Better follow-up care could be provided to MS patients
One doctor's attempt to provide follow-up care to MS patients that have undergone the liberation treatment could be coming to an end, before if even really gets started.
"I have a moral duty to care for these people, being a vascular specialist with some expertise," said Dr. Ruben Rajakumar, a cardiologist and retired University of Saskatchewan medical professor.
He wants to be able to assess neck veins in people who had the treatment, but he said that these precautionary assessments are not covered by the Ministry of Health and he doesn't want to charge.
"I'm getting a little bit frustrated," Rajakumar said.
"If they come with complications and they have to be treated … that is covered."
But if patients come in just wanting to make sure everything is okay, they are not covered, he said.
It was Michelle Walsh, an MS patient who has had the liberation treatment, who was having chest pain that introduced Rajakumar to the need of those who had undergone liberation treatment.
"This is all my initiative, the poor guy definitely did not need more of a workload by any means," she said.
She said she had been turned down by other cardiologists, where she was referred.
"Thank god Dr. Rajakumar didn't refuse me because needed to know my heart was okay," Walsh said.
There is no proper follow up vascular care for those who had undergone the liberation treatment, which opens up neck veins using angioplasty, she said.
"I think having the support there for the patients … could help alleviate a lot of the problematic complications down the road, if we catch it early."
At this point, all Rajakumar has done is agree to see patients that have undergone the therapy in his office. Before the clinic started seeing these patients, they would need to make some modifications to the ultrasound equipment they already used for cardiac follow-up appointments. They have also looked at what protocols could be used.
Rajakumar said, all he wants to do is make sure the patients are properly managed based on the skills he has.
"We really need to know that there is a vascular specialist that knows about this, so god forbid, we don't end up with a complication or die," Walsh said.
For now, the diagnostic service will stay uncovered by Saskatchewan's Ministry of Health
"Because the validity of that type of treatment after that treatment has not been clarified within the medical community, it wouldn't be a public service within the community," said Shaylene Salazar, executive director of medical service branch.
Patients have their physicians that they see on an ongoing basis and those doctors will decide if other care is needed, she said.
However, if the liberation were to be accepted by the medical community, the ministry would revisit the coverage, Salazar said.
Walsh calls it a turf war between the different area of health care - with neurologists saying they need to go there for follow up, but she said she wants a vascular specialist for her vascular issues.
Her argument that the liberation treatment, to open veins, is done in people for other medical reasons, and those people have access to follow-up vascular care, but she does not.
"That is why I fight so hard," Walsh said.