We welcome September as the first month of the Fall, still warm and beautiful, with crisper air and golden leaves peeking through. Things start settling into routines as we head towards cooler weather. In this issue, we bring to you some news about a promising new Alzheimer’s blood test, some information on how to get your medical records in Canada and a list of Medical travel Do’s and Don’t.
September is Alzheimer’s Awareness Month
Alzheimer’s disease is the most common cause of dementia. It is progressive and not reversible, causing memory problems that become severe over time. Eventually, people with Alzheimer’s can not perform their daily tasks.
Detection and Diagnosis
Diagnostic methods have improved in recent years, but there is still not a single diagnostic test to determine if someone has Alzheimer’s disease. A number of tools and tests are used to help with diagnosis. They usually include physical exam and review of medical history, a neurological exam, mental status test and brain imaging, such as CT scan or/and MRI. All other diseases should be ruled out prior to diagnosing someone with dementia.
Getting an early accurate diagnosis is beneficial for several reasons. The person is able to participate actively in their own health-care decisions and future plans. They are able to focus on what is important to them, make informed decisions about legal, financial and care matter and ensure that their families and friends know.
Starting medications early, when they are most effective, is another benefit. While current medications can not stop the damage Alzheimer’s causes to brain cells, they may lessen or stabilize symptoms for a limited time. Also, people that are diagnosed early are able to participate in clinical trials of new medications and diagnostic tools. All current medications help mask the symptoms of the disease but do not treat the underlying causes or delay its progression. Several new medications are in development and testing. However, they need more volunteers. Trials are recruiting people with Alzheimer’s and mild cognitive impairment, as well as healthy individuals to be controls. To find out more about participation in a clinical trial click here.
Future of early diagnosis
Two proteins are linked to Alzheimer’s disease, one is called tau and the other one is beta-amyloid. The disease is described as having tangles and plaques on brain MRI images. Tau forms tangles and beta-amyloid form plaques in the brain.
Tau proteins play a vital role in how nutrients and other important materials are transported in the brain and keep the brain cells alive. In unhealthy brain areas, tau protein collapses and twists, thus “tangles”. These tangles prevent nutrients from reaching brain cells, resulting in cell death.
Beta-amyloids molecules clump and those clumps form plaques. As plaques spread, the cells of the brain are unable to receive signals between nerve cells and cause cells to die.
Beta-amyloid spreads throughout the brain at an early stage, decades before the patient notices signs of the disease. Tau, on the other hand, starts to spread at a later stage, from the temporal lobes to other parts of the brain.
Early detection of these proteins enables earlier diagnosis of Alzheimer. Two of the recent detection research findings are worth noting.
The first one is a tau-PET scan. Researchers developed a PET scan to determine the presence of tau. When tau begins to spread the neurons start dying and patients start experiencing the first problems with the disease. A tau-PET scan detected 90-95% of all causes of Alzheimer and only gave a few false positives in patients with other diseases.
The second one just recently made the news. It is a blood test that can identify Alzheimer’s almost 20 years before symptoms appear. The blood test developed can detect the start of beta-amyloids build up in the brain. PET scans can already detect these build-ups, so researchers looked at the results of the newly developed blood test and the results of the PET scans. They saw that the results agreed 88% of the time. In an attempt to refine the results and improve the blood test accuracy the researchers then took into account other risk factors such as age and a specific genetic variant. The accuracy went up to 94%!
Also of importance is the fact that those participants flagged as false positives based on the results of their PET scans showed positive test results years later. This may suggest that some of the early blood tests were more sensitive than the brain scans in detecting the disease in the very early stages.
Blood tests are much easier and faster to perform than PET scans and if these findings are approved then Alzheimer’s will be easier to diagnose, treat early and recruit participants in clinical trials.
Medical Records and How to Obtain Them in Canada
When we start working with a prospective client, we ask them to collect and submit their medical records for a doctor’s review. This part of our process sometimes takes the longest. We came across a few cases where people were unaware how to get them, other than asking their family doctor. Asking your family doctor will probably get you as far as the visits in her office and sometimes blood work, but other important records can be at a hospital or a diagnostics facility you were treated at.
So how do you get your medical records at a hospital or a diagnostic facility? Under the Freedom of Information and Protection of Privacy Act (FIPPA), a request must be made in writing. Depending on the province you reside in the request can be usually faxed or emailed to a hospital’s Health Records Department. They, in turn, have up to 30 days to provide you with an electronic or paper copy of your medical records. There is a small charge involved in this and usually depends if you wanted your diagnostic records on a CD, if you prefer printed copies, etc. The fees range between $35-$85, from our experience, although they may change in the future.
In Nova Scotia, where we are based, all the records have to be requested by either faxing or emailing in a request form.
In Alberta, you can access your medical records online. Once you create an account and digital ID, you should be able to view your records any time.
In British Columbia, you will need to reach out to your local health authority. This can also be done online. For example, for those belonging to Island Health, you can go here, or if you are under Vancouver Coastal Health the form can be found here
In Ontario, the process is very similar to that of BC. You will need to contact the Health Information custodian and submit a form via fax or email. Health Information custodians are defined as doctors, hospitals, pharmacies, labs, etc. We always advise calling the hospital or facility you were treated at and ask them what their processes and fees are, as they may have their own form to fill out.
Other provinces have similar rules and processes.
Getting medical records can take time and patience. Health Vantis can do this for you, provided the proper forms are filled out and signed by you, our client. For more info, please contact us at toll-free 1 877 344 3544 or by email firstname.lastname@example.org
Medical Travel Do’s and Don’ts
Travelling for medical reasons can be complicated. Not only someone is stressed about their surgery or treatment there are other things to consider when planning a trip to get better. Here we highlight a few do and don’t items to help you plan your medical journey successfully.
- Do all the research you can about the doctor and the facility you are going to. Ask if you can talk to some of the doctor’s patients. Sometimes it is possible. Doing your own research will help you make a better decision on where to go for treatment. If you are short on time and are not able to do all the research, consider hiring a medical travel facilitator. A good medical travel facilitator will be able to provide you with feedback on the doctor and the facility.
- Ask your doctor questions about your procedure. Make sure you understand the risks and possible outcomes. Knowing these things will help you keep calm before and after surgery. Stress hinders recovery and can affect surgical outcomes.
- Find out the exact pricing and what additional items you may be charged for. This one is sometimes very tough, but most of the time once a doctor reviewed your medical records, they will be able to provide you with an accurate estimate
- Communicate with your doctor in Canada. It is a good idea to bring up the intent to travel 4-6 weeks before you plan to go. Your medical provider needs to know about your plans because she or he will be able to give you some valuable advice beforehand as well as see you after you come back home.
- Make a selection of the doctor and facility based on price only. Ensure that you will be receiving treatment in a safe manner by a qualified doctor and at a certified facility with known outcomes. Many news stories covered cheap surgeries in the Dominican Republic and Mexico that ended badly. Be wise, and when in doubt, ask questions.
- Give up on an exercise program or a healthy diet. Even if your mobility is limited, there are a number of programs that allow for gentle exercises, such as swimming (for those with back pain) or walking. Eating healthy will keep your weight in check and prevent unnecessary weight gain.
- Expect the results overnight. Any surgery is a serious medical procedure and the recovery may be lengthy no matter if you had it at the best place and by the best surgeon possible.