Still awaiting the outcome

I will place a letter I have put out giving a little more background to Chris and his situation. Hopefully making everyone a little more informed. I would love to see people actively voice their concerns and astonishment not just with Chris but with every person in this province that is going through the same scenario as we are.

Have a read and let me know how you feel better yet let the Province and the Country now how you feel.

In the next few days I will be attempting to link twitter and facebook to the blog so as to spread the word far and wide. I have spent the last several days here at home trying to get word on Chris' extension with no success yet! It is looking good that we will be doing a piece on the CBC TV to bring to everyone’s attention the injustices that we face every day. Will keep you informed as it unfolds.

Here is the Letter:
It is a long one, followed by excerpts from Dr's and therapist's in support of Chris Staying in Pononka and continue the therapy that has been so great.

Dr. Christopher Bigelow touched so many people I had no idea just how many until all the cards and calls came after the accident, from all over the world where he practised or was a part of.

The government has made it hard in so many ways. Starting with all the red tape just so Chris could leave to get his medical education, again something they have no plan in place for in the training of doctors, at least none of any value in relation to the need. It continued the whole time he went through his studies abroad something he was forced to do if he wanted to pursue his medical education. The Provincial education system even refused to give him a student loan because the health ministry asked them to not fund any students who left Canada for their training, unbelievable. Chris did not let the obstacles get him down he fought through them never taking breaks from Medical school he worked semester after semester to get to his goal, as well as volunteering in the places he studied thinking he could make a difference.

As it would turn out all the places Chris had to travel to for training and practise would have him see and learn things never possible here at home. I remember him saying that many times that it was one of the hardest things to do, yet he would do it all over again given the chance, the people Chris came in contact with made his attitude and sense of reality very grounded and sound. It produced and even more caring person than Chris already was.

Christopher completed his Bachelor of Science degree at the University of British Columbia, and then went on with his academic studies in the Caribbean, at the American University of the Caribbean in St.Martin. BWI. While completing his medical degree he also received his Master’s of Science degree then went on to Ireland for a year to complete his medical rotations, finishing them off in Bakersfield, CA, and Vancouver BC.

Christopher then interviewed with Cottage hospital in Santa Barbara, CA. and ultimately spent three years as medical resident and Chief Resident there. Then with his need to come home and practice the government again threw obstacles in front of him which he was dealing with when this accident happened.

I am writing to expose and ultimately get us some help for my son, Dr. Christopher Bigelow, who was in a bad car accident November 3, 2007. He suffered a traumatic brain injury. He was rushed to Royal Columbian Hospital, where he spent 4 months then transferred to Surrey Memorial Hospital, where he spent 12 months. Throughout this time more so at Surrey Memorial he received very little if any physical therapy (which is key ingredient for recovery) and we were told there was nothing that could be done for him in BC by the Fraser health region.

The lack of staff and resources was the reason we were given for such little therapy. While I questioned the ability of the Physiatrist and his knowledge in treating injuries of this nature, I never received anything more than, “you should place Chris in an extended care home and walk away”, basically writing Chris off, meanwhile an excellent physical therapist who worked in the same hospital as the Physiatrist, was spending some of her own time in getting Chris to work and making some progress. Again, due to lack of funding in our medical system, Chris was not getting the quantity or quality needed. So I looked at other options for further help. But no such facilities that house therapists all together under one roof for injuries of this magnitude exist in BC. I took my son out to, Hyperbaric chamber 3 – 5 times a week this was an all day event, acupuncture until we were told only 10 sessions at reduced cost were allowed under our health plan, some of the first changes happened in the hyperbaric chamber and with acupuncture. We also tried to get into see a neuro-trained physio therapist, but found that only a few exist in the lower mainland and waiting lists are long and are not covered completely by our health plan.

I then found a place with two amazing people at an aqua-therapy in Aldergrove. Even though it was an all day trip I made sure that Chris got driven there 3 times a week and when they were short staffed I would jump in the pool and help out. My family and I were doing daily stretching with Chris to keep him limber. More things were happening all the time after the pool sessions took off. We were witness to amazing rehab and people given access to this therapy that is totally underrated. Also found that allot of these people could not be made aware of other treatments that may help by the people running this center or they risk losing their right to bill and have more clients from these sources.

I will not name so no retribution will be possible, the only reason for this suppression of knowledge would be it was going to cost the companies that were paying, even more, if the injured people find out what is out there for more help.

Then, after being turned away from all treatment possibilities in BC, we heard about Halvar Jonson centre for brain injury in Ponoka, Alberta.

After several discussions I had with the doctors in Ponoka explaining the only therapy tried, was one I had talked to doctors in California about, this was a drug trial. The Physiatrist in Surrey wanted nothing to do with it so I talked to the Neurologist about it, the Neurologist thought it had merit and put together the trial while Chris was still in the hospital in Surrey. This drug had no affect at the time, but the doctors in Ponoka knew of several drug therapies that are common place in brain injuries and still could not believe that none had been tried. They agreed to accept Chris, on a trial basis to try all of the standard things that should have been tried in our home Province but never were, frankly they were quite amazed to see nothing had been administered or tried according to basic rehab philosophy. He has been in Ponoka, AB since March 10, 2009. He was accepted and funded by our BC health for 3 months ending in June 2009.

Then I reviewed the test and results noticed that things were not as they seemed and in conjunction with the Doctor and therapists wanted to do some more trials with drugs Chris resulting in another extension due to administration of these drugs.

During this time I had researched out exercise equipment for Chris to aid in his circulation and respiratory system to avoid the pitfalls that all brain injuries encounter. To his surprise Chris started pedaling the bike on his own and again filled the center with disbelief. This then vaulted all in the rehab team to look and go further. This whole process has been filled with doubt and disbelief all of the endless pushing and fighting continues to move forward. I was able to get the letters and support of the wonderful neurologist at Surrey and was able to get an additional extension based on the things that were starting to happen in Chris and his awareness.

From the moment I started working with Chris and the new Physio therapist in Ponoka things started to open up fast and furiously which spread to other disciplines and their encouragement, wanting to work to make a change.

Now, here we are in December and the Halvar Jonson Center has suggested another extension as BC cannot accommodate Chris’ needs; physical therapy 5 ½ hours split into 7 sessions. Recreation/ aqua therapy 2 hours allotted, 4-5 hours given each week. Occupational therapy 2 hours split into 4 times a week. Nursing also is providing stretching and ranging of his joints, minimum of twice a day as well as the freedom to try of new and current drugs/medications. Our BC health system has denied his extension which means Chris will have to come home mid January and sit in a bed in extended care with no rehab once home. That is because some government employee decides it is time to end it, “just because”.

Again I have been trying through government offices and the legal system to get funds to help out with altering a house that Chris can live at home in and continue therapy the way it is supposed to be done.

But as long as no help or funds are released from the insurance or Health ministry, they’ll put him up in an extended care home take away all rehab funds then he will get to watch television all day and rot away a unbelievable human spirit which will become another statistic because that’s what governments are good at keeping numbers but not helping.

I have been looking for a suitable house for over ten months now and the plan is to bring Chris back and have him live at home close to family and friends. The house will have to be adapted for wheelchair accessible and other necessities for Chris. Then we need nursing staff/aids and therapists. All of the programs just drag their feet hoping the requests will stop most of the time you are told such programs do not exist, until you come across someone who is willing to share that they have a program that is funded or provided by a particular agency.

If our province continued their support for Chris in Ponoka, because there is no place in BC that provides this treatment and the government has acknowledged this, then Chris’ recovery and progress will have a chance to continue daily. This will also give us time to get all the things in order here at home so he could come home and step into a rehab program designed by the therapists in Alberta and myself. He will then be close to friends and family. Currently, I am commuting weekly back and forth to Edmonton to be with Chris and provide the things that are not done or covered by health care. Just as things start to come together and progress is being made the government is deciding to pull support away even though they cannot provide it in our own Province. The cost is basically the same whether Chris is in Alberta or in Surrey a difference of $28.00 a day which we offered to pay, somehow.

The Halvar Jonson center in Ponoka, Alberta provides access to all the therapies and doctors as well as 24 hour care all brought together under one roof, or he could be in a hospital bed in Surrey with no therapy and no plan or future.

All of the senior doctors Chris worked with whether in the Caribbean, Ireland, Vancouver, Bakersfield, Los Angeles or Santa Barbara will attest to his unrelenting passion in the pursuit of medicine. The praise was endless and any one of them would tell of his unique qualities in dealing with people. Chris is a person with a caring loving attitude towards all and his endless pursuit of knowledge always wanting to be on the cutting edge of new research.

For the last two years since his accident, he has become a victim of the very system that he wanted to come back and help by being a part of, even with all the crap put in front of him.

It is very frustrating I would love to tell his story but from the beginning not just the accident, people would then realize just how awful the system treats our own. Then turns around and tells the public about all it's doing to make things better.

All I want is to give Chris the best rehab possible and give him every chance to pull through this he deserves that much considering he survived through 6% that live after an injury like this and survived the 3% that survive after the first year of that 6%. He is a fighter and if given the chance will make every effort to succeed. In a nut shell that is what I want to get out, let people know what is really going to happen if you are injured and need help. Imagine those who do not have anyone there to fight every step of the way? They end up in extended care home in front of a TV set because it is the cheapest for the Government to do.

We the family and friends of Dr. Christopher Bigelow would appreciate and be eternally grateful for whatever help or assistance you could provide.

Kevin Bigelow,

Christopher’s Father



Excerpts from Dr. R


HALVAR JONSON CENTRE FOR BRAIN INJURY                                
November 3, 2009                                       

British Columbia Ministry of Health Planning

Ministry of Health Services

Regional Commitment Payments and Support

Out of Province Claims ‘

Victoria, BC


Attention: Lolanda Emerson

As of August Dr. Bigelow was finally on an adequate dose of the last possible medication to be tried, namely lamotrigine. This intervention also stopped his frequent epileptic seizures and since then he has very slowly, but definitely, started to follow simple and repeated verbal commands in specially designed sessions usually in cooperation between physiotherapy and occupational therapy.

Within the next two months (i.e., by the end of October 2009), he achieved the ability to use his left upper extremity (LUE) to identify playing cards, their suits, and numbers, and he demonstrated that he could do simple math such as addition or subtraction He will also answer yes or no to simple questions.

As of this date, Dr. Bigelow is receiving the attention of OT (occupational therapy) for 2 hours/week broken into four sessions, PT (physical therapy) for 51/2 hours/week in seven sessions, RT (recreation therapy) for 2 hours/week for two swimming pool sessions plus 3 extra hours of swimming with his father (who also participates in swimming sessions with RT), adult Education Centre for 2 hours/week, and several hours a day of heavy nursing care. This rehabilitation nursing also includes regular ranging of his joints and stretching muscles minimally twice a day.

As a result of the above described attention in the last month, Dr. Bigelow has also increased his responsiveness to nursing staff who now also report witnessing his attempts of communication with them using yes/no responses with his left hand thumb pointing up for “yes” and closing the left ,and fist for “no”.

Based on this outcome, all the staff involved in Dr. Bigelow’s care are now advocating that their interactions continue with the hope that it will maintain his current physiologic and motor status as well as to hopefully further potentiate his ongoing improvements in his ability to interact with his environment.

In summary, I can report that the effort of the past 8 months resulted in changes in Dr. Bigelow’s ability to meaningfully interact with his environment. While this may lead to some improvement in the quality of his life. I recommend that OT, PT, S-LP and RT should be involved in designing and follow-up of such maintenance programs that are based on the level of function that has been achieved at HJCBI. Hopefully this should be available in his home province of British Columbia once he relocates to his permanent residence there. It is my opinion that this level of care and ongoing stimulation does not necessarily require the expertise of HJCBI. However, as HJCBI presently is not experiencing pressure for its available resources, and should the BC Ministry of Health continue to approve financing for Dr. Bigelow’s out of province treatment, then Mr. Bigelow is welcome to continue to receive the attention of this facility and its staff.

Regardless of any possible extension in his stay at HJCBI, he will be returning to BC to a permanent residential setting.

Physician

Halvar Jonson Centre for Brain injury



Alberta. Health Services

To:

British Columbia

Ministry of Health Planning

Ministry of Health Services, Regional

Commitment Payments and Support

Out of Province Claims

Christopher Bigelow is presently in the Halvar Jonson Centre for Brain Injury at The Centennial Centre for Mental Health and Brain Injury, Ponoka, Alberta. It is the opinion of the physician and treatment team members that Christopher:

• Continues to benefit from ongoing rehabilitation and a discharge date has not been set.

Physician


Halvar Jonson Centre for Brain injury



Excerpts from Dr. D November 27, 2009


Re: Bigelow Chris

To Whom it May Concern,

I have reviewed the progress notes and letters supplied to me by Dr. Rosenkranz of the Ponoka facility currently housing Dr. Bigelow: I have not examined this patient since the time he left British Columbia.

However, I have a great deal of confidence in Dr. Rosenkranz’s observations, and feel that based on those observations, he is drawing the correct implications for Dr. Bigelow’s prognosis and treatment plan.

I would agree with Dr. Rosenkranz’s recommendations - if there is no similar facility in British Columbia and no imminent need to utilize the Ponoka facility for a higher-needs patient, Dr. Bigelow would be most appropriately maintained at the Ponoka facility.

Dr. D Bsc, MD, CSCN, FRCPC

Neurology, Surrey Memorial Hospital

Clinical Assistant Professor, Neurology

University of British Columbia





November 27, 2009

Ms. Lee Cave

Ministry of health services

Out of Province Claims

2-1, 1515 Blanchard Street, Victoria, B.C. V8W 3C8

Tel 1-250-952-1940

Fax: 1-250-952-1334

Re: Dr. Bigelow, Chris.

Dear Ms. Cave:

As you are aware, Dr. Bigelow sustained a traumatic brain injury in a motor vehicle accident on November 3, 2007. At this time Dr. Bigelow is in Halvar Jonson Center for brain injury in Ponoka. I am writing this letter to support Dr. Bigleow’s extended stay in Ponoka, Alberta.

He is receiving aggressive rehabilitation for his traumatic brain injury and, according to his treating physiatrist, has made moderate gains in his functional status. Based on these gains, which have translated into functional improvement by all accounts, I would fully recommend an extended stay at the Halvar Jonson Center.

Sincerley,

Dr. D Bsc, MD, CSCN, FRCPC



Excerpts from Physio

Progress Report Novernber 10, 2009

Attendance and Participation:

Dr. Bigelow is scheduled for five – six 60-minute active PT sessions per week in addition to a morning stretching program 5 times per week.

Tracking from October 15, 2009 November 10. 2009 revealed he was alert and participated in 16/19 (84%) of his active treatment sessions.

Dr. Bigelow’s father attends PT regularly and receives information at that time. He is an active participant in his sessions.

Motor Control:

Left Upper Extremity:

Mr. Bigelow demonstrates his greatest control and active movement in this extremity. At present all movements lack the strength. Timing and target accuracy to be used in functional activities. Mr. Bigelow does demonstrate active movement at all joints in the left upper extremity. Controlling. The active movement in this arm continues to be challenging for Mr. Bigelow. Presently, with his hand supported on a table and his elbow positioned and stabilised ahead of his shoulder. He can slide his arm towards a, target placed on the table in the directions of shoulder flexion, extension, internal and external rotation. All movements are completed in short 1-2cm movements and lack target accuracy.

When supported in sitting at a table, Mr. Bigelow has been successful in using. Shoulder internal and external rotation to respond to yes/no questions using his left hand to touch an X or check mark.

Left Lower Extremity: Mr. Bigelow demonstrates the ability to activate most muscle Groups around the hip and knee. Coordination and recruitment accuracy remain poor and strength presently is <2-/5. He is noted to actively recruit his hip extensors in supported sitting as a balance strategy.

Assessment and Treatment Recommendations:

Over the past month Mr. Bigelow has been alert and participated well in 84% of his PT sessions. He continues to demonstrate an increased ability to actively control the movements of his left arm and hand and is working towards accessing simple switches with OT and Speech Language Pathology. Vhen positioned on the tilt table or in . iupported sitting he continues to be able to utilise his left arm in communication through thesetection ofYes/No. OT continues to explore modifications to his headrest in hopes I hat he will be able to utilise his arm and hand more effectively in his wheelchair

At this time Mr. Bigelow is continuing to benefit from a multidisciplinary approach to his rehabilitation. PT. OT and Speech Language Pathology are presently exploring different seating options (head. Rest and lap tray) to aid Mr. Bigelow in sitting upright in his wheelchair. Also with his increased ability to consistently produce active movement in his left arm and hand accessing simple environmental controls (switches) may soon be .n option for Mr. Bigelow.

Conversely, failure to receive adequate services, weather in the community or in an institutional setting will have a detrimental effect on Mr. Bigelow’s systemic health particularly in the areas of contracture management and protection of his respiratory health. This in turn will result in an increase in both caregiver burden and his need to access acute care services in the future.

Treatment Plan:

Mr. Bigelow will continue to attend five to six active (tilt table and supported sitting) PT sessions per week to work on increasing strength in his left arm and hand and to work on head control. He will also continue to receive 5 stretching sessions per week to maintain passive range of motion. Collaboration with OT and SLP is ongoing.

BScPT