The first time six-year-old Tristan ate a piece of feta cheese, he started turning blue, his breathing slowed, he broke out in hives and his lips swelled up.
That anaphylactic episode required not one, but two injections of epinephrine and a trip to the hospital.
“It was very scary,” said his mother Jennifer Roberge.
Tristan has severe anaphylactic reactions to sheep’smilk products and is also allergic to cow’s milk and tree nuts. That attack wasn’t the first sign he may have had food-based allergies – it was the eczema all over his body that made Roberge think something may be wrong.
When the eczema started to appear, Roberge wanted to have her son checked out, but had to bring him for tests at an external clinic because she was told it can take up to three years to see an allergist at a hospital.
It wasn’t until Tristan had that first anaphylactic episode that the Montreal Children’s Hospital opened up a spot so he could be tested – and that was four months after the feta cheese incident.
When the Montreal Children’s Hospital moves to its new site in late May, only urgent cases will be seen there, which means up to 60 per cent of patients will be referred to outpatient clinics.
That means it may soon be tougher for parents to get their children in to a specialist, and not just for those with allergies.
“The visits that will be in the hospital will be for the sickest of the sick, children who have the most complex needs requiring huge teams of people and high technology,” explained Dr. Robert Barnes, associate director of professional services at the Children's.
That means non-emergency cases – in ophthalmology, immunology, and endocrinology to name a few - won't be seen within the walls of the superhospital.
“The government's thinking is to move those visits out into the community closer to home,” Barnes said.
Health Minister Gaetan Barrette said the Glen hospital is not a replacement for the Children's, and isn’t supposed to be.
“It was never designed to maintain all the services that were done there previously,” he said.
That’s where outpatient clinics will come in. But pediatric sub-specialists such as allergists are not available in abundance, and often not close to people's homes, doctors say.
Many outpatient and specialist clinics already have long wait lists and are in high demand, leaving many asking how thousands more children will be seen once the move is completed.
Dr. Barnes says the new rules have physicians at the Children's scrambling to find facilities where they can see patients. He warns the status quo will be upended in the next six months.
“It's the same doctors who are now going to be [looking for] adjacent facilities in order to be able to offer timely, accessible, quality care,” he said.
