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N.S. woman with painful condition seeks MAID amid battle to fund surgical treatment

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HALIFAX – A Nova Scotia woman has applied for a medically assisted death, saying after years of battling to receive out-of-country surgery for an illness that causes “indescribable” pain, she struggles to maintain the will to live.

Jennifer Brady completed her MAID application in June. She has lymphedema in her legs, a condition in which tissues swell from the accumulation of fluids normally drained through the body’s lymphatic system.

In an interview Thursday, the 46-year-old mother of two said she has intense daily pain, skin infections that resemble a sunburn intensified “1,000 times,” and blood infections that exhaust her to the point “you feel like you’re dying.”

However, Brady said that after she received treatment in Japan in 2022 — at her own expense — her swelling decreased, particularly in her right leg, and some symptoms were relieved. She said she believes that if she can receive the funds to pay for more surgery, her condition can improve — as will her desire to remain alive.

The possibility that her health can improve is what led to her MAID request being denied.

In a letter sent to Health Minister Michelle Thompson on July 7, Dr. Gord Gubitz, the clinical lead of Nova Scotia’s MAID program, said his team is rejecting Brady’s application because her condition is not considered “irremediable.”

“It seems reasonable to me that if an assessment (and surgery, if clinically indicated) … could help to reduce Brady’s suffering and obviate the need to consider MAID, this option should be explored. Your office can make this happen,” Gubitz wrote to Thompson.

After telling her story to CBC this week, Brady said she has received online support from people offering encouragement and financial help. However, she said she still needs the health minister to authorize funding for treatment she cannot get in the province.

On Wednesday, Thompson told reporters, “I will not make a commitment to do that,” and then added, “If that individual will work with the department and reach out, perhaps there is another path forward.” The minister refused detailed comment, citing an ongoing court case and privacy law.

In Brady’s case before the Nova Scotia Supreme Court launched over two years ago, she took issue with the province’s decision to deny her funding for out-of-country care, arguing it was unreasonable and unfair.

In legal briefs, government lawyers argued Brady failed to receive a referral for the treatment. The lawyers said she was on a wait-list to see a Nova Scotia plastic surgeon and became “frustrated.”

Brady’s January 2024 affidavit responding to the lawyers said that given her physical deterioration, the plastic surgeon’s years-long waiting time and his lack of expertise in her illness, “the department created standards that were functionally impossible to meet.”

On Thursday, Brady said she found the minister’s latest comments frustrating and “somewhat disingenuous,” adding that they left her wondering whether Thompson had personally reviewed her case.

She said that even if she wins in court and is awarded about $60,000 in costs related to her 2022 treatment in Japan, the years of legal battles, the continuing pain and her deteriorating mental health have led to her decision that MAID is the best option. “It was after a winter where I could barely get out of bed and when I did, I just didn’t want to be here.”

Brady spends at least five hours daily in a full body massage machine that helps move fluid in her legs to reduce swelling. “I mean, what’s the point honestly? I’m in that machine and the machine itself is so uncomfortable.”

Applying for MAID “definitely isn’t a strategic move,” she said. “That’s not my plan A. I want to live. I want to be here for my kids. I love my job.”

“I want the option (of MAID) to be there. But if I were given the treatment today (for lymphedema) I would definitely take it,” she said.

Brady, a dietitian and professor at Acadia University’s faculty of nutrition, said she is also suffering from depression, a condition for which she’s been unable to take medicines as they tend to increase the swelling in her legs.

Her lymphedema developed after a hysterectomy to treat her cervical cancer in 2019. She said she was informed in 2021 that local surgical options weren’t available to her, which led her to Dr. Joshua Vortenbosch, an expert in lymphedema at McGill University. However, she was denied funding for the surgery in Montreal. The rejection led her to do research, and to her 2022 trip for surgery in Japan.

In Japan, she received lymphovenous anastomosis, a procedure in which a surgeon connects lymph vessels in the limbs to nearby veins to bypass damaged areas and restore the flow of lymph fluids.

This report by The Canadian Press was first published Sept. 20, 2024.

— With files from Keith Doucette in Halifax.

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Health-care announcements expected with two weeks to go in N.B. election race

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New Brunswick‘s Liberal and Green parties are set to make announcements about health care on the campaign trail today as the provincial election race enters its second half.

Liberal leader Susan Holt is scheduled to hold her announcement this morning in Saint John, N.B., followed by lunch at the city’s market.

A spokesperson with the Progressive Conservative party shared few details about the event scheduled for leader Blaine Higgs in Fredericton this morning.

Green Party Leader David Coon will hold a news conference this morning about “local health-care decision-making” alongside deputy leader Megan Mitton in her Sackville, N.B. riding.

On Saturday, Coon said he was proud to put forward a gender-balanced slate among the party’s 46 candidates.

While the Liberals and Progressive Conservatives are running with full slates, the Greens are three candidates short and will not have full representation when the province’s residents go to the polls on Oct. 21.

This report by The Canadian Press was first published Oct. 7, 2024.

The Canadian Press. All rights reserved.

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Alberta Health Services’ snag leads to potential delay of patient referrals

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EDMONTON – The Health Quality Council of Alberta is investigating how some medical referrals weren’t properly processed, potentially affecting 14,000 patients over the last five years across the province.

The referrals were made to specialists outside of Alberta Health Services, such as physiotherapists and dietitians.

The health authority’s CEO, Athana Mentzelopoulos, says it does an average 100,000 referrals per year, but in some cases it can’t confirm if patients received referral services.

She says the problem was flagged in late September, and a preliminary estimate suggests 31 patients may have experienced a potential negative outcome due to the delays.

The provincial government requested the investigation, and the quality council is to find out how the snag occurred and how it can be prevented in the future.

The health authority says it has begun notifying patients who may have been affected by the disruption, and the cases could date back to 2019.

This report by The Canadian Press was first published Oct. 4, 2024.

The Canadian Press. All rights reserved.

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Don’t fall for fake dentists offering veneers and other dental work on social media

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WASHINGTON (AP) — If you have stained or chipped teeth, you might be considering veneers, customized teeth coverings that can restore a photogenic smile without more extensive dental work.

But dentists warn that these pricey cosmetic enhancements are at the center of a worrisome online trend: unlicensed practitioners without proper training or supervision offering low-cost veneers.

These self-described “veneer techs” often promote themselves on Instagram and TikTok, promising a full set of veneers for less than half of what dentists typically charge. Some also market their own training courses and certifications for people looking to get into the business.

It’s misleading, health professionals warn — and illegal. All states require dental work, including veneers, to be performed under the supervision of a licensed dentist.

On Thursday, Georgia law enforcement officials arrested Brandon Diller, who promoted himself to 158,000 Instagram followers as “Atlanta’s top veneer specialist and trainer.” Diller practiced dentistry without a license and sold “training and certificates, which were worthless” and “provided no legitimate or legal credentials,” according to an arrest warrant from Fulton County’s District Attorney’s office.

Here’s what to know about veneers and how to avoid bogus providers and services:

What are dental veneers?

Veneers are thin, custom-made dental coverings used to hide minor imperfections or to fill in gaps between teeth. Unlike crowns or more invasive dental implants, veneers are almost always considered cosmetic dentistry and generally aren’t covered by insurance.

Dentists usually charge between $1,000 and $2,000 per tooth for veneers, with higher prices for those made from porcelain compared with lower-grade materials.

Placing veneers involves stripping some of the natural enamel from the tooth and bonding the new covering into place. Because of that process, getting veneers is considered an irreversible procedure, according to the American Dental Association. They are not permanent, and can be expected to last between 5 to 15 years before they degrade and need to be replaced.

In recent months the ADA has been stepping up warnings about the risks of veneer procedures done by unlicensed individuals.

“Quality control is lost without the involvement of a licensed dentist,” said Dr. Ada Cooper, a New York-based dentist and ADA spokesperson. “We undergo years of education and training and need to be licensed by various regulatory bodies before we can practice.”

What are the risks of getting veneers from someone who isn’t licensed?

Improper veneer procedures can cause a range of health problems, including severe pain, nerve damage and tooth loss.

Patients need to be anesthetized before the enamel is removed from their teeth.

“It could be incredibly painful if they’re not anesthetized correctly,” said Dr. Zach Truman, who runs an orthodontics practice in Las Vegas. “You can also go too deep into the tooth and penetrate what’s called the pulp chamber, which contains blood vessels and nerves.”

One of the biggest problems Truman sees with unregulated veneer work is that customers aren’t getting screened for existing dental problems, such as gum disease and cavities.

“If you put a veneer on a tooth that has an active cavity, you’re just going to seal it in there and eventually it’s going to progress to tooth loss,” Truman said.

Dental veneers aren’t the only option for improving the appearance of teeth. Over-the-counter whitening kits can help with minor stains and discoloration. And dentists can sometimes use composite materials to reshape chipped or uneven teeth. But Truman says those fillings are prone to crack and won’t last as long as veneers.

How can I spot bogus veneer providers online?

One clue: Many individuals performing unlicensed dental work promote themselves on social media as “veneer technicians.”

Instead of working out of a dental office they often perform treatments at beauty salons, hotel rooms or private homes. Some advertise multi-city tours and encourage clients to message them to book an appointment in advance.

Much of the appeal of the services is in their pricing, with some offering a full set of veneers for a flat fee of $4,000 or $5,000. That’s less than half of what patients can generally expect to pay at a dental office.

Performing dental work without an appropriate license is illegal, the ADA notes.

Dentists and hygienists are licensed by state governments, who also define the work dental assistants can perform. But in all cases, veneers and other dental procedures must be supervised by a licensed dentist.

Earlier this year, Illinois law enforcement officials arrested a woman running a business called the Veneer Experts after she posted videos of herself fitting braces, veneers and other dental products without a license. She was previously arrested in Nevada on similar allegations of practicing dentistry without a license.

What are the best ways to find legitimate dental providers?

The ADA maintains a website detailing the training and licensing requirements for dentists across the U.S. Most states also maintain websites where you can lookup and verify licensure information and find any past disciplinary actions for dentists and other health professionals.

“It’s really critical to understand that dentistry is a regulated health care profession that requires formal educations and licensure,” Cooper said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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