Wednesday, November 19, 2008

Pack a lunch, we’re going for medical supplies

Canada Post is out of the question

When Frodo Baggins set off on the quest of the ring, he sang, “The road goes ever on and on / out from the door where it began…” I wasn’t singing, but I was at least humming, as I headed out to get filters for my CPAP machine.

A CPAP is the cheapest, simplest solution to sleep apnea, a common disorder affecting 2 - 4% of adults. In sleep apnea, as a person falls asleep and then slips into deeper sleep, the air passage relaxes and air can no longer pass, sort of like trying to suck a milkshake through a collapsed straw. To resume breathing the sleeper must rise to a lighter sleep state, something they are not aware of, so they never enter deep, restful sleep.

The CPAP (Continuous Positive Airway Pressure) machine, pronounced SEE-pap, was invented by an Australian in 1981. It solves the problem by squirting air up your nose while you sleep. This sounds goofy, and looks goofier (imagine headgear like a cross between the creature from the black lagoon and a vacuum cleaner) but it is an elegant effective solution to a non-trivial problem.

As you might imagine, if you’re going to have air blown up your nose, you probably want to filter the air. Thus, my quest for new filters.

Our province covers these supplies. Four years ago when I was diagnosed, the supplies were available from the main hospital in the heart of the city, and thousands of people dealt with them.

Then 18 months ago the province farmed out this part of the job to Rana Medical. What nice, patient people they are. It’s too bad they’re so far away.

They are NOT in the heart of the city, nor even the liver or gall bladder. No, their offices are in the lower left ankle of the city, in a galaxy far away.

So when I drove down there today, it took an hour and a half to get there, pick up my filters, and go back home again, a 32 kilometer round trip, mostly on main routes.

But what if I didn’t have a car? That’s even better. Here’s the bus schedule, one-way at midday.
Option Transfers Departure Time Arrival Time Total Time Walking Time Wait Time
Option 1 2 14:38 15:44 66 minutes 8 minutes 7 minutes
Option 2 2 14:38 15:44 66 minutes 9 minutes 6 minutes
Option 3 1 14:47 15:57 70 minutes 17 minutes 5 minutes
Option 4 1 15:00 15:57 57 minutes 12 minutes 1 minute

An hour each way, including 8 to 17 minutes of walking, is a good chunk of time. (At other times of day it takes even longer.) But I suppose if you’re poor enough to not have a car, then you must have a lot of free time.

But wait – there’s a little bit more.

These filters weight nothing, maybe an ounce or less. Mailing them would cost $1.00 at present. But when I asked if Rana would mail them, I was told by their patient, sweet receptionist that they were not allowed to mail supplies. In fact, I was told that stipulation was in the bid contract from Manitoba Health – no mailing of supplies even if the winning bidder wanted to.

So let’s see what this means. While I was there, another seven people crowded the front desk to get supplies or replace broken equipment. How many people go to Rana in all? At least 7000, probably double that by now.

Say 10,000, that means that on average these CPAP patients travel 320,000 km each year, and spend a little over 2 years of total travel time each year. And who knows what the infirm or elderly do.

Is the savings in money to Manitoba Health worth the extra burden of time and trouble to their patients? I guess it depends which side of the ledger you check – the government side, saving ten grand on postage, or the patient side, making their pilgrimage every year to the wilds of south Fort Garry.

Next time I'll pack "Canterbury Tales."

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