI), women’s imaging, pediat-ric imaging, computed tomog-raphy scan (CT Scan), preventa-tive health scans, heart scan, lung scan, virtual colonoscopy, 2-D ultrasound, 4-D ultrasound, bone mineral densitometry (bone density), gastrointestinal studies (GI studies), mam-mography, pain management injections, pain management therapy, fluoroscopy, X-ray.

Depending on where the procedure is done and

the underlying problem, some patients will have

complete pain relief that can last for months or

even years.CDC Radiologist Dr. Rob Davies Dr Rob Davies, a radiologist at Canada Diagnostic Centres, says patients have access to proven medical therapies to treat diagnosed causes of pain.

12 13


1486

By JACQUELINE LOUIE

Good health is more than the absence of illness, and achieving optimal health takes a team approach.

“People consider themselves to be doing well just because they haven’t collapsed,” says Dr. Rohan Bissoondath, medical director at Preventous Collaborative Health in Calgary, a private medical clinic that takes a multi-disciplinary approach to individual and family health care.

Physicians are trained in recognizing, diagnosing and treating people who are sick. Bissoondath — whose background is in urgent care and emergency care medicine — came to realize that in order to truly benefit people, he had to step back and put his main focus on prevention.

Health is not just the absence of illness, but rather a person’s overall state of well-being: mental, emotional and physical, he explains.

The Preventous team of physicians and supporting health-care specialists focuses

on illness prevention by using medical and lifestyle strategies. The goal is to prevent illness by focusing on the cornerstones of health, including proper nutrition, exercise and mental and emotional well-being. A registered dietitian is on hand to help patients manage their nutrition and a personal trainer/kinesiologist can provide guidance on healthy living by focusing on form and function — including knees, back, hips and cardiovascular health.

“Having a kinesiologist and dietitian in-house makes for a good team atmosphere. We can interact together around a patient’s care,” Bissoondath says. “Having that team that talks regularly and knows you inside and out — you can’t beat that for its success.”

It’s an approach that is working well. In the last five years, Preventous has “gotten people on board,” Bissoondath says, taking people who are too busy to pay attention to their health, turning them around and making them aware of how their lifestyles have been affecting their health, in terms

of cholesterol level, blood sugars, waist circumference and other numbers. Lowering patients’ risk factors “reduces the risk of their first interaction with a doctor being at a catastrophic time.”

The results, according to Bissoondath, speak for themselves: clothes that fit, elimination of back pain, and the spring back in their steps. “From a professional and satisfaction point of view, it’s terrific.”

Taking a team approach also works well at Landmark Collaborative Health in Calgary, which offers a multidisciplinary setting integrating family physicians, alternate clinicians and specialists to provide proactive, preventative care to patients.

“The key thing we can provide, is better quality of care,” says Landmark president Jesse Stein. “It creates better care for patients and a better practising environment for physicians.”

In Landmark’s collaborative model, the health-care team meets weekly to discuss patient cases, so all team members are on the same page. The physician, who manages the

process and does a baseline health assessment of each patient, is able to speak directly to Landmark’s in-house clinicians which include holistic nutritionists, dietitians, psychologists, kinesiologists, chiropractors, massage therapists, physiotherapists and naturopathic doctors. The clinicians in turn support the wellness process.

Accessing the services offered by a team setting such as Landmark Collaborative Health requires a fee, “but the benefits far outweigh the costs,” Stein says.

“As well, many health services can be reimbursed through traditional benefits or a health spending account, and can be deductible on their income tax.”

Team approach suits practitioners and clients — Thinkstock photo

The key thing we can provide is better quality of care.

MULTI-DISCIPLINE

LAnDmARK COLLAbORATIVe HEALTH began operations in 2012 and was designed to provide a new level of personalized health care for individuals, families and corporate groups.

Landmark’s team includes family doctors, chiropractors, psychologists, naturopathic doctors, dietitians, mas-sage therapists, physiotherapists, holistic nutritionists, kinesiologists, and life coaches. Landmark’s main services are its Collaborative Healthcare Packages which include services from its family doctors, a complete health assessment and appoint-ments with its extensive health care team.

Operating under the slogan, ‘Your Health, Your Choice,’ Landmark strives to meet the personal needs and prefer-ences of each client, says company president Jesse Stein.

“We build each client a custom pack-age that’s completely tailored to their needs,” Stein says.

Landmark offers a number of packages designed for adults, students and children. Custom packages are also available for corporate groups and clients with unique situations. Couples receive a 10 per cent discount when both are registered and services to children are free when at least one parent is a client.

The complete health assessment is an in-

depth exam that includes assessments with a family doctor, registered nurse, psychologist, kinesiologist, dietitian or holistic nutrition-ist, and massage therapist. Then, based on personal goals and needs identified by the health assessment, each client chooses the add-on services of other clinicians they want included in their package. For example, in addition to a dedicated family doctor and the complete health assessment, the bronze package includes a total of 48 appointments with our team of clinicians which are specifically chosen by each client.

The majority of Landmark’s clinicians are available on an “a la carte option” basis as well. Here, clients can book individual appointments with clinicians on a one-time or recurring basis. The 70-point complete health assessment is also a popular choice for people just looking for an in-depth assessment of their health and where they may need to make improvements.

“No one is pigeon-holed into services they don’t need,” Stein says. “We ask clients what they want to achieve and we develop a personalized plan to help them reach their goals. Our system is really driven toward the services clients want.” best of all, she says, the cost of Landmark services can be partially or fully recovered from employer health

plans that typically provide coverage for the add-ons Landmark offers. If a couple are both employed and both have health insurance through work, the cost of the bronze package can typically be fully recovered from insurance, she says. With one insurance plan, half the cost is normally covered.

“Many people are able to obtain our services at no charge by effectively using their employee plans,” she says. “That is a big attraction, when people realize they can have this level of care at no cost to themselves.”

“At Landmark, we book longer ap-pointment times with our family doctors and clinicians to allow clients adequate time to review medical history, progress, and discuss any and all concerns.”

“You actually have a chance to have a conversation,” she says. “It is a more proac-tive and preventive approach that aims for better overall health, rather than interven-tion after people become ill or injured.”

In most cases, Stein says, same-day appointments can be arranged with our family doctors or clinicians as needed. Landmark also works with corporate hu-man resources departments to provide pre-ventive health care for employee groups.

At Landmark, it’s ‘your health, your choice’

At Landmark, it’s ‘your health, your choice’


Many people are able to obtain our services

at no cost by effectively using their employee

benefits plans. That is a big attraction, when

people realize they can have this level of care at

no cost to themselves.

Jesse Stein, President Landmark Collaborative Health

Name: Landmark Collaborative Health

Location: Cambrian Wellness CentreSuite 310, 2000 Veteran’s Place N.W. Calgary, T3B 4N2

Contact info:Phone: 587-779-2690Email: [email protected]: www.landmarkhealth.ca

Services: Landmark’s extensive team of family doctors and health-care clinicians provide a variety of services including complete health assessments, family medicine, massage therapy, psychotherapy, naturopathic medicine, chi-ropractic treatment, kinesiologist assessment and tailored exercise programs, physiotherapy, registered dietician plans to aid in the preven-tion and management of disease, food allergies, sports nutrition, vegetarian and vegan diets, and holistic nutrition coaching and counselling.

Pictured L to R: Dr. Bobby Sreenivasan; Dr. Ingemaud Gerber; Jesse Stein, president; and Lindsay Bumanis, sales.

15


10

By BARB LIVINGSTONE

For 85-year-old Yvette DeGagne, knee replacement surgery at the Swedish Orthopedic Institute in Seattle,

“revitalized me — it opened a better door for my end of life” time.

After four years of suffering the severe pain of osteoarthritis, “I was really wanting to let go. I had made my will and told my kids, and was praying to God to take me,” says the Calgarian, who three weeks after her surgery was already walking with her Bichon Shih Tzu dog Muffin.

“I was at my wits’ end and then I saw the ad in the Calgary Herald (for Swedish).”

The orthopedic institute, a separate facility that is part of the five-hospital Swedish Medical Centre in Seattle, has 25 orthopedic surgeons on staff.

DeGagne’s wait to see an Alberta orthopedic specialist was two years, so when she heard about the U.S. hospital’s specialty and that surgery could be done within a month, she made the call.

“I said to my daughter: ‘I resent that you have to leave Canada to get health care,’ and I always believed Canadian docs and nurses were the very best — once you can get into see them.”

And while her family doctor had told DeGagne there was to be a new hip and bone clinic in Calgary, “I said: ‘I can’t wait.’ So I made up my mind — I couldn’t live this way.”

DeGagne, a mother, grandmother and great-grandmother was, alongside her late husband Gerry, a pioneer in Calgary’s hotel industry — building and operating Hospitality Inn North, Best Western Hospitality Inn South and Best Western Village Park Inn.

Used to tackling challenges, she paid her $25,000 and was booked for surgery at Swedish on June 15.

The day before her knee was replaced, she was taken to a quiet, private room, talked to the surgeon (Dr. James Crutcher) for the pre-op session — “he listened, had gathered all the information on me, went through and reassured me about everything” — and he was there the next morning to greet her for surgery.

“It went perfectly,” says DeGagne, who then spent two nights in hospital recovering.

Crutcher “told me they have the biggest inventory of all sizes of hips and knees. I had a friend who had the surgery (somewhere else) and it never fit properly. I am small and this was a perfect fit.”

DeGagne, and her daughter who accompanied her to Seattle, spent a night in a hotel before leaving for Calgary the next afternoon.

As for her recovery, she used a walker for two days “to appease my children” but was soon out walking with her dog.

“There is so little pain. I know there is metal in the kneecap and I exercise the leg like mad. I have only had three painkillers since I got home,” she says.

This after years of pain medication and cortisone shots that offered less and less relief.

“Now, I can feel the blood working its way through the new knee. It means the doctor has connected every artery. It’s a healthy knee.”

Within just two weeks of being home, her Swedish doctor had already talked to DeGagne’s Calgary doctor twice, to her twice, and to her daughter.

“That is follow up care. He is not just a doctor you see once in an operating room.”

DeGagne says she now feels she was meant to see the ad — and to take action.

“It was hard for me to do that — to bypass the health system. I love Canada but I don’t think we should be afraid of privatization.”

She says she gave a lot of thought to having surgery at her age, because of the potential risks.

Now, healthy again, she is inspired to use her energy to continue her charitable work.

“I’ve had a great life and, at 85, I’ve helped look after the next generation in my family. That work was done but there must be something left to do, other than get a new knee. Now that I am free of pain, I take this as a gift to seek out ways to help others.”

‘He is not just a doctor you see once in the operating room’

At 85, Calgarian Yvette DeGagne is pain-free thanks to the knee replacement surgery she received at a private clinic in Seattle, Wash.


I said: ‘I can’t wait.’ So I made up my mind — I couldn’t live this way.

PROFILE

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16 1710


PROFILE

By COLLEEN BIONDI

Through most of her career as a licensed practical nurse, Carolyn Cochrane, 67 and recently retired,

enjoyed an active life. She tended to her garden. She walked

every day. But about five years ago, she woke up and her legs felt swollen.

Within three weeks, the pain and stiff-ness in her back and hip and radiating down her left leg was so bad, she could hardly walk.

She saw her general practitioner who referred her to a neurologist. The special-ist tested her muscles and took a biopsy. Nothing came up. Within a year, she was using a cane as a walking aid. Her doctor then referred her to a rheumatologist in case the issue was arthritic. That special-ist theorized Cochrane likely had some arthritis, but nothing that would result in the severity of her condition.

“Things got progressively worse over a three-year period,” says Cochrane.

Cochrane then tried cortisone shots and, although they helped, the relief was short term. Next, she was prescribed prednisone, an experience she describes as “a night-mare.” She gained more than 50 pounds and developed shortness of breath which resulted in an emergency trip to the hospital and even a referral to a heart specialist.

Finally, her husband and son did some private investigating and found Copeman Healthcare Centre. “They were tired of seeing me the way I was.”

Cochrane joined the facility in November 2012 and they referred her to Kalispell Re-gional Healthcare in Montana for a consult.

Kalispell requested all medical records, including an updated MRI which Co-chrane purchased privately within three days in Calgary. A neurosurgeon and an orthopedic surgeon reviewed the data and thought the issue might have to do with the nerves in her spine, which, when compromised, can result in deferred pain. They invited her down for a facet block injection. After that diagnostic procedure,

which targeted the facet joints between L4 and L5, the pain was gone.

“I could’ve run a mile after that. It took the inflammation down. It was great,” she says. Cochrane was asked to return to Calgary and keep a record of her pain. Within three weeks it was back. It was at that point that they knew they had found the source of the issue.

This past June, she returned to Kalispell for a procedure called a facet rhizotomy, which provides pain relief by “shutting off” the pain signals that the joints send to the brain. This is done by placing a needle — with a heated electrode tip — alongside the small nerves of the desig-nated facet joints.

The cost for the procedures, consul-tations, gas, meals and hotel, came to about $8,000 US, which she expects will be reimbursed in part by Alberta Health Services.

“It is a quality of life issue,” Cochrane says. “I was at the point where I felt the world was passing me by.”

‘I could have run a mile after that’

Carolyn Cochrane enjoys walks with her husband Robert after receiving treatment at the Kalispell Regional Healthcare Center in Montana for debilitating back, hip and leg pain.



By BARBARA BALFOUR

Look to the person to your left. Now look to person right of you.

By the end of this decade, one of you will either have diabetes or prediabetes.

With close to 10 million Canadians living with either Type 2 diabetes or its precursor, there are 60,000 new cases per year and at an estimated annual cost of $6 billion, the numbers are, quite simply, “out of control,” says registered dietitian Nina Hirvi.

“Lifestyle intervention is absolutely crucial whether in prevention or maintenance,” says Hirvi, a certified diabetes educator with Copeman Healthcare Centre.

“Landmark studies suggest the earlier you find out you are at risk, and the earlier you have a team around you that supports the management of it, the better your long-term outcomes will be 40 years down the road.”

In March 2011, Copeman introduced a diabetes management program consisting of a team of physicians, registered dietitians, certified exercise physiologists and diabetes educators, psychologists and lab technicians.

The program led to significant improvements in key health outcomes in patients with Type 2 diabetes. After only 18 months, the number of patients achieving a target blood pressure reading improved from 16 to 60 per cent.

Additionally, 74 per cent of Copeman patients meet the target international

standard for blood sugar levels over a three-month period, compared to the Canadian average of about 50 per cent.

“What we do is screen all our patients even for prediabetes and we particularly follow people who are heavy in the middle; we find them early,” says Hirvi.

“Blood sugar has a legacy effect — the faster we get it down, the better they’ll do later on. Losing even a little bit of weight makes them less insulin resistant. The lower the blood sugar, the lower the blood pressure and the lower the cholesterol.”

Copeman regularly tracks patient outcomes, looking at their latest sugar and cholesterol readings.

“Time gets away from us and all of a sudden, you haven’t seen a patient in six months,” says Hirvi.

“We address that list of patients: What’s happening with this person? Do they need more education or medication? We pull out the names of people we see who are in trouble and determine what we need to work on.”

Even those who are athletic and eat a healthy diet may still get diabetes if they carry a genetic risk for it, says Dr. Jan Hux, chief scientific adviser for the Canadian Diabetes Association, who describes two types of the disease.

The less common one, Type 1 diabetes, is caused by an autoimmune attack to a pancreas which normally produces insulin and eventually gets destroyed. It

isn’t commonly hereditary, and is caused by the loss of the ability to make insulin, which acts as the key to let sugar, or fuel, into the cells. Instead, glucose stays in the bloodstream and climbs higher, while cells remain starved because no fuel is getting in.

With Type 2 diabetes, says Hux, the problem is that the cells are resistant to insulin. “Somebody has changed the lock so insulin doesn’t work anymore,” she says. “The end result is the same, but the mechanism is different.”

Despite the genetic link, there are plenty of things people can try to reduce their risk.

“Activity and diet are really important. For instance, a recent study showed immigrants living in the least walkable neighbourhoods in Toronto have a 50 per cent higher chance of developing diabetes,” says Hux.

“We recommend at least 30 minutes of activity that raises your heart rate, three to five times a week. Add in achievable goals within the context of your regular routine instead of making it an add-on. When you go to the mall, park on the far side of parking lot. At work, get off the elevator two or three floors below office level and walk up the stairs. Next week, add four flights and the week after, that add five.”

Hux also recommends increasing intake of fruits and vegetables, using whole grains instead of refined foods, and portion control.

Above all, avoid demonizing any one particular food.

“Sugar is essential for life — it’s the fuel that our cells use. A diet where substantial calories come from sugar is probably missing in other important components such as protein and complex carbs.

“I remember a patient with a very high cholesterol level who was completely mystified because he didn’t eat any eggs. However, he would sit down with a pound of butter and a stack of crackers. It’s all about the total impact of food you eat.”

DIABETES

Sugar is essential for life — it’s the fuel that our cells use. A diet where substantial calo-ries come from sugar is probably missing in other important com-ponents like protein and complex carbs.

Lifestyle intervention crucial to prevent diabetes — Thinkstock photo

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By BARBARA LIVINGSTONE

For more than 20 years, Thomas Nish fought to get his weight under control.

At Christmas 2010, his family said it was time to do something to “make sure I stuck around,” says the 57-year-old father of five and grandfather of 18.

The then 346-pound Cardston man had tried everything from fad diets to lifestyle pro-grams but nothing had stuck.

“I’d take some off, then put more back on.”In May 2011, he paid $16,000 and under-

went lap band surgery at Benefis Health Sys-tem in Great Falls, Mont.

“It was a life-changing event,” says Nish who now weighs 242 pounds and is still losing two to three pounds a month. “I didn’t realize the limits the excess weight was putting on me.”

Before, when the family was waterskiing, “I was watching from the dock. And while I was still able to do my job, it is definitely easier now when you are a heavy-duty technician and moving around a lot.

“I am a much healthier person than I was two and a half years ago.”

In lap band surgery an adjustable and revers-ible device — a silicone ring — is placed around the upper part of the stomach. The gastric band creates a new, smaller stomach above the ring and leaves the remainder of the stomach and intestines intact below the ring, restricting the amount of food a person can consume.

Before the family intervention, Nish said he had not even heard about lap band surgery, so he first of all checked how long it would take to have it done in Alberta. “I was told it would take about three years to get it — and that’s after you got in to see a specialist.”

Nish started investigating online and found Benefis’ Bariatric Institute, which is recognized as a Centre of Excellence by the American Soci-ety for Metabolic and Bariatric surgery. It is part of the larger Benefis hospital system — one of the largest in Montana, which also has specialties in cancer care and heart and vascular surgery.

He decided to check the bariatric institute out and called in April 2011. “I was told I could have an appointment that Tuesday and the sur-gery two weeks later,” says Nish, laughing.

“I said I wasn’t quite that ready but booked an appointment. My daughter who is a nurse

went with me to make sure I asked the right questions, I guess, and I was really impressed.”

Nish says his Benefis doctor, Dr. David A. Rohrer, took the time to outline all the details — “there was no rushing. I was convinced and booked the surgery for the next month.”

Before he had the surgery, Nish had other health issues associated with his weight, in-cluding high blood pressure.

“I had hypertension; I did not have diabetes but knew I needed to do something before I developed that. Since the surgery, I have cut my hypertension medication in half and the objective working with my local physician is to get off it entirely.”

Nish says he knows the surgery is not a cure all to his weight challenges but for the first time he feels full because of the band, and he has had very few setbacks.

The Cardston man says he is grateful to his family who insisted he take action because they “wanted me to live to be an old man.”

His only regret is that “I didn’t look at do-ing it earlier.” Despite the cost that he had to assume, “I would do it again in a heartbeat. It was worth every cent.”

‘It was a life-changing event’PROFILE

By BARB LIVINGSTONE

At the beginning of August, Joray Schwab did her first five-kilometre run.

This, from a 35-year-old who, just five months ago “couldn’t get off the toilet without grabbing something to help me up.”

The Calgary woman, who works in document control in the oil and gas industry, says her health issues began just over a year ago.

After undergoing gastric bypass surgery in Mexico in June 2012, Schwab started feeling “really tired” that fall.

She had been 403 pounds before sur-gery, stayed in Mexico a month for post-op care and had lost 206 pounds.

Schwab considered the surgery a success and was seeing her Calgary doctor once a month, getting regular blood work done.

However, despite her complaints of not feeling well, she says her local doctor simply said it was because of the surgery, “it’s OK and come back next month. I was never told what my blood levels, etc. were so I did not know what normal was.”

She started having other problems besides the fatigue, including tingling and numbness in her legs.

“I was working and had lost a lot of muscle. I live up four flights of stairs and after the second floor I had to pull myself up by my arms. I was a very strong per-son before — I would haul up a chest and drawers that I needed to put together.

“I was not used to this. I couldn’t even get off the toilet seat without grabbing something.”

Again, her GP said it was a side effect of the surgery and “I felt like I was put on the back burner. There was never any investigation of what could help — I was just told that it was probably a side effect of the surgery.”

It was a chance conversation with Jesse Stein, president of Landmark Collabora-tive Health, who Schwab knew, that led her to a new health path.

“She said, ‘you need a new doctor’ and that she was opening a new clinic with great doctors. I talked to her on a Sunday, Monday was a holiday and on Tuesday morning she texted me that one of her doctors had already done some research

and had some ideas.”Schwab went to see Landmark’s Dr.

Bobby Sreenivasan and was told her vitamin B and D levels “were shot, a section of my thyroid was shot, and my

hormones were shot.”The doctor told her that should not

be happening; “that we need to get that changed.”

For the first time, she says, solutions

were being recommended.In March, Schwab joined Landmark

and, besides seeing Sreenivasan, also started seeing the clinic’s chiropractor/acupuncturist because her weight loss had affected the nerve endings in her legs, and the kinesiologist for an exercise program to get back muscle.

Landmark’s attentions mean her thyroid and hormones are now under control and “my blood levels have gone from 0 to more than 250, and with my exercise program, the doctor wants to see them up in the 600s.

“I take vitamin B shots and it now feels like night and day.”

Schwab describes herself as a ”go, go person; very social but I was dragging myself — my friends would laugh at me and say ‘you’re so slow.’”

Now, “I run for an hour every second day. I do the stairs at the Rosedale bluff and add another set each time. I have a second run slated for San Francisco, when I go there at the end of August. I have gone from not being able to lift up off the toilet to this.”

The collaborative nature of Landmark has looked after her whole health, including finding a gastric surgeon in Edmonton that can be consulted if she has any issues down the road from her surgery, she says.

“I had planned to go to Mexico for a check-in with my surgeon there. The thing you find when you have surgery else-where, is the hardest thing is to find some-one to do follow-up. Now, I don’t have to go to Mexico… that is so reassuring.”

She pays her own fees at Landmark and does not regret a penny.

“When it comes to my health, I do what I have to do. I just wish I had talked to Jesse sooner.”

‘When it comes to my health, I do what I have to do’

I live up four flights of stairs and after the sec-ond floor I had to pull myself up by my arms.

PROFILE

Health experts at Landmark Collaborative Health helped pinpoint the cause of the fatigue Joray Schwab was feeling after undergoing gastric bypass surgery in Mexico a year ago, something her previous doctor dismissed as a surgery side effect.


After decades of unsuccessful fad dieting, Thomas Nish of Cardston underwent lap band surgery in Great Falls, Mont., a procedure that has helped him shed more than 100 pounds.

— Thomas Nish photo

The LAP-BAND®Adjustable Gastric Banding System is indicatedfor use in weight reduction for severely obese patients morethan 100 lbs overweight or with a BMI between 35 and 50.

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19


mOST PeOPLe KnOw you can pre-vent getting chronic and life-threatening diseases. However, do you really know how big a difference prevention can really make? The folks at Preventous Collaborative Health do, and that knowl-edge is what drives them.

“The U.S. Centers for Disease Control estimates that 40 per cent of cancer and 80 per cent of heart disease, stroke and type 2 diabetes are prevent-able. That’s why we exist and why we’re passionate about what we do,” says Preventous medical director Dr. Rohan bissoondath.

It’s been six years since Preventous became Calgary’s first preventive health care clinic and the number of families in its Twenty-Four Seven Club has grown extensively. bissoondath says people are realizing they can take control of their health and why it’s so important to do so.

“People want the best for their children and spouses, and for themselves. growing numbers are beginning to understand that peak health is a foundation for everything else,” says bissoondath.

The warm, welcoming clinic delivers

all the services required to improve health and prevent disease, from total health as-sessments and medical guidance to fitness and nutrition consultation and psycho-logical counselling. There’s even a fitness facility on site where kinesiologists work with you to create an activity plan and monitor your fitness level.

bissoondath says he incorporated nutritional and fitness services into the clinic because achieving and maintain-ing peak health is impossible without knowing how to make healthy choices in these areas. Having everything under one roof also allows his medical team to work directly with registered dietitians and kinesiologists.

With its broad range of services and commitment to providing care 24 hours a day, seven days a week, Preventous is a busy place. but the experience it provides is a relaxed one and patients get as much time as they need.

Everyone is welcome at Preventous — men, women, executives, and even corporate teams.

Families, however, are its specialty and the Preventous family loves working

with their youngest patients.“To see them become more mentally

alert, more energetic, is wonderful. but for us, the joy is in knowing that these kids are going to be set for life. It’s such a gift to them and an honour to help their parents achieve that,” says bissoondath.

What are Preventous’s patients saying? Here’s how one knowledgeable member sums up his experience:

[M]y personal experience has been as positive as I could hope for, and has established for me an intimate relationship with a team of health professionals who have my interests at heart and take whatever time is needed to deal with those interests.

From a corporate perspective and from a personal one, Preventous provides its services at an investment cost which seems to have an infinite yield—given that I have access to the highest quality health care on a 24/7 basis.

So why Preventous? I can answer for me by saying that I have tried alternatives, and Preven-tous is ‘as good as it gets.’

– David Tuer, former chair of the Calgary Health Region

Family-centered clinic focuses on disease prevention and improving health


Our goal is to help people take control of their health and the health of their loved ones so they can fully enjoy all

that life has to offer.

Preventous founder, Dr. Rohan bissoondath Members of the Preventous team from left, Georgie Weeks, Dr. Aaron Woodard, Dr. Sarb Grewal, Barb Schafer, Dr. Maya Grover and Dr. Rohan Bissoondath.

Name: Preventous Collaborative Health

Location: 1635 17th Ave. S.W.Calgary, T2T 0E5

Contact info:Phone: 403-229-0129 E-mail: [email protected] Web: www.Preventous.com

Services: n 24/7 Access to our health

care teamn Total health assessmentsn Executive medicalsn Fitness assessmentsn Nutrition assessmentsn Free consultations

Q: What are the most common shoulder issues you see?

The most common shoulder condition in adults involves the rotator cuff, a group of four tendons which surround the shoulder joint. The rotator cuff assists in overhead movements and provides strength to the shoulder. It is a very important and dynamic stabilizer.

Age-related issues are the most preva-lent, as degeneration of the rotator cuff makes it predisposed to injury. High-levels of activity, trauma, micro-trauma and even genetic factors, connected to vascularity, can also damage the rotator cuff, as can a hook or bone spur in the shoulder area.

It is estimated that 30 per cent of people over the age of 50 have rotator cuff tears. Damage to the rotator cuff includes bursi-tis, tendonitis, irritation and inflammation, partial-thickness tears (some of the tendon is torn off the bone) and full-thickness tears (the complete tendon is torn off the bone).

Rotator cuff injuries frequently result from workplace activities (they are second only to neck and back issues). Lots of people have repetitive jobs — working on an assembly line, sorting and delivering the mail or paint-ing houses. These jobs lend themselves to reaching, pulling and performing overhead activities all day long and can overwork the rotator cuff.

The next most common condition is an unstable shoulder. The most well-known example of that is the dislocated shoulder, which is the true disjunction of the ball from the socket. You see that typically in slightly younger populations associated with higher activity levels.

Q: How are these issues diagnosed?

We listen to the patient’s history and do a thorough physical examination (it’s a common misnomer that we use MRIs all the time). The patient may complain of pain with reaching, at night, with overhead movement and/or weakness in the joint. We test strength and range of motion. To delineate a partial from a full tear we may

use advanced imaging. X-rays will not help because the rotator cuff involves soft tis-sue; an ultrasound or MRI would be used instead.

An unstable shoulder is also determined through history and a physical exam. An acute dislocation is typically easy to see and can be confirmed by X-ray.

Q: How are these issues treated?

A rotator cuff injury can often be treated without surgery, particularly when there is no full-thickness tear. This could include a home exercise program directed by a physi-cal therapist. Pain medication could be rec-ommended and, in rare cases, an injection

of cortisone. If there is a full-thickness tear, but it is age-related, 70 per cent of patients can be treated successfully in this way also.

If there is an acute tear, the patient is bet-ter off having surgery quickly. The surgery is arthroscopic and involves mechanically re-attaching the tendons to the bone with anchors and screws; the body will then bio-logically heal the tendons to the bone.

For unstable shoulders, many people also see improvement with physical therapy, strengthening the stabilizers of the shoul-der. However, younger people who are involved in high-risk sports, for example, will generally require surgery to repair the glenohumeral ligament and labrum. When the shoulder is dislocated, it will be “re-

duced” (popped back in) in the emergency department. Rarely is surgery required.

Q: How can we best protect our shoul-ders from harm?

The best way to protect our shoulders is by committing to a fitness routine to strengthen the back, the legs, the core and the scapular muscles. A strong body will absorb the pres-sure of day-to-day (or elite) activities and will reduce the strain on your shoulders.

Contributor Dr. Ian Lo is an orthopaedic surgeon who works at the University of Calgary Sport Medicine Centre and at Canadian Surgery Solutions in Calgary.

THE LASTWORD

give rotator cuff tears the cold shoulderCalgary orthopaedic surgeon Ian Lo, pic-

tured at right, discusses common shoulder issues, treatments and ways to avoid injury.

CORPORATE PROFILE – Contents · 2013-08-22 · 2 Contents 4 6 8 10 CORPORATE PROFILES 2 5...

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