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Delay in getting in to see a doctor almost cost Victoria writer his leg

After having no luck with walk-in clinics, Urgent and Primary Care Centres and virtual care, Mark Leiren-Young ended up in ER with an infection that was at first thought to be flesh-eating disease

As Mark Leiren-Young lay writhing in pain in a hallway bed at Victoria General Hospital for days, doctors would look at his inflamed leg and tell him not to worry, he wouldn’t lose it.

“There wasn’t quite a ­question mark at the end of the ­sentence, but there wasn’t a period either,” he said. “The ­doctor just stared at the red, swollen elephant leg in the room, like he was also wondering if my real leg would ever ­reappear.”

The writer and filmmaker, who teaches writing at the ­University of Victoria, had landed in hospital last fall after numerous failed attempts to access care for a sore foot that, left untreated, developed into an extreme case of cellulitis — one that was initially thought to be necrotizing fasciitis, also known as flesh-eating disease.

He documented his frustrating tour of Greater Victoria’s walk-in clinics, Urgent and ­Primary Care Centres and virtual care in a public letter to one of his favourite comedians, Lewis Black.

“Dear Lewis Black, I don’t remember the exact jokes you made at your Victoria show about how terrifying it is to get sick in America and how ­awesome Canada’s health care is,” writes Leiren-Young on his site.

“But since I was sitting in the fifth row, laughing at those jokes while I almost lost my leg to an infection ­courtesy of Canada’s health care system, I thought I’d share my ­adventures in our medical Wonderland with you.”

Leiren-Young, whose ­family doctor is in ­Vancouver though the writer moved to Victoria in 2015, said in an ­interview that he initially imagined his foot was sore and slightly red because of a ­flare-up of arthritis or gout.

“If it had even crossed my mind it could be this ­serious I would have gone to the ER” — or at least travelled to ­Vancouver to see his family doctor, he said.

Instead, he went to see a pharmacist, who advised taking painkillers and visiting a ­doctor if the pain didn’t resolve by morning.

With his foot still red and painful the next morning, Leiren-Young tried to get a ­virtual appointment through Telus Health but the service had no doctors available.

Next, he tried an Urgent and Primary Care Centre. As soon as the UPCC opened, he phoned and was told he was caller No. 12 — first on the waitlist — and he’d likely be called later that day. It didn’t happen.

Meanwhile, he continued to log into the Telus Health app, hoping a virtual appointment would open up, with no success.

He didn’t try calling 811 to talk to a nurse, because he felt their default recommendation is always to visit the ER, which could result in an hours-long wait.

The next day, with the redness now turning slightly purple and spreading to his leg, Leiren-Young tried several walk-in clinics but found they were no longer taking drop-ins. “One ‘walk-in’ clinic had a sign on the door that said they were booking a week in advance,” he said.

At this point, Leiren-Young returned to visit another pharmacist, who offered “more obscure” online options for virtual appointments, such as Tia Health.

While he was told he had an appointment within minutes, he then got a text saying it was cancelled and telling him to book an in-person appointment at a walk-in clinic as his issue required a physical exam.

With no diagnosis and tickets to see one of his favourite comedians, Lewis Black, Leiren-Young decided he’d go to the show, using a cane, and assess afterwards.

On the way home, his foot hurt to press on the gas pedal. His wife suggested calling 911 but he opted for a cab to the ER at Victoria General.

After a blood test, the attending physician looked “grim” and asked Leiren-Young if he knew what necrotizing fasciitis was. Leiren-Young well remembered Quebec separatist leader Lucien Bouchard losing his leg to the “flesh-eating” disease.

Doctors immediately began pumping him with antibiotics via an IV drip and he was raced for a CT scan, resulting in a diagnosis of cellulitis likely caused by a tiny cut on his foot.

“I’m sure I’ve been more scared in my life, but even months later I can’t recall when,” he said.

After a night in the ER, he was taken to a bed on a ward in the hallway, where he’d remain for seven days. Told to elevate his leg, he did so with a computer backpack and coat. He had asked for an extra pillow but was told “the hospital didn’t have any to spare.”

The pain was excruciating, the medication was about as effective as “Coke Zero,” and there was no privacy in the hospital hallway, but Leiren-Young said once he was told he didn’t have flesh-eating disease, he felt he could tolerate anything. “I’m walking out of here with two legs — it’s a win,” he thought.

Leiren-Young wasn’t aware that cellulitis could still cost him his leg. “I thought the idea of losing my leg was off the table until doctors and nurses kept coming and saying: ‘Don’t worry, you’re not going to lose your leg.’ ”

Seven days later, he was discharged.

In a phone interview Friday, Health Minister Adrian Dix said he couldn’t comment on the case for privacy reasons but is sympathetic. “Obviously, for anyone whose had a bad experience with the health-care system, I’m concerned about their issues, and it’s why we’ve given such attention to primary care.”

Dix said the province continues to build out primary-care and walk-in clinics, and has 32 UPCCs and networks that have served 2.7 million patient visits since 2018 — noting 550,000 people were added to the province’s Medical Services Plan over the last three years as B.C.’s population grows.

But while the province has “many more” people practising primary care, he acknowledged more needs to be done.

“There’s never been this much investment in primary care, there’s never been this much demand, and the overall number of appointments we’re seeing indicates that progress is being made, but that doesn’t mean that in every circumstance in every case that people don’t face difficulty, because they do,” said Dix.

Today, Leiren-Young is still recovering. He’s lost considerable muscle in his right buttock and leg and his skin colour is still mottled: “My leg still looks like a bit of a Rorschach test.”

He goes twice weekly to a Royal Jubilee Hospital outpatient clinic, where a machine massages his leg to increase blood flow and reduce fluid retention. He also gets physiotherapy and more. His extended coverage through the Writers Guild of Canada is good but only covers a percentage of that follow-up care.

Leiren-Young said he is grateful he spent seven nights sleeping in hospital beds while a “wonderful” team of dedicated medical professionals “pumped me full of antibiotics and did everything in their power to make sure I left the hospital with the same number of limbs I’d been admitted with.” His GP called daily while he was in hospital.

And while he’s also grateful the majority of his care was free, he said the lack of accessible urgent care could have cost him his leg.

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