Doctor in Vancouver BC

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Doctor in Vancouver BC

Postby AshliMal » Jul 08, 2009 2:39 pm

Hi
Thinking about TTC in vancouver bc
I've terminated two HG pregnancies ( I blame it on poor medical care, but it was my decision and tottally my fault)
I was hoping to find an OB that was really helpful but All the OB's in vancouver want you to be pregnant before they will see you.
Even when you are pregnant they don't want to see you, not until your really pregnant.
The OB i saw in the hospital wouldn't take an appointment with me once i got out :(
anyways
I was hoping to find an OB to make a "plan of action" so i can know ahead of time what they will prescribe me and what they won't.
thanks
Also do we have Phenagan or Regalan in canada?
Also do they prescribe steriods in canada?
thanks so much
~ Ashli
2 HG pregnancys
10 wks 0 d
7 wks 3 d
AshliMal
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Postby Lianna » Jul 08, 2009 5:35 pm

Are you in downtown Vancouver or are you in the suburbs? I live in Abbotsford and I received some amazing care through the Antepartum at Home Care Program through Surrey Memorial Hospital. The ladies there are phenonmenal and they will do at home care for Abbotsford - Vancouver. I would really encourage you to contact them.
Mackenna Oct. 02 normal nvp 6 wks - 16 wks
Kaidan Jan. 06 severe nvp 3 wks - birth
Kennedy Dec. 07 mod hg 4 wks - birth
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Postby AshliMal » Jul 08, 2009 7:45 pm

Thanks I'm in coquitlam
I was wondering if you knew if they would talk to me before i got pregnant 'cause i would love to get as much info together before we made the decision to get pregnant!
thanks so much
~ Ashli
2 HG pregnancys
10 wks 0 d
7 wks 3 d
AshliMal
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Postby Lianna » Jul 08, 2009 7:50 pm

I don't know if they would talk to you pre conception but I think it is worth a try. Also have you contacted Motherrisk? They are another great resource. They will definately talk to you pre conception. Do you have a gp? You should be able to make an appointment with them also. You would need a referally to an OB anyways. You can take the info from Motherrisk and the AHP at SMH with to your GP to set up a protocol.
Mackenna Oct. 02 normal nvp 6 wks - 16 wks
Kaidan Jan. 06 severe nvp 3 wks - birth
Kennedy Dec. 07 mod hg 4 wks - birth
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Postby Corrine » Jul 08, 2009 7:52 pm

Joanna had a good OB in Coquitlam. Perhaps she can chime in here with his name. And yes, Reglan is available in Canada (Maxeran).
Neil -9, Ian -5, ^Linnea^ (Oct 22-Dec 17, 2008 HLHS), Rainne - 1 and expecting #5 Jan 2012

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Postby AshliMal » Jul 08, 2009 10:20 pm

Thanks so much
My GP thinks HG is in our heads and didn't want me to take gravol.
I tried finding a new GP but it is impossible here.
I didn't know that maxaran and regalan are the same thing
They tried Maxaran on me and it made me insane and gave me akathsia (restless motor skills) it was so awful! I'm guessing phenagran is stemitil
allergic to that too! I think i'll call motherrisk see what they have to say.
My hope is to find a OB that will prescribe steroids because that's the only thing i haven't tried yet. My last OB was really good but said that he wouldn't prescribe me steroids I'm not sure i'll try again without an OB saying they will prescribe steriods if i request it
any thoughts would be welcomed
thanks
I'll give motherrisk a call
~ Ashli
2 HG pregnancys
10 wks 0 d
7 wks 3 d
AshliMal
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Posts: 26
Joined: Jul 06, 2009 3:13 pm
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Postby Lianna » Jul 09, 2009 5:47 am

Phenegran and Stemitil are 2 different drugs. I know finding ANY GP to take you on is hard let alone one treat that is familiar and knows how to HG. What treatment did you recieve in your previous pregnancies? Maybe we can help you brainstorm some idea's. Maybe the doses could have been different or different combos. As well as suffecient hydration. I know the ladies at SMH are incredible. They even had their own pharmacist who was very familiar with HG drugs and he tweaked my combo with the times that I was taking them and even that made a difference. I really hope you can get on with a decent GP. Contact motherrisk and contact the ladies at SMH maybe they can help get on an appointment with a GP or straight to an OB :hugs:
Mackenna Oct. 02 normal nvp 6 wks - 16 wks
Kaidan Jan. 06 severe nvp 3 wks - birth
Kennedy Dec. 07 mod hg 4 wks - birth
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Postby bibliojo » Jul 09, 2009 2:46 pm

Hi Ashli, I saw Dr Mark Rosengarten in Vancouver (his office is in the City Square Mall) I saw him before I got pregnant to discuss treatment options - at that time Ondansetron (zofran) being used for HG was fairly new in Canada and he hadn't heard about it but he took the time to research it and then phoned me back to say he would be willing to prescribe it. So I was impressed that he took the time to look into it and was willing to be proactive in treating the HG. When I got pregnant I wasn't able to get an appointment with him until 9 weeks but he later told me I should have just asked the receptionist to speak with him directly and he would have gotten me in ASAP.

The key to treating HG for many women is a combination of medications. So medications that don't work on their own might still work in combination with other medications. My first pregnancy I was on Gravol, Zantac and Maxeran. Didn't do a lot for me. Second pregnancy I was on Zofran, gravol, diclectin and Zantac and that was a better pregnancy. Can you give us a run down of what you took when, what the doses were, how long you were hospitalized for, how often did you have fluids etc? You said in another thread of yours that you took Zofran but it's effectiveness only lasted a week - was that zofran on it's own? When you were in the hospital did they give you the meds via IV? Was that more effective for you? I'm wondering if you should maybe be pursuing a PICC line or something like that because meds via IV are more effective than when taken orally. I think many doctors in Canada are reluctant to give steriods - especially before 10 weeks because of the risk of cleft palate. But I do think Dr Rosengarten is one doctor who would consider steriods if I remember correctly. The downside is that because he is such a popular doctor it does take a few months to get in to see him initially.

Hope this helps...I'll continue to brainstorm to see what other options I can come up with for you...
2 HG pregnancies
Lukas - February 2003
Katya - October 2006

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Postby AshliMal » Jul 09, 2009 3:14 pm

Thanks so much everybody!!
I was on the Maximum dose of Zofran i took it orally and IV. (IV first (worked amazing for a week, I was fluffy) then orally (because i was feeling so great) then when oral stopped working back on IV but it wouldn't work again ) the OB i saw in the hospital said sometimes it can wear off It still stopped most of the vomit but none of the nausea. At the same time i was on Gravol (max dose) and diclectin (6 a day, 2 morning, 2 mid day and 2 at night)
I can't take Maxaran or stemitil which is another complication! I am terribly allergic
I did have to take ranitadine (zantac).
They tried putting the doses in the IV fluids so that i could have a constant supply but that was awful.
I had 2 to 3 bags of fluid a day in the hospital with potassium in them which burnt through my veins but stupied me i refused a picc line ( i was to scared, still am) I did feel better when i was fully hydrated but still so so sick. It's the nausea i can't deal with (the never ending nausea)
i feel like the only thing i didn't try was steriods
I think if i could find a doctor who said deal with it until 10 weeks then we'll give you some relief (steroids) i could tuff it out till 10 weeks but when your sitting at 8 weeks (sick for a month already) 8 more months of living like that is daunting to say the least :(
Oh yeah: the one thing that helped but would probably wear off after a while too was ativan but the doctor wouldn't write a script for it! Just for use during hospital "freakouts"
I also tried Marijuana it worked a bit i got some food down but couldn't smoke it without barfing, which would just start another bout of vomit for a few days, also i just felt so horrible about doing it i would sit in the bathroom and cry .
~ Ashli
2 HG pregnancys
10 wks 0 d
7 wks 3 d
AshliMal
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Joined: Jul 06, 2009 3:13 pm
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Postby bibliojo » Jul 09, 2009 3:33 pm

So 24 or 32 mgs a day of Zofran? Zofran is good for stopping the vomiting (the primary intent of the drug) but it doesn't help with the nausea as much as one would like. How long did you try with the Zofran the second time via IV? I'm wondering if maybe you weren't hydrated enough and so it wasn't as effective? Gravol - was that 4 50 mg pills a day or 8 50 mg pills a day? Diclectin can go up to 12 pills a day but with either of these medications they are side drugs than the main drugs if you know what I mean. How much ranitidine were you on? You can take 150mg twice a day. In my opinion that you can't take Maxeran shouldn't make that much of a difference - what Maxeran does is that it speeds the contents of your stomach through the intestines but if you have nothing in your stomach to begin with what real help is that. As for ativan, Dr Rosengarten prescribed that for me later in my pregnancy. I think you should try and get a referral to see him and at least discuss your previous pregnancies with him and see what he has to say about other possible treatment plans.
2 HG pregnancies
Lukas - February 2003
Katya - October 2006

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Postby AshliMal » Jul 09, 2009 4:08 pm

Thanks for the reply JOanna, lianna and corrine
Doctor said to take 24mg of zofran but i saw on the forum that you girls were taking 32mg so i took 32.(a day)
I was pretty well hydrated i don't think that would be the problem but i was severly constipated (i didn't "go" for almost 2 weeks)
Doctor said to take 6 doses (every 4 hours) of 25mg of gravol but i took 6 doses of 50mg
and i don't remember how much ranitadine but i didn't have any heart burn type problems. It wasn't very much though. my GP told me it causes birth defects :{?
IT's good to know maxeran wouldn't do much i always wondered if i could take it if it would help. but no there was nothing in my stomach.
I wonder if i could somehow get the constipation under control if it would help alot. because in my first pregnancy The zofran worked great for a week but then stopped i wonder if it's because i got so "backed up"
~ Ashli
2 HG pregnancys
10 wks 0 d
7 wks 3 d
AshliMal
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Posts: 26
Joined: Jul 06, 2009 3:13 pm
Location: Vancouver, bc

Postby opal » Aug 20, 2009 6:58 pm

My angel of a Doctor was Valerie Rychel (with a soft ch sound).
I lucked out and was assigned to her when I was hospitalized at St.Pauls hospital.
She. Was. Amazing.

She tried everything in her power to help me and took my case very seriously. She's a fan of TPN. She did a bunch of research for me on her own time and suggested steroids (which didn't work at all for me)
She's the reason my son exists.

Same problem as Rosengarten though. A very good OB is a very busy OB. I doubt you'd be able to see her before you're pregnant. But send a letter to her office addressed to her and make a special request. You never know! It never hurts to ask!
HG survivor
~7 month hospitalization on TPN. First born healthy Feb 7 2001
~Severe HG second pregnancy, made it to 10 weeks.
~Third pregnancy was hit with HG. Less severe than in the past due to aggressive pre-emptive treatment and a good support system!
Yelqotkwe Ella Opal July 22nd 2010
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Postby brewergogo » Aug 20, 2009 11:27 pm

First of all...I'm so glad I live in the states...I couldn't imagine having to wait for a doctor with this condition looming on the horizon! You ladies are heroes to me for having to jump through all the hoops of your health care system. Obama and his stupid health care reform...anyway!!!!

In any case, this is my 3rd HG pregnancy so I knew to go into it pleading early intervention. My doctor delivered!!!! Although still difficult and was in bed for over 8 weeks, I ate, could talk to my kids and bathe occasionally. He called it his "HG Cocktail" and I couldn't have made it through without it. I never became dehydrated, no trips to the ER/hospital, went weeks without vomiting and was rarely nauseated. My only problem was the inital weight loss (at 7 wks I had already lost 10 lbs in 13 days , spit nonstop into a bucket, & peed as i vomited several times a day) and that I didn't drink for 9 weeks. I'm 18 weeks and just hit my pre-pregnancy weight today.

Anyway, here's how I was treated and I felt like it was just a miracle:

PICC line (not bad at all...nothing to worry about, doesn't hurt at all :) )
Home Health Care (to change dressings)
4L of fluids/day (1 D5LR & 1LR in the am & second set in the pm)
1st bag of D5LR contains antacid (pepcid), vitamins & folic acid
Zofran ODT (not regular zofran, or any generics...8mg 2-3doses/day)
Scapolomine Patch (takes away the nausea the zofran doesn't help)

With this treatment I was constantly hydrated, maintained balanced sugar & electrolyte levels, didn't throw up bile and blood in the event I did have to puke, actually got vitamins and folic acid to the baby, got the vomiting to stop for days at a time and with the patch felt little to no nausea daily. I stayed in my bed though because I just did not feel well enough to do anything, but he took care of the terrible, terrible nonstop HG symptoms.

It wasn't all roses...don't get me wrong, but compared to my other pregnancies...this was bearable. I considered termination, too, with the others...this time it never crossed my mind because I never got to the level of feeling like I was going to die (except at my first 7 wks visit :wink: ). I know I'm going on and on...but I just hope you'll get what you need.
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Postby Corrine » Aug 21, 2009 2:53 pm

The issue in Canada is not really our universal health care. It is just that Canadian doctors are pretty conservative regarding treatment. You can definately get in to see someone early on in the pregnancy if you ask. What scares me is ladies on these forums who are in the US and either don't get treatment because they don't have insurance OR they have to argue with their insurance companies to get coverage for necessary items. Although some of our wait times up in Canada are atrocious (knee MRI's and some elective surgeries), most emergent cases are treated in an appropriate time frame.
Neil -9, Ian -5, ^Linnea^ (Oct 22-Dec 17, 2008 HLHS), Rainne - 1 and expecting #5 Jan 2012

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Thank you so much !

Postby AshliMal » Aug 23, 2009 10:41 pm

Thank you so much for all your help
I thought we had decided that we would adopt however after reading about steriod use!! and your helpful stories We are going to try one more time maybe third time will be the charm!!
I am going to try and get a hold of both dr.rosengarten and dr.rychel and i'll keep you all updated on what happens Maybe i'll need to get pregnant first then they'll see me but i've decided i'll push until I find a dr that will prescribe steroids
thank you all so much i'll keep you updated!
~ Ashli
2 HG pregnancys
10 wks 0 d
7 wks 3 d
AshliMal
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Joined: Jul 06, 2009 3:13 pm
Location: Vancouver, bc

Postby bibliojo » Aug 24, 2009 2:10 pm

I'd agree with Corrine...our struggles are because of the more conservative nature of our doctors. You can get in to see a doctor pretty much right away but if you want a good doctor that is maybe a bit more progressive on the HG front you may have to wait a bit. But in my opinion it's worth the wait. If things get bad you can always go to the hospital and they will treat you there right away and without a humugous hospital bill. That's what scares me about the US health system is the cost - especially for those with no health insurance. People have been bankrupted for life with the huge debts accured by seeking medical care.

Ashli, Dr Rosengarten saw me before I got pregnant to discuss a protocol so I don't think it's a problem to see him before you get pregnant.
2 HG pregnancies
Lukas - February 2003
Katya - October 2006

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Postby opal » Aug 25, 2009 4:59 pm

brewergogo wrote:First of all...I'm so glad I live in the states...I couldn't imagine having to wait for a doctor with this condition looming on the horizon! You ladies are heroes to me for having to jump through all the hoops of your health care system. Obama and his stupid health care reform...anyway!!!!




Oh there aren't any hoops whatsoever. This Doctor in particular is a high-risk specialist and has a huge wait list. You also need a referral from a GP to see her in the first place.

I have had nothing but a positive experience with our health care in Canada.
I had a 7 month hospital stay with every single medication and expensive treatment available to me offered and used to keep me alive. I never ONCE had to discuss my stay with an insurance company or have to worry that my treatment wouldn't be covered. My medical treatment was unlimited.
Oh, and did I mention that I had no income and was 18 years old? The poorer you are, the cheaper it is and no matter your socio-economic status you recieve the exact same medical care. My Doctor is the Doctor to the Doctors. If I were in the U.S with my circumstances, I wouldn't have received the stellar medical treatment I did.
I am so blessed to be a Canadian.
HG survivor
~7 month hospitalization on TPN. First born healthy Feb 7 2001
~Severe HG second pregnancy, made it to 10 weeks.
~Third pregnancy was hit with HG. Less severe than in the past due to aggressive pre-emptive treatment and a good support system!
Yelqotkwe Ella Opal July 22nd 2010
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opal
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Dr.Rosengarten

Postby AshliMal » Aug 27, 2009 12:12 am

So I phoned dr.rosengarten's office they receptionist was really nice! But I was told that Bc womens wouldn't accept me because they are really strict on what is high risk and what isn't (i guess I'm not) so apparently I cannot see him, but she did say that if I wanted she could give me the name of some doctors at St.Pauls although she doesn't think they will see me both because HG isn't seen as being "high risk" and becuase I live in coquitlam! Great! My GP says OB's won't see me until I'm pregnant and says that there is nothing more they can do aside from the diclectin and zofran he also told me gravol isn't good (so clearly he knows what he's talking about :? Not) I phone the Port Moody Maturnity clinic they can't help until i'm pregnant and even then I would need a doctors note (which my GP said he would give me) but it seems that until I'm pregnant no one will see me :evil:
I also contacted Dr.Valerie Rychel office and the front desk is useless they said that she only see's pregnant women and not until i'm pregnant!!!
If anyone has any ideas I would love to hear them.
I would just love to find a doctor before because it's so much harder to navigate and advocate for myself when I feel so sick! (DH is so helpful but not at all forceful and sometimes it''s neccessary i.e. when trying to get an emerg appointment with the doctor and things like that)
any ways
any input at all would be so welcomed!!!
~ Ashli
2 HG pregnancys
10 wks 0 d
7 wks 3 d
AshliMal
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Posts: 26
Joined: Jul 06, 2009 3:13 pm
Location: Vancouver, bc

Postby opal » Aug 27, 2009 12:27 am

Hi Ashli

Sorry to hear that you're running into problems with seeing an OB.
My suggestion would be to write personal letters to the Doctors themselves briefly explaining why you'd like to see them before you get sick. Especially Dr.Rychel.
Receptionists are trained to say certain things. They're not allowed to break protocol, but the Doctors can, and they're the boss!
You have nothing to lose in asking them personally.

I've had an appointment with an OBGYN without being pregnant to discuss protocol and TTC. Not in Vancouver tho, but in Kamloops. I needed a referrel, but I did get in to see him to discuss my options and see if he'd be on board with treating me.

Sometimes it just takes some good old fashioned snail mail!
HG survivor
~7 month hospitalization on TPN. First born healthy Feb 7 2001
~Severe HG second pregnancy, made it to 10 weeks.
~Third pregnancy was hit with HG. Less severe than in the past due to aggressive pre-emptive treatment and a good support system!
Yelqotkwe Ella Opal July 22nd 2010
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opal
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Location: Chase, BC Canada

Postby bibliojo » Aug 27, 2009 4:28 pm

I forgot about BC Women's policy about only Vancouver women giving birth there or high risk pregnancies. I sneaked in with my second because I had already had a baby at BC Women's. How very frustrating nobody will see you! I wish I knew of someone in the Coquitlam area that could help. The only suggestion that I have is Dr Buie - I believe her office is by Lougheed Mall. One of my friends that had HG with her third pregnancy that was her dr. I don't think she had outstanding care from her but she was somewhat knowledgable about HG. I'll keep thinking of possible ins for you...

Have you talked to Motherisk yet? They may be able to suggest a doc?
2 HG pregnancies
Lukas - February 2003
Katya - October 2006

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