Advice from Canadian J-pouchers?

Welcome to Canada!

My situation was a little different as I had HNPCC (Colon Cancer).  So there really was not much of a wait list.  It was about 4 weeks between when they found the polyp and did the first surgery (they could have done it sooner but mine was Stage 1 so not very advanced)

You would probably have to go see a family doctor who would refer you to a GI.  that process might take some time.  I am in Toronto and it can take a couple of months here depending on how urgent the need is.  

You can definitely pick your surgeon. You would just need a referral to go to another specialist if you do not like the first one.  Best to maybe do your research ahead of time so you can ask your referring doctor for a specific specialist.  

Really I am not sure your experience will be much different from in the US.  Although the hospitals/rooms might not be as aesthetically pleasing ;-)

Hello, Mremp.

Welcome to Canada. I wasn't put on a waiting list to meet a surgeon or for the operations. I trusted my surgeon when I met him so I didn't switch to anyone else, and the choice of surgeon was always mine. You won't be under pressure by any insurer or GP to go to a specific GP or a surgeon. Bwils is right: do your research in advance, search for surgeons based on location, hospital affiliation, years of experience as a colorectal surgeon, and suggest those names to your new GP. It could take a few weeks to get an appointment with a surgeon/specialist, but your GP might be able to request a date based on the urgency of your situation. 

When I was searching for a new GP, I googled doctors near my location or within an hour travel time. I had a list of eight names and started dialing. Only two were accepting new patients because they were newly minted doctors trying to establish their practice. The others were full up and not accepting new patients or referrals. You could also ask new friends or colleagues for GP suggestions. I didn't mind a new or young GP, but it is very important that your eventual surgeon have years of experience in colorectal surgery.

You might be asked for your medical records so if you've already got copies from your US doctor that might speed up the process. I don't know if you'll need to pay a fee to your US doctor for copying?  Your new GP will do their own medical on you but previous records might help fill in gaps. Insurance paid for all my appointments and the two surgeries. If you or your husband have private insurance it might cover your ostomy supplies and prescription meds. Best wishes to you!

I had my surgeries done at Kelowna General hospital for the the first step and then had j-pouch and takedown at St Pauls in Vancouver this was in 1997 & 98.  I wasn't really on a waitlist as it was emergent and then j-pouch and take down were done once my healing were done.  I did have a complication so there was 11 months and three surgeries. 

Hi Mremp!

I'm in BC as well and had my proctocolectomy / pouch / reversal all done last year. Could you please clarify what condition you have? You may just need to be in more frequent contact with a gastroenterologist. Surgery is often last resort and it is unclear which medication combos you have tried. Usually, you get referred from a family doctor to a gastroenterologist. If they can't provide any different medical management, they refer onto a general surgeon. I think you need to see a specialist instead of trying to self manage with rounds of prednisone. Its actually unsafe and by the sounds of it, not working.

Either way, if you're looking for recommendations. Theres a group of Gastroenterologists in downtown Vancouver who all work on the same floor of a building. They're known as Pacific Gastroenterology Associates. I'd recommend Dr. Brian Bressler. In terms of surgeons, the colorectal group is all based out of St. Paul's Hospital. The head is Dr. Carl Brown and he's really good. The other's are Dr. Manoj Raval and Dr. Ahmer Karimuddin. They've all got good reviews.

In all seriousness though, I realize you're in a tricky situation where your insurance is not totally sorted. I still think by delaying things you could make things worse. I hope this helps and would strongly advise getting seen sooner rather than later! Maybe try calling MSP to see if they can expedite your coverage?

Edit: For referrals, you just have to ask your family doctor to refer you to a specific person. If you have been told in the past that you need a J-pouch, it would be reasonable to tell your family doctor that this procedure is most routinely done at St. Paul's therefore you would like to see a specialist that works there.

I will echo Min990's advice above. Once you are sorted with your BC MSP, definitely look up Pacific Gastro. I actually found Bressler via RateMDs.com (or whatever that site is called). I had been with another GI whose "care" had me unnecessarily addicted to prednisone and leaving her office in tears the last time I saw her. When I got over that trauma, I looked up that website, found Bressler, and got a referral from my GP. It took a few months to get in to see him. He did everything he could to get my UC under control, but it was chronic and intractable, so eventually I had no choice but to have surgery. He told me to go to St. Paul's Emerg and tell them I needed surgery immediately (which was true), on his recommendation. So I did that, and 5 days later I had my colectomy. Dr. Brown did my surgery and I cannot stress enough how excellent he is. Not just an expert surgeon (head of colorectal at that hospital), but also a stellar bedside manner. My other 2 surgeries (end ileo and takedown) were done in what seemed to me to be a pretty timely manner -- all 3 surgeries done in 13 months.

3+ years after my takedown I have developed some issues that resemble (but have not been definitively diagnosed as) pouchitis, and I am back in Dr. Bressler's care. He is working on solutions for me, and he is willing to entertain "alternative" therapies where possible and realistic. By way of saying, he is a thoughtful and creative doctor who looks not just at my wonky organ, but my entire self and life, and tries to find solutions that will fit all of that.

I will also say, during the years of my UC treatment I was involved with a couple of clinical trials, so I actually interacted with a number of doctors in the Pacific Gastro practice, and I would recommend pretty much any one of them. 

Good luck on your journey, and welcome to BC!