Tuesday, July 18, 2006

Ask Dr. Denise: Accessing Medical Care

exerpts published in The Filipino Journal: July 5-20 2006 issue p 19

Kumusta ka and thank you for your queries, support, and good wishes! Thank you also for challenging me to do a quick tutorial in Tagalog—there’s no better way to learn than diving right in! I must however, mention that as I am still learning our native tongue, I am unable to fully address your questions if posed in Tagalog, and because I must protect your health information, I can’t simply forward your letters to translators. If at all possible, please send me your questions/comments in English, and if you’d like a tagalog translation, I can attempt to do that. I really value your questions/comments, and will do my best to help out in as timely a fashion as I am able. Please keep in mind that due to the nature of this forum (my limited ability to gather a medical history or perform physical examinations or laboratory tests) and from a medico-legal perspective, I can’t offer explicit individual medical advice nor provide any type of follow-up care. I cannot take the role of a reader's physician or health care provider. All I can do is provide general health education with the intent of having this health information accessible to the Filipino Journal's readers. My plan is to incorporate my responses in this column, along with your medical questions. Please indicate precisely if/how you would like your question published. I do not plan to identify you or anyone you've inquired about in the column unless you specifically request this and I have received written consent from the involved individuals. Depending on the volume of readers' questions I receive, I may need to prioritize my responses in the journal (leave some questions for future issues) and categorize types of questions for summarizing my responses. Salamat po—thank you for your patience and understanding. Here are a couple excellent questions that have come up:

- I just immigrated to Canada. I need a doctor, preferably Filipino/Filipina. How do I get one?


Finding a family physician here is difficult, and finding a Pinoy one is even tougher. I don’t know of any Filipino doctors right now accepting patients, but I’m looking into compiling a list. Your best bet is to contact:
The Family Doctor Connection at (204) 786-7111. The Manitoba College of Family Physicians and Manitoba Health will give you an up-to-date list of Winnipeg family doctors accepting new patients.

- Our daughter has been feeling quite ill, throwing up and headaches. When should we take her to see a doctor?


If you have an urgent medical concern, please contact your doctor or health care provider, if possible. On Page 08 of the Health Services Directory (dark blue pages in the middle of the MTS Winnipeg White Pages, there are Emergency Room Tips and the contact information for the Emergency Departments. The Urgent Care Centre (Misericordia Health Centre) and Pan Am Minor Injury Clinic are good places to consider for non-emergent/less urgent problems. You can also try one of the walk-in clinics in your area. It is always helpful to call ahead of time, if possible, to coordinate your care.

If you are unsure if you need medical care and/or are unable to contact your doctor, you can call Health Links-Info Sante at (204) 788-8200; Toll-free 1-888-315-9257 where registered nurses can answer your health-related questions and direct you in more detail.

If your question is specifically regarding a medication/drug you are taking, you can contact your dispensing pharmacist for details on the medications.

For Mental Health concerns (such as for depression, anxiety, etc): you can call the WRHA Mobile Crisis Service at (204) 946-9109 where hospital emergency rooms and the Urgent Care Centre provide some mental health crisis services. KLINIC has a 24-hour Crisis/Suicide Line at (204) 786-8686; Toll-free 1-888-322-3019; Deaf Access (204) 784-4097; Counselling Appointments at (204) 784-4059; Drop-in Counselling call (204) 784-4067.

The 24-hour Sexual Assault Crisis Line is (204) 786-8631; Toll-free 1-888-292-7565; Deaf Access (204) 784-4097; Counselling Appointments at (204) 784-4059; Drop-in Counselling call (204) 784-4067.

Health Emergency/Ambulance call 911.
For the Poison Helpline call (204) 787-2591.

A couple of useful websites:
The Winnipeg Regional Health Authority www.wrha.mb.ca; (204) 926-7000
Manitoba Health: www.gov.mb.ca/health

- My lola hasn't been to the doctor in years. She is scared to be examined by the doctor. What can she expect?

I encourage patients to be pro-active about their care, especially considering the current difficulties with access to physicians/medical care. If there are any parts of the doctor’s visit that you don’t understand, please feel free to ask your doctor. S/he should run through the procedure with you ahead of time, if you are fearful. Doctors also have the duty to keep personal health information confidential. Often the pap/gynecological/breast exams are the more worrisome to some women. Nothing is done w/o consent of the patient, so if it feels uncomfortable, don’t necessarily do it. A patient also has the right to request a helper. Many physicians automatically bring in a “helper”/witness because of the sensitive nature of the tests.

Saturday, July 01, 2006

Ask Dr. Denise: Readers' health questions welcome

The Filipino Journal: Vol 20, No 11 p 25
June 4-20 2006 issue

Kumusta kayo, mga kababayan! It feels good to greet you in Tagalog. I’d like to introduce this column and myself. My name is Denise Marie Koh, and I am a physician here in Winnipeg. I was born in Regina, Saskatchewan of Filipino parents after they took up citizenship here in the 70s. Although my family has left the Philippines, the Philippines is still very much in us. Throughout my life, my family has always been actively involved with the Filipino community at many levels—in the social, religious, and creative/artistic spheres, to name a few. From a young age, I have continually been encouraged to be proactive and speak out on issues close to home. In Regina, as a Filipinas Youth Group Ambassador, I was involved with Philippine Folk dancing and the language school. When I moved to Winnipeg in 2003 to continue my medical training, my journey to understanding my roots kicked into high gear. Since my move, I’ve had an opportunity not only to plug into the culturally rich Filipino network and eat a lot more pancit, lumpia, and other goodies, but I have also gotten to work closely with many Filipinos. I got a good look at the health issues affecting our people, having seen and treated Filipino patients at the hospitals and outpatient clinics. I’ve noticed recurring themes in my medical practice, especially among the Filipino patient population. This was reinforced greatly by my medical mission to Catanduanes in January, 2005.

What an eye-opener. When the majority of the hundreds of patients I saw requested vitamins, I learned of a serious problem that makes my stomach turn. In this day and age, no one should suffer malnutrition. Ever. On top of limited essentials such as running water and electricity, I noticed a major lack of health care services and medications, and saw the problems inherent in this health care system, particularly compounded in rural areas. I learned only too well that the people who need the health resources the most in our and many communities, get the least by way of limited access, communication difficulties, and cultural barriers. This socio-cultural isolation is self-perpetuating—the perfect catch 22. I have seen certain illnesses and health issues that are common to our kababayan, and at the suggestions of some patients, I’d like to address those problems as a service to you. It is one of my life missions to educate and help Filipinos understand about their health and make a positive impact on their collective wellbeing. Simply put, I know I can help Filipinos lead a healthy and healthful lifestyle, and I am hoping to use this forum to do so. I plan to discuss such issues as gout, diabetes, sexual health, high blood pressure, high cholesterol, musculoskeletal injuries, drugs and alcohol, depression, nutritional supplements, common medications, and laboratory tests. A Q & A format would be most useful, and would ensure the column is tailored to what you, the readers, want. Despite my busy schedule, I am doing this with no expectation of remuneration (I'm not kidding, Tita Linda!). So please, feel free to ask me any health or medical questions—if I can’t answer you, I will find the right sources who can. Alagaan ninyo ang katawan at kalusugan ninyo! Take care, and mind your health!

written ~5/31/06