5.11.2007

better living through canada

Last year, I blogged about how much happier and calmer I feel since moving to Canada. I mentioned that I also experienced a (coincidental?) drop in my blood pressure.

My blood pressure. I want to tell you more about it. If you hate when people blather about their medical conditions, skip this entry. It's a personal post, to be sure, but as we feminists say, the personal is political, too.

Some medical history. I had elevated cholesterol all of my adult life, which was not responsive to diet or exercise - meaning, it was just me. About 10 years ago, I also developed hypertension, or high blood pressure. This didn't come as a surprise, as both my mother and my sister had been taking medication for high blood pressure for a very long time. They are both thin and very fit, but (as with my cholesterol levels) hypertension seems to be part of their makeup.

As cardiovascular disease runs rampant in one half of my family - multiple heart attacks and strokes - I couldn't very well walk around with untreated high cholesterol and high blood pressure.

I started taking red rice yeast capsules, a natural statin (cholesterol-lowering drug). I saw a dramatic improvement in my cholesterol levels, and have taken it ever since. (I've recently added fish oil capsules to the mix.)

When it seemed clear that the elevated blood pressure readings weren't flukes, I also went on blood pressure medication. It was very effective, with no noticeable side effects.

[As an aside, please note that neither of these conditions figured in to my medical exam for immigration. Most people in the application process worry greatly about the medical exam, and no one believes me when I tell them they cannot be rejected for ordinary conditions such as these. But it's true.]

So when I moved to Canada, I was taking red rice yeast to keep my cholesterol levels in check and prescription high blood pressure meds.

Fast-forward to this time last year: we return from three weeks in Peru. For the past two weeks, we've been in a desert - zero humidity, zero pollen, zero pollution. We come home to Port Credit and everything is in bloom. Plus, the blooms are different here, and there's a lot more of them than there were in New York City. I have a major allergy meltdown.

I try to treat it myself, and it gets much worse. I end up with a horrendous, uncontrollable cough that borders on asthma. Finally I go to the doctor.

I get a bunch of prescriptions, mostly for my lungs, and I switch to the new allergy medication Aerius (desloratadine). I improve.

While I was hacking my lungs up, I was concerned that my blood pressure medication could be contributing to the cough. Coughing can be a side effect of these meds, and when I switched to the generic brand in Canada, I did think it made me cough a bit. So without consulting my doctor, I stop taking the blood pressure meds, figuring I will go back on when my allergies calm down.

On a follow-up visit - which I can do in Canada with no concern for cost - I mention this to my doctor. She checks my blood pressure and says, "It's normal. I wouldn't treat you for high blood pressure with this reading." She suggests we monitor my blood pressure closely to see if I can stay off the meds or if I should go back on.

Because of my family history, at first she asks me to come in twice a week. I can do this in Canada with no concern for cost. That is: I can take simple preventative measures that might prevent a serious, even life-threatening, incident later. I don't lay out any money out-of-pocket, because I already pay for my health care with my taxes. Which, by the way, are the same as what I paid in the US. Got that?

After the twice-weekly blood pressure checks, we drop to weekly, then every-other week, then monthly. Normal, normal, normal. I'm having normal blood pressure readings for the first time in 10 years.

I'm not doing anything differently: same eating habits, same exercise habits. At that time, I probably was getting less exercise, as it took me a long time to get into a new exercise routine after moving to Canada, and I don't walk as much as I did living in NYC.

After normal readings for several months, my doctor declared me good to go. But, as an extra precaution, she doesn't write too many refills for my other medications. This way I have to come in her office at least every three months, and she can then check my blood pressure. I can do this in Canada with no concern for cost.

This year, I've decided to use the absence of blood pressure meds as a motivation to get more exercise. Exercise is the single-best way to keep your blood pressure down. I'm swimming a lot and it feels great.

But because of my family history, not monitoring my blood pressure concerns me. Two weeks ago, I finally acted on a recommendation from both my former doctor in New York and my current doctor in Mississauga. I bought a blood pressure monitor and I'm checking it myself a few times a week.

Normal, normal, normal. Not just in the normal range, but actually normal.

Is it a coincidence that my blood pressure dropped to normal after I left the US? There's evidence that Canadians, on average, live longer and are healthier than Americans. But on a very personal level, as I've said before, I feel markedly happier and calmer living in Canada. I feel more at peace. And there is actually a health benefit - possibly a life-saving or life-extending health benefit - to feeling at peace with oneself.

I wish I could give everyone this gift I've found.

* * * *

My mother used to suffer from debilitating migraines. I have a childhood memory of coming home to a dark house, and having to be very quiet because my mother had a killer headache. She doesn't get the headaches anymore. How did she get rid of them? Divorce!

She left my father. Let me tell you, the man was a headache of brain-tumour proportions.

If you can cure migraines by leaving an insane, abusive spouse, you must be able to cure high blood pressure by leaving the United States. The parallels are too obvious.

34 comments:

West End Bound said...

Glad you're doing better health-wise!

We look forward to moving ourselves:
Moving north of the 49th, and moving our blood pressure readings south!

Good plugs for the Canadian health care system, BTW . . . .

Idealistic Pragmatist said...

Oh, this is the sort of post I love most about your blog. Very cool.

James said...

One important point to remember about the longer life expectancy for Canadians over the US is that a lot of that is due to the remarkably high infant mortality rate in the US, which brings down the average substantially.

The life expectancy figures you usually see are from birth, but they're different for every age. For one thing, if you're already 81 years old, you don't have a life expectancy of 79.3 years! If you've made it to 81, changes are good you'll make it to, say, 89.

I'd be very curious to see the US vs. Canada life expectancy figures for ages 20, 40, 60, and 80.

L-girl said...

Thanks, WEB. :)

Oh, this is the sort of post I love most about your blog.

Really? I wonder why that is. Thank you very much.

L-girl said...

One important point to remember about the longer life expectancy for Canadians over the US is that a lot of that is due to the remarkably high infant mortality rate in the US, which brings down the average substantially.

Ah, I blogged about that recently. Infant mortality is on the rise in the US again, especially among certain populations. Guess which ones.

There might be some good life expectancy links in that post.

M@ said...

Guess which ones.

Well I'm sure they're the ones who benefitted most from Bush's tax cuts, right?

One thing you've mentioned before that surprised me -- in addition to, but in the same vein (ha!) as, the blood pressure thing -- was that dogs seem happier and more peaceful here than in the USA. I think that's probably a good sign too.

I am stunned by the amount of misinformation about the Canadian health care system in the USA. It's as though there's an irrational fear of "big government" there -- a fear that doesn't extend, of course, to government monitoring of its citizens' phone calls and web use.

loneprimate said...

I had an interesting battle in defense of single-payer medicine on a conservative blog site a couple of months back. I had statistics on my side; they had opinions set in concrete on theirs. Still, it makes for some interesting reading to see what proponents of the system are up against in the United States. I think the most disheartening moment came when the host of the site, who despises the medical profession there as having abused pretty much every member of his family, turning right around and insisting that in spite of that, it was still better than anything available in Canada...

http://rhjunior.livejournal.com/355879.html

L-girl said...

Well I'm sure they're the ones who benefitted most from Bush's tax cuts, right?

Heh.

in the same vein (ha!) as, the blood pressure thing

Was that intentional? Because I pun unintentionally - not consciously - all the time. Back to the topic...

was that dogs seem happier and more peaceful here than in the USA. I think that's probably a good sign too.

Fellow political refugees S&A remarked on this - dogs they see in Toronto vs several US cities they lived in, including DC and Boston.

I am stunned by the amount of misinformation about the Canadian health care system in the USA. It's as though there's an irrational fear of "big government" there -- a fear that doesn't extend, of course, to government monitoring of its citizens' phone calls and web use.

It is stunning. Besides the irrational - but misplaced - fear of government, it's also the extreme defensiveness. Nothing anywhere can possibly be better than the USA. We must all pretend everything is perfect, and nothing can be improved. It's bizarre. Canadians have no trouble recognizing the need for improvement, and know that that recognition is not in itself treasonous, nor incompatible with love of one's country.

I had an interesting battle in defense of single-payer medicine on a conservative blog site a couple of months back. I had statistics on my side; they had opinions set in concrete on theirs.

I would love to see that. Maybe that's what you've linked to below. But can my blood pressure handle it?

Still, it makes for some interesting reading to see what proponents of the system are up against in the United States.

What they're up against, more than anything, is the insurance companies. They make a fortune off the current "system," and they protect it by contributing mightily to both Republican and Democratic coffers.

turning right around and insisting that in spite of that, it was still better than anything available in Canada

And what is that "knowledge" based on? Lies and propaganda spread by the people who profit off medicine in the US.

loneprimate said...

And what is that "knowledge" based on? Lies and propaganda spread by the people who profit off medicine in the US.

Well, and in that blogger's case, the ego-cradling notion that nothing in the world can possible meet, much less exceed, standards and conditions in the United States of Jesus.

L-girl said...

the ego-cradling notion that nothing in the world can possible meet, much less exceed, standards and conditions in the United States of Jesus.

Exactly. I feel this is more to blame than fear of government.

The insurance companies and their lobbyists definitely exploit that fear of govt, too. I often think they actually create it.

But more of the resistance to the idea is, I think, down to this bizarre concept of TGNOTFOTE.

lindsey starr said...

Glad your health is better. I am intrigued with the red rice yeast. I hadn't heard of this. I too have high cholesterol (and my parents too), and diet and exercise do nothing. Except..... I gave up meat last spring (so vegetarian- but eat fish and seafood). My cholesterol went from 310 to 201! so vegetarian I stay...

I love hearing about the good health care in Canada too. And also, since I have had cancer, I was worried that when I get around to the medical tests at some point, that it might be an issue. Glad to know it might not be.

Scott M. said...

I remember when I watched John Q a few years ago when it came out.

While I mentally understand that the US health system is vastly different, the visceral reaction I walked away with from that movie was one of pure science fiction. It seemed so farfetched that I was left with a feeling that the setting of the movie was not that of modern day Earth, but rather a parallel "Mad Max" kind of earth.

L-girl said...

It seemed so farfetched that I was left with a feeling that the setting of the movie was not that of modern day Earth

Kind of like the negative image of how we felt when we first used the system here. "How can this be? Yet it is. But it can't be..." We knew it existed in theory, but in reality, it was some sort of happy dream.

I think we both still have a bit of that any time we go to the doctor.

L-girl said...

I am intrigued with the red rice yeast. I hadn't heard of this.

My former dr in NYC suggested I try it. You have to find a very reputable brand, to have some assurance that it is actually red rice yeast in the bottle - as I'm sure you know, that industry is not regulated, and full of fakery. And you should have your liver enzyme levels checked for a while, as if you were on prescription statins, just for safety. (Mine were always normal.)

My results from RRY were: first three months, a reduction from 250 to 220, second three months, a reduction from 220 to 190. First time it was ever sub-220 in my life - including when I was a vegetarian.

[The Canadian cholesterol count was a shock. It's a different scale. Here, high cholesterol is over 5, very high is 7! "What? My cholesterol is 4.3? What does that mean?" I had to get a conversion rate... :) ]

I gave up meat last spring (so vegetarian- but eat fish and seafood). My cholesterol went from 310 to 201! so vegetarian I stay...

Wow, good for you! Mine was never that high (highest ever was 250) and going vegetarian barely made a dent.

And also, since I have had cancer, I was worried that when I get around to the medical tests at some point, that it might be an issue. Glad to know it might not be.

It shouldn't be. They will probably ask for documentation on the status of the cancer - eg, the last report that shows you are cancer-free. But, as I've said many times here, the Supreme Court of Canada ruled that prospective immigrants cannot be excluded on the basis of health, including cancer and HIV status. You may have to jump through an extra hoop, but it shouldn't affect the final outcome.

(And of course my wishes for a fully cancer-free life ahead of you...)

Idealistic Pragmatist said...

Really? I wonder why that is.

Oh, it's the whole "the personal is political" thing. It's a refreshing change from my usual bloggy fare.

M@ said...

Besides the irrational - but misplaced - fear of government, it's also the extreme defensiveness. Nothing anywhere can possibly be better than the USA... It's bizarre.

I realise that this is something I just cannot wrap my head around. I don't expect people to think this way, I can't imagine thinking this way, and I cannot empathise with this point of view. I just don't get it.

You know, I can kind of understand where things like racism and misogyny come from -- I don't agree with people's conclusions, but I can follow their thinking. It makes sense in some twisted way. But the self-satisfaction and xenophobia that appears to explain the point of view of some Americans... I just can't get it.

Was that intentional? Because I pun unintentionally - not consciously - all the time.

Unintentional, but I noticed as I was typing it. I do the same thing. At least I amuse myself. :)

L-girl said...

I/P, thank you, that's very cool.

M@, it's truly bizarre. A strange parallel for me is that my father was like that about our family. If we said that a friend had a nice house, my father would be angry. "You have a perfectly nice house! There's nothing wrong with your house! You have everything you need!"

He was defensive, which I see now came from his own insecurities.

What instills the same syndrome into a huge portion of an entire country?

Re puns, I do the same thing. :)

Mark Campbell said...

I have enjoyed this post and all the comments. My own experience of the difference between Canada and the US has been stunning. Arriving in British Columbia last year I quickly decided to deposit a kidney stone. The Canadian health care system took care of me immediately, politely, respectfully AND with no paperwork. I gave my card to the woman at the front desk, end of conversation. It just blew me away. Then, NOTHING came in the mail. Americans will know that if you have any kind of treatment what always happens afterwards is that you get bombarded with indecipherable junk mail from the doctor, hospital, and most of all, your "insurance" company. Anyway, just another endorsement of this system which levels the playing field for all. "The land of opportunity" is Canada where health care and education are not a function of social class.

One BIG caution, however. The Canadian approach to MENTAL HEALTH, is way out of touch. Feels circa 1975 from a US perspective and ironically for Canada, is completely unregulated. In BC, you can call yourself a counsellor or therapist and open up shop. No license required per se. Scary.

L-girl said...

In BC, you can call yourself a counsellor or therapist and open up shop. No license required per se. Scary.

This is the case in most US states as well. You can't use the certified initials after your name, but you can still practice counseling or therapy.

Does anyone know if this the case in Ontario?

The Canadian approach to MENTAL HEALTH, is way out of touch. Feels circa 1975 from a US perspective

Do you feel the US approach to mental health is enlightened? I have not seen that to be the case. The big HMOs now cover some limited therapy (and meds if you have prescription coverage), but that's pretty recent, and still very limited. Has your experience been different?

James said...

This week's Science Friday on Talk of the Nation covers (among other things) health care reform in the US. An interesting discussion. You can find it here.

Mark Campbell said...

In BC, you can call yourself a counsellor or therapist and open up shop. No license required per se. Scary.

This is the case in most US states as well. You can't use the certified initials after your name, but you can still practice counseling or therapy.

Not really true. In every US state there is a process by which counsellors or counselors :-) are licensed at the master's level while the Ph.D and Psy.D from an APA approved school essentially gets you "Clinical Psychologist" designation. It involves an exam and prescribed set of course work as well as a certain number of practicum hours as well. There is variation but essentially, there is some regulation in every state. In BC, folks seem to be able to call themselves whatever they please, their training is not regulated, there is no exam, etc.

Does anyone know if this the case in Ontario?

The Canadian approach to MENTAL HEALTH, is way out of touch. Feels circa 1975 from a US perspective

Do you feel the US approach to mental health is enlightened? I have not seen that to be the case. The big HMOs now cover some limited therapy (and meds if you have prescription coverage), but that's pretty recent, and still very limited. Has your experience been different?

My goodness no, the U.S. approach is still hugely flawed but, surprisingly, it seems apparent that insured Americans generally have better and more generous mental health coverage than Canadians although it certainly varies according by plan. Having worked in the mental health field in the U.S., I am completely aware of its weaknesses. My experience back here at home in Canada is that the approach is even less "enlightened", the training of therapists less rigourous and the barriers to entry at the doctoral level, significant. For example, Canada does not have one single Psy. D program which is, in my view, the best kind of preparation for clinical psychologists. It is something of a "closed shop" and that does little to serve the public.

L-girl said...

Your comment is a little tough to read, but I think I wasn't clear, or you've misunderstood what I meant.

I know there are quite rigorous standards to become a licensed psychologist, psychiatric social worker, etc. in the US.

However, I believe anyone can call themselves a "therapist" or "counselor" and open a practice. They are not violating any laws as long as they don't put letters after their names that they haven't earned, or claim to be something they are not.

Similarly, anyone can call him- or herself a "doctor". Obviously it is illegal to practice medicine without a license (although the HMOs do it every day!), and you can't put an MD or similar designation after your name if you haven't earned it and been certified as such.

But in New York State, and many other states, I could hang up a sign for "Dr. L-girl", and hand out advice and sell OTC products - and charge fees, of course - and I would be violating no law.

I'm pretty sure about this because I've worked on lawsuits concerning these issues.

L-girl said...

In any case, though, I'm sorry to hear of your observation re Canada and mental health. Sounds like another area Canada has a lot of work to do.

Scott M. said...

I have to concur that the mental health system in Ontario has a lot of growing up to do... simply there's not enough professionals and there's so many cracks in the system that it's more like jumping between islands in the ocean.

Quick rundown:

- "Therapists" and "Counsellors" etc. are unregulated though may volunteer to be a member of a professional group. They are not covered by anything.
- Psychotherapists are regulated and paid for (to some extent) by most PRIVATE health insurance.
- Psychiatrists are paid by OHIP.

You can get an appointment with a therapist or counsellor at a moment's notice... psychotherapists tend to have a 1-2 month waiting list (self referral is OK), psychiatrists (if there are any) have a 6-8 month waiting list and must be referred to by a Doctor.

Many psychiatrists specialize solely in drug therapy and are now just doing "consulting"... ie. they have an appointment, evaluate, and then send a report back to your GP to follow up.

Of course there are exceptions if you are suicidal, etc. If you present at Emergency or another Doctor with clearly suicidal tendancies (definite plans/threats and/or attempts), or intentions/attempts to hurt others, a Doctor is legally obligated to force you to have a psychiatric evaluation. They fill out a form and you are requried to go to Emergency (if you're not there already), by police escort if necessary, and you are admitted for up to 72 hours for evaluation by the on-call psychiatrist. If they think you are a continued threat that can be extended.

It's unfortunate that that's really the only way you can get to see a psychiatrist in short order here. Yep, lots of work to do.

M. Yass said...

But more of the resistance to the idea is, I think, down to this bizarre concept of TGNOTFOTE.

I know what you mean.

The U.S.? TGNOTFOTE? Compared to where, Angola? The U.S. rates at or near the bottom of every important index among industrialized nations. Our health care sucks (unless you win the lottery as you pointed out in another post) and our education system is horrible. Our economy is impotent, riding on a precarious housing bubble that, like all bubbles, must eventually burst.

The U.S. has lots of jobs? I know. I have three of them. Even with that, there's no way in hell I can consider renting a house, much less buying one. Sweden, that awful communist nation of Big Government and high taxes, has 3% unemployment and the highest standard of living in the world, orders of magnitudes higher than that of TGNOTFOTE.

One of the things I like about Canada is that they don't have this TGNOTFOTE complex. The attitude is, "it's nice here, but there's definitely room for improvement." If you point out that there's room for improvement in the U.S., you're labelled an "America hater" or a least a terrorist. 20 years ago, you were labelled a communist.

Not much has changed, eh?

L-girl said...

Scott, thanks for that info. That is really, really sad. Therapy is still something for the relatively well off - i.e., people who have private insurance or can pay out of pocket.

It seems that psychiatrists do increasingly work as consultants, doing an evaluation and writing a prescription. This is fine if it's hand-in-hand with long-term talk therapy. Not so good if it's just write and go.

Family doctors can (and do) write prescriptions for anti-depressants and anti-anxiety meds, but there are potentially serious problems with that. For some people, it works great and that's all they need. For others, it's a disaster.

I'm sorry to learn this about Ontario. It's a real shame.

L-girl said...

One of the things I like about Canada is that they don't have this TGNOTFOTE complex. The attitude is, "it's nice here, but there's definitely room for improvement."

IMO, this is a principal difference between the two cultures. It's manifest in so many ways, large and small, all the time.

Health care is a HUGE example. Most Canadians seem to believe something like: "Our system is very good - there is room for improvement - how can we make it better?"

There is disagreement (of course) on what path to take to strengthen the system, but people aren't afraid to discuss it. They don't act as if criticizing the health care system means you are anti-Canadian.

Scott M. said...

[Canadian residents] don't act as if criticizing the health care system means you are anti-Canadian.

Unless, of course, you suggest that having a multiple-tiered system where people who want to pay can do so. In which case you are labelled "Anti-Canadian".

While I don't agree with people who would like to introduce two-tiered health care, I personally think that it's unfair to attack their loyalty to the country. I think we should stick to attacking their morals and values.

L-girl said...

Unless, of course, you suggest that having a multiple-tiered system where people who want to pay can do so. In which case you are labelled "Anti-Canadian".

Oh yes, good point. I've noticed that. It happened on wmtc a few times, a while back.

While I don't agree with people who would like to introduce two-tiered health care, I personally think that it's unfair to attack their loyalty to the country. I think we should stick to attacking their morals and values.

Heh. Yes, in the health care debate, the worst thing you can be accused of is "Americanizing" the system. Then you are beneath contempt.

Often the accusation is ridiculous, demonstrating how little the person knows about health care in the US.

On the other hand, if the label helps people not vote Tory, it's fine with me.

Thursday said...

"Tory"?

My word - you have been here a while, haven't you?

Don't tell me you know what a whig is...!

(Pardon the ignorance: first time visitor - came here from Jon Swift)

L-girl said...

"Tory"?

My word - you have been here a while, haven't you?


That's what Conservatives are called here. It's a very common nickname.

And welcome to wmtc. :)

M. G. said...

Congratulations on your move! It sounds like you're much happier there. One of the nicer things about free trade is that immigration/emigration is much easier.

When you say, "without regard to cost" when referring to your several visits to the doctor, I was reminded of an American I met at a party. He's in his 60's, and semi-retired. He has houses on both sides of the border.

He was telling me how great the Canadian system is. How once a month, he drives to Thunder Bay to pick up his medications.

I asked him if he did all his shopping in Canada also. "Oh hell no. I ain't paying those damn taxes. I buy all my stuff in Bemidji (Minnesota)."

I have high blood pressure. It came on quickly and sharply. My doctor, in order to keep my cost down, suggested I check my pressure using the pharmacy machines at local grocery stores. It works. They're quick and accurate. I suppose the cost of the machine shows up in my med costs--fractions of a penny. But I can't see using a doctor to take my blood pressure when anyone with training, or a machine, can do it.

L-girl said...

Hi MG, thanks for your comment (and your congratulations).

If you read the post, you'll know that I also bought my own blood-pressure device, too. I've never seen the service available at grocery stores (in either country) but I do now check it myself at home.

But as I said, I had to see my doctor for this, for a while at least, because we were dealing with a change in my medication.

One of the nicer things about free trade is that immigration/ emigration is much easier.

Not sure where you get that idea. It took several years and many thousands of dollars to emigrate to Canada. It is a very long, involved process.

I asked him if he did all his shopping in Canada also. "Oh hell no. I ain't paying those damn taxes. I buy all my stuff in Bemidji (Minnesota)."

He is probably pulling your leg. If he shops in Minnesota, he must declare all his purchases at the border and pay tax on them, or he commits a crime (and risks penalties and fees) every time he shops.

If you're implying that taxes are higher in Canada than the US, that depends what part of Canada one lives in vs what part of the US one lives in. Coming from NY, our taxes were the same. There is sales tax here, but there was sales tax in NY, too.

Perhaps where you live there are no taxes? Not so where I lived.

L-girl said...

And PS: I would gladly and freely pay a lousy 5% sales tax to ensure that every person has access to health care, if that would make the difference. Wouldn't you?