Spotlight on Erin and Jean Guy Belzile
 Our journey: A rural perspective
March 2022
“Living in a small community makes you feel isolated, as if you don’t have choices, a right to a second opinion or the best care possible. When my husband was diagnosed, one blunder after another nearly cost him his life. Difficulties with appointments for essential procedures and approvals for the drug we wanted led us to travel hundreds of kilometres and change treatment centres. The trips are difficult and expensive but what choice do we have?”
– Erin & Jean Guy
Here is a snapshot of our story:

My husband Jean Guy was chief of the Emergency Medical Services in our district of Nipissing, Ontario for 20 years. By profession, I was a registered nurse and spent 35 years working in the ER. When Jean Guy retired in August of 2019 at the age of 62, he was excited to really start enjoying his new-found freedom…so many things we planned to do in retirement!  

At 62, just 3 months after his retirement, he started to experience back pain. By January and the start of the Covid pandemic, his pain increased so much that it caused him to be bedridden
Jean Guy, March 2019
It was like the perfect storm: to be shunned to your home and medically ignored while the world was trying to cope with the pandemic. His pain led us down a horribly dark path.
This is how JG spent months in severe pain with copious amounts of narcotics – without an adequate exam – in a pandemic.
In March, after 3 months on bedrest, Jean Guy had a heart attack, followed by 6 pneumonias, each of which resulted in hospital admissions. At that point, he had not yet received any diagnosis.

It was a living nightmare that found us feeling left behind by the medical system. I call this time “the black hole of Covid”. No one seemed to care about anything else, and if you were sick, you were thought to be infected by the virus and shunned even more.

In August, Jean Guy had several visits to the local ER with sudden and random chest pains that were sharp and stabbing. He had X-rays done and was told that it’s “just some inflammation” and was sent home.
We later found out that these X-rays showed multiple fractured (broken) ribs. But for what I call “the Covid effect”, we were never notified of this and would not learn about these fractures until his myeloma diagnosis 3 months later, in November. 

In September, Jean Guy also started to experience sudden ice pic headaches that would drop him to his knees. He had several visits to both, the ER and his family doctor yet, still no diagnosis. Because of the pandemic, I was locked out of his medical care.
By October, Jean Guy had significant blatant neurological signs. He awoke with tongue deviation, slurred speech, and facial drooping. When I brought him to the ER, he finally had a CT and an MRI. That’s when he was told, in a private room alone, that he had some form of cancer, with a tumour at the base of his skull. At this point, we didn’t know what cancer he had. To be told this devastating, life changing news alone and left there was an unacceptable experience.

When we met with his family doctor in November, we heard the words multiple myeloma for the first time. 
Repeated visits to ER and discharged 
It was one blunder after another...
Looking back, my husband had an admission to the hospital 5 years prior. He had suddenly ruptured 3 discs. Then later, he found out he had extensive degenerative disc disease in his cervical spine. He had hip pain for which there was never a reason. In hindsight, we both feel these were all likely myeloma related. He had to go through 5 years with these findings and it wasn’t until he couldn’t talk due to cerebral edema from a tumor in his clivus (neck/base of skull) that he finally received a diagnosis!

It's heartbreaking that it went on for that long before his myeloma was diagnosed.
Accessing the first line of chemo recommended by Jean Guy’s oncologists proved to be extremely anxiety-producing. Even with me advocating on my husband’s behalf, we still had a lot of difficulty getting the prescribed cancer drugs and pain medication for Jean Guy.
Because of my background as an emergency room RN, I am used to speaking up and being a patient’s advocate. I understand that for some, it can be intimidating, so I would try and be their voice. I also understand why patients may be reluctant or afraid to speak out, especially in a small rural community with limited options for medical care. It can be a very scary experience.

The sad irony is that I now find myself in this role for my very sick husband. It proved to us how important it is to be a strong self-advocate or have someone advocating on your behalf.
Awaiting his stem cell collection
This was New Years Eve 2021 in the midst of his
pre- stem cell transplant. We were full of hope for a better year ahead.
When it came time for Jean Guy’s transplant in Sudbury, I was advised not to stay with family since they had school age children. I had thought I could stay at the Daffodil Lodge, a place attached to the cancer centre and hospital. It was affordable simple accommodations for families of cancer patients. When I went to arrange my stay, the space was closed and being used for the growing drug addiction problem during the pandemic. The Northeast Cancer Centre (NECC) of Health Sciences said I could stay at the hotel next door for a 10% reduced rate, which would bring the nightly charge to $129 per night x 30 nights = $3,870. Imagine? Who could afford that? This amount didn’t even cover food! 
We found the 10% to be an insult, especially since living in North Bay, we are just 30 km short of qualifying for government financial assistance for accommodations. Yet, our reality is that the treatment centre is still a 1 1/2 hour drive each way; it's not possible for us to travel this distance -– there and back -– daily in the winter, for a month. This too added to the anxiety with which we were living.
Both Jean Guy and I are retired and on a fixed income. We are aware of how difficult a cancer diagnosis is, and even more so if you are still working and financially need to work. I am very thankful to have insurance for Jean Guy’s treatment otherwise we would have never been able to afford the cost for his stem cell transplant in Sudbury.

I honestly do not know how patients do it without a strong advocate.
The laptop became our connection to the world
In most rural areas, oncologists are caring for multiple types of cancers. As such, and through no fault of their own, they sort of become a “Jack of all trades and master of none” in my opinion.

Being in an isolated northern city, we unfortunately encountered situations that were alienating and non-supportive. As a result, we made the decision to seek out a myeloma specialist during Jean Guy's treatment.

The good news is that the pandemic has opened access to remote areas from major treatment centres. Video appointments have been instrumental in accessing specialists that previously were geographically difficult to consult with.
So, there is a silver lining. We are now feeling confident with the care that Jean Guy is receiving.
I cannot stress enough the importance of advocating for yourself and/or your loved one as you go through this journey together.
4 of the 6 reasons life is worth living!
The first time JG saw his mother in 2 years. He had had debilitating back pain, a heart attack,
6 pneumonias, a mm diagnosis and a stem cell transplant since seeing her last. It was a touching moment we will never forget.
Let me put it this way, if you had a choice to bring your loved one to an oncologist that specializes in the cancer your loved one has or go to an oncologist that treats many different cancers because it is close by…honest question, which one would you choose? I realize it is not always that simple and there are many factors that come in to play. We are fortunate to be able to make that decision.
My heart goes out to those that cannot. But that doesn’t mean that you stop advocating for the best possible treatment and care you can get in this great country.
Jean Guy and me
I would be remiss if I did not mention the huge support we received from Myeloma Canada. I reached out to them when we felt lost and they offered great advice. We cannot thank them enough for the ongoing work they do for Canadians with multiple myeloma.

Also, if I was to recommend another resource that was, and continues to be invaluable, it is the Facebook support group for all Canadians: “Myeloma Canada Patient & Caregiver Support Group”. It made us realize the struggles other rural patients were experiencing.
Certainly, in my opinion, patients being treated in rural communities should most definitely request a second opinion. It just makes sense, and it should not be perceived as disrespectful to your present oncologist. Myeloma care is continually changing, and cancer care is most prudent when approached as a team from many disciplines.

If you live in a rural area in Canada, know that you have a right to equal access to health care, regardless of where you live in our great country.
Thank you,
Erin 
Editor’s Note: We hope you enjoy meeting our 2022 Spotlight Stars and your fellow Myeloma Canada community members. The Spotlight section of Myeloma Matters features stories and reflections supplied by members of our community - those living with myeloma, caregivers, healthcare professional - in their words. The views expressed and shared are those of that individual. We recognize that everyone’s journey and experience with myeloma is different.
 
To all of you who have shared your stories in the past, and those of you who continue to do so today, we are indebted...you are an inspiration.  

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