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RCMP open probe of N.S. nursing home death

A police probe has been launched into the nursing home death of a “sweet” 79-year-old Halifax-area man, as his wife alleges he was pushed by another resident with severe dementia, fell and died later in hospital.

RCMP Cpl. Jennifer Clarke confirmed that Gordon Birchell died at the Ivy Meadows home on Oct. 29 and that police have opened a suspicious death investigation, but she declined to provide any further details.

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READ MORE: 8 have died in NS nursing homes due to violence from other residents since 2008

Joan Birchell, Gordon’s wife, said in an interview that she was told by a staff member that her husband was pushed on Oct. 24 at the home in the Halifax suburb of Beaver Bank by a female resident with severe dementia.

Birchell, 79, says her husband fell, hit his head and was hospitalized at the Cobequid Community Health Centre. He was returned to the home, where he died.

Birchell said her husband, who had an earlier stage of dementia, had been pushed by the same person on repeat occasions, including one occasion when she was present.

“The people who work there were told that … if she comes after him, you’re supposed to stop her from going near him,” she said.

“The public should be informed,” she said, regarding the Health Department’s decision not to release details.

READ MORE: Violent nursing home deaths in Nova Scotia prompt urgent calls for change

The woman also wonders why her husband was returned to the home after his initial treatment at the Cobequid Community Health Centre, rather than receiving further treatment in a larger hospital.

“They took him down to the Cobequid centre and glued his head back together again and … sent him back to the home,” she said.

Tracy Bonner, the administrator of the provincially regulated home — owned and operated by the Halifax-based Stevens Group — confirmed an investigation is underway and declined further comment.

The medical examiner, Dr. Matthew Bowes, said in an email that his office is still investigating the cause of death, while a Health Department spokeswoman said an investigation has been opened under its Protection of Persons in Care legislation into Birchell’s care.

Tracy Barron, the spokeswoman for the Health Department, declined to provide any further details.

In May, reported that to that date eight residents of nursing homes in Nova Scotia have died since 2008 due to aggression from other residents, raising questions about why the majority of the deaths were never publicly disclosed.

The list of death reports were provided through freedom of information requests made to the chief medical examiner, and included deaths at six homes at locations around the province, with some having multiple incidents.

Bonnie Cuming, a friend of Birchell, said she had visited him four days before his death and was shocked to hear he had died when her husband returned to visit on Nov. 11.

READ MORE: Nurse accused of killing 8 people at nursing homes in Ontario

Cuming said Birchell was a native of Newfoundland and Labrador and was a former maintenance worker at the school where her husband had worked.

“He was a nice man, a sweet, sweet man. … We’re just sick that he died in that way,” she said in a telephone interview.

Cuming said the Health Department should make brief notices to the public of pushing deaths that are the result of aggressive outbursts due to dementia.

The Nova Scotia Nurses Union has said on several occasions that the province needs to begin disclosing the nursing home deaths caused by pushing and other outbursts from residents with dementia.

Janet Hazelton, the president of the union, has said that at times there are cases that could have been prevented with additional staff and training.

The union has argued the lack of public discussion of pushing deaths adds to a lack of momentum for reforms that other provinces are already exploring or funding.

READ MORE: Spending details outlined for $14 M budgeted for N.S. seniors home-care

For example, the chief executive of the Ontario Long Term Care Association says a public inquest and recommendations from a committee formed by the Ontario chief coroner has helped bring attention to dementia-based aggression in nursing homes.

The Ontario Liberal government’s last budget provided $10 million a year for three years for programs that can help reduce aggression and other behavioural problems.

In an interview last May, Nova Scotia Health Minister Leo Glavine said he’ll “give every consideration” to changing the province’s current policy of not disclosing the nursing home deaths resulting from pushing and other aggression.

However, in an email, Barron said any consideration to changing the disclosure would only occur as the department develops its “continuing care strategy,” which is a five-year strategy the province expects to launch late next year.

Does Christmas make your kid overly demanding or ungrateful? Here’s what to do

Late night host Jimmy Kimmel proves ever year at Halloween that while some kids can handle loss and not getting what they want gracefully, others struggle to keep their emotions in check in his segment “I Told My Kids I Ate All Their Halloween Candy.” (See the video proof at the bottom of this article.)

And if kids can get that upset over candy, imagine how stressed out they may become if they don’t get what they want from Santa Claus for Christmas.

“We teach kids that Christmas is a time to get presents,” Natasha Sharma of NKS Therapy says. “So if it’s set up that way, then we need to tailor the expectations of [how our kids will behave]. Because yes, they will expect to receive gifts and I don’t think that’s being ungrateful.”

That’s not to say it’s OK if your child throws a tantrum or melts down because of what they find – or don’t find – under the tree. Far from it. But both Sharma and Kathy Lynn, of Parenting Today, say there are ways for parents to navigate and manage the potentially fraught scenario that is a demanding child during the holidays.

Is it just a phase?

The phase of children (or even young adults) expecting to get what they want whenever they want it can last as long as the first quarter of their lives, says Sharma.

“I’m speaking very generally because of course there are always exceptions,” Sharma says. “But generally the first 25 years of life are spent focusing on the self – and why not? You are alone… So I think it’s OK to place focus on yourself. But to be overly demanding and have high expectations, that’s where you run into trouble. For young people to have over-expectations in what they think they should be getting out of this world, that’s not a healthy thing.”

Lynn adds the peak for this type of demanding behaviour often happens when a child is six to eight years of age.

“They know Christmas is fun but they don’t [understand] it,” says Lynn. “It’s when they start to understand that when it’s Christmas and they’re going to get stuff, sometimes they get into the collecting rather than the appreciating.”

To help break the spiral, it’s often up to parents to teach their children to appreciate things early on.

Children’s Behaviour

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Children’s Behaviour

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Study looks at where rule breaking behaviour may come from



Broach the topic of Christmas early

“Parents should manage exactly what their expectations are around Christmas [with their kids well before the day comes],” says Sharma. “Christmas is setup in a way to create demand in young children and we’ve played a role in creating that expectation. So figure out what is normal and what is unacceptable behaviour.”

Sharma says that if a child’s behaviour is deemed unacceptable and/or bordering on ingratitude, try these three suggestions:

    Validate the disappointment in not getting what they wanted and not liking what they received as a gift;Teach them to be grateful for what they have because they could have a lot less – or nothing;Use the opportunity to teach kindness and sharing by having them donate the gift they didn’t like. This will teach gratitude and positive action.

Lynn adds that parents should continue to stick with a bedtime and mealtime routine, even if children are on holiday break from school.

“When kids’ schedules are thrown off; they are thrown off,” Lynn says.

And that’s when a bad attitude may rear its ugly head.

Lynn also suggests that parents get their kids involved in the holiday planning and prep.

“There’s a lot of things that they can be doing like sealing cards to making placement tags for the table to taking coats when people come to the door,” she says. “That allows us to express our appreciation and to let them know they’re part of a process. This also puts them in a situation where they’re not just getting everything, they’re also participating.”

Lastly, get children involved in situations where they give back – for example, have them volunteer at a soup kitchen or donate old toys.

“They’ll start to understand that on the one hand sometimes some people give them stuff, and sometimes they give people stuff,” Lynn says. “Kids should not only be receiving at Christmas, but giving at Christmas as well.”

What if none of that works?

Much like the children seen in Kimmel’s Halloween segment, some children exude certain types of alarming behaviour that may signal a bigger issue (think extremes like violence or withdrawing oneself from family activities because of disappointment).

If a temper tantrum is the kid’s reaction when not getting what they want (gift or otherwise), the best thing parents can do is keep an eye on the child to make sure they don’t hurt themselves, Lynn details in a blog post. She adds that parents should not try to talk to the child right away because they won’t hear you – instead, wait a few minutes.

Next, she says, remove them from the situation and put them in a quiet room or corner. This allows the child to regain control.

But don’t try to reason with the child, parenting author Alan Kazdin tells Parents长沙桑拿. “Once you’re in a situation where someone’s drowning, you can’t teach them to swim – and it’s the same with tantrums,” he says. “There nothing to do in the moment that will make things better… Once [s]he chills out, then you can talk.”

According to Kids Health, some preschoolers and older kids are more likely to use tantrums to get their way if they’ve learned the behaviour works, so don’t give into that pattern. If you do, you’ve proven the tantrum was effective. Instead, verbally praise the child for calming down and regaining control.

“Kids may be especially vulnerable after a tantrum when they know they’ve been less than adorable,” Kids Health says. “Now (when your child is calm) is the time for a hug and reassurance that your child is loved, no matter what.”

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B.C. chosen over Winnipeg and Saskatoon to host 2019 World Junior Hockey Championships

The cities of Vancouver and Victoria have been awarded the 2019 World Junior Hockey Championship on Thursday.

Hockey Canada’s Chief Operating Officer Scott Smith says they have reviewed multiple bids, but British Columbia’s bid came on top.

“It was the opportunity to bring this junior world championship to B.C. while they celebrated 100 years of hockey in the province.”

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  • Manitobans to try out for Canada’s World Juniors team

    B.C. hosted the Women’s World Hockey Championships in Kamloops in April and the 2006 IIHF World Junior Hockey Championships that were held in Vancouver, Kelowna and Kamloops.

    B.C.’s bid was in partnership with BC Hockey, the Victoria Royals, the Vancouver Giants and the Vancouver Canucks.

    “[The bid] had a ticket strategy with multiple tiers and really made family engagement a priority,” said Smith, adding the bid also had a great amount of provincial support.

    “All of that gave us a level of confidence that there would be an excellent legacy from this event that would be re-invested back into all levels of the game across Canada and internationally.”

    The announcement that was made at Rogers Arena in Vancouver meant a joint bid to bring the tournament to Winnipeg and Saskatoon has failed.

    True North Sports + Entertainment, which owns the Winnipeg Jets, the Manitoba Moose, MTS Centre and MTS Iceplex, partnered with Saskatoon Sports Tourism to try to land the 2019 World Juniors. The organization says the competition to host the tournament was extremely high.

    “Our fans can be proud knowing the Winnipeg/Saskatoon bid met or exceeded every measurable aspect of Hockey Canada’s criteria, leaving us well-positioned for potential bids for World Hockey Championships in the future,” said Kevin Donnelly, senior vice-president of venues & entertainment for True North Sports + Entertainment in a statement.

    READ MORE: Winnipeg, Saskatoon in the running to co-host 2019 World Junior Hockey Championship

Ontario’s election finance reform legislation passes unanimously

TORONTO – Ontario politicians now have one month left to get in a last kick at the fundraising can before they are banned from attending such events.

Legislation that dramatically alters the political fundraising landscape in Ontario unanimously passed Thursday, including banning corporate and union donations and lowering individual donation limits.

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Though all parties voted in favour of it, the leaders of the Progressive Conservatives and the NDP were quick to point out that the Liberals introduced the bill in the first place amid a cash-for-access scandal.

READ MORE: Ontario’s chief electoral officer raises concerns about proposed MPP fundraiser ban

The governing party was harshly criticized over fundraising events that saw cabinet ministers attend private, high-priced functions with stakeholders.

Under the new law, which comes into effect Jan. 1, members of provincial parliament, candidates, party leaders, nomination contestants, leadership contestants, chiefs of staff, premier’s staff and other party leaders’ staff are all banned from attending fundraisers.

Politicians could still, however, attend events where the ticket price only recovers the cost of hosting it, and solicit funds by mail, phone or email.

That strikes NDP Leader Andrea Horwath as a significant loophole.

READ MORE: Ontario government one step closer to banning politicians from fundraising

“You ban MPPs, cabinet ministers, from doing that direct ask, if you will, at a fundraiser…but you don’t stop them from picking up the phone and having the exact same conversation,” she said.

Attorney General Yasir Naqvi was not able to clearly explain Thursday the difference between soliciting donations in person and over the phone, and why one would be banned but the other accepted.

“Unless you’re suggesting that there should be no fundraising and political parties can only fund elections by getting money through public subsidy, that’s a whole different question,” he said. “Of course, there has to be some mechanism to raise funds. The new world, in my view, what that will look like is smaller donations from large groups of people just like the federal parties do.”

When asked if banning politicians from fundraising over the phone was just not enforceable, he said, “I’m not suggesting that, but I’m saying that is a big part of it.”

READ MORE: Ontario PCs say Liberals continuing to fundraise in secret

Progressive Conservative Leader Patrick Brown said on the whole it was a good bill bringing much-needed reforms, but banning politicians from fundraisers was overkill.

He will still be hitting up donors at fundraisers for the last few weeks that they’re legal, he said.

“I don’t apologize for being a worker bee,” Brown said.

Ontario’s chief electoral officer has raised concerns about the ban on politicians attending fundraisers, saying his office was not consulted on the rules before they were publicly announced, and it’s clear they will require a “significant amount of work” to administer.

READ MORE: Ontario MPP fundraising ban to include candidates, nomination contestants

And he didn’t find any other jurisdictions with similar rules in any other North American jurisdiction.

Under the law, political parties will be given a per-vote subsidy to offset the loss of corporate and union donations. Individuals will be allowed to donate a maximum of $3,600 in an election year, down from $33,250.

Restrictions are also now placed on the amounts that third parties can spend on political advertising during elections and the six-month period before scheduled general election periods, as well as limits to the political advertising spending of registered political parties in the six months before an election.

Alberta-wide checkstop blitz on Dec. 3 targets impaired drivers

Alberta RCMP are warning motorists about a checkstop blitz planned for Saturday, Dec. 3.

The large-scale operation will include hundreds of sheriffs from across the province working together to stop impaired driving.

RCMP said the checkstops will run throughout Saturday and into Sunday morning. Some checkstops will be mobile and moving locations in order to cover as much of the province as possible.

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  • Alberta RCMP charge suspected impaired driver with 3 young kids in van

  • 153 drivers nabbed in Alberta checkstop blitz

  • Calgary police crack down on commercial vehicles with week-long checkstop blitz

    Drivers suspected of being impaired will be subject to road-side sobriety tests that may result in immediate licence suspensions and/or criminal charges.

    READ MORE: Calgary police crack down on commercial vehicles with week-long checkstop blitz

    “Having a checkstop blitz in early December provides a very visible reminder that the RCMP, with the help of the Alberta Sheriffs, will be out on the roads throughout the holiday season on the lookout for impaired drivers,” Insp. Steve Daley said in a Thursday news release.

    The blitz is part of the RCMP’s National Day of Enforcement campaign and serves as the kickoff for Impaired Driving Enforcement Month.

    Although this specific event takes place this weekend, RCMP said it marks the beginning of a month of increased and enhanced checkstops throughout the province.

    The blitz comes as the provincial government and anti-impaired driving activists are reminding Albertans driving after smoking marijuana is no safer than driving drunk.

    On Thursday, the province issued a news release with figures it says backs up its claim. According to the government, 82 Alberta drivers killed in collisions in 2012 tested positive for drugs. By comparison, 71 drivers who died in crashes tested positive for alcohol that same year.

    READ MORE: 153 drivers nabbed in Alberta checkstop blitz

    “While society has made significant inroads against impaired driving, drugged driving is on the rise and Albertans need to be aware of that,” Transportation Brian Mason said in the statement. “In the eyes of the law, there is no difference between drunk driving and drugged driving. That is because alcohol and drugs impair a driver’s ability and increase the risk of an otherwise fully preventable crash.”

    According to the province, driving performance studies have shown cannabis use increases the likelihood of drivers swerving, having difficulty keeping a safe distance from other vehicles and speeding.

    “While SADD (Students Against Destructive Decisions) Alberta continues to raise awareness about the dangers of drinking and driving among Alberta’s youth, we have received alarming feedback about the increase of drug-impaired driving and the casual attitude many young people take toward the risks associated with it,” SADD Alberta’s Arthur Lee said in a statement. “Drug-impaired driving will likely surpass alcohol-impaired driving soon and it’s a topic we’re going to address with our Alberta schools going forward.”

    According to the RCMP, 3,880 people were charged with impaired driving between Jan. 1 and Oct. 31, 2016. Of those, 11 were charged with impaired driving causing death and 29 were charged with impaired driving causing bodily harm.

    With files from Phil Heidenreich

Alberta reports 1st flu death of 2016-17 season in Calgary

One person with the flu has died in the Calgary area, Alberta Health Services said Thursday.

It’s the first reported death of someone with lab-confirmed influenza in the 2016-17 flu season.

READ MORE: Calgary hit hard this flu season

An AHS spokesperson said they would not release the person’s gender and age due to privacy concerns.

The patient died on or before Nov. 26 after being hospitalized with the flu diagnosis, AHS said.

“Even healthy people can get influenza and have bad outcomes,” Dr. Judy MacDonald, medical health officer with Alberta Health Services, said. “It is important that people take influenza seriously. It’s not a walk in the park. It’s not just a sniffle or two.”

Calgary has been hit harder than Alberta’s capital city this year: there were 245 lab-confirmed cases of influenza A and three of influenza B in Calgary, compared to just 24 cases of influenza A and four of influenza B in Edmonton as of Nov. 26, AHS said Thursday.

Eighty people had been admitted to hospital with the flu in Calgary, compared to just 12 in Edmonton.

Watch below from Nov. 25: The flu is hitting Alberta hard this year and the number of people sick is much higher now than the same time last year. As Kim Smith explains, most of the confirmed cases are in Calgary.

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  • Near-fatal bout with H1N1 spurs Edmonton teacher to promote flu shot

    According to Dr. Gerry Predy, senior medical officer of health with Alberta Health Services, the virus hit the Calgary region first this year before spreading elsewhere.

    “When influenza hits the province, it starts in one part and then spreads from there,” Predy said in a past interview.

    READ MORE: Flu arriving ‘a little early’ in Calgary this year, says AHS

    Last year, 62 people in Alberta died after contracting the flu.

    MacDonald said some people are at a higher risk of complications from influenza.

    “Young children, especially those under two years of age, elderly individuals 65 and older, people that have heart disease, lung disease, diabetes, pregnant women… Those are all of our higher risk groups,” she said.

    “If they get it, they may be more likely to be hospitalized and have severe outcomes.”

    The massive spike in Calgary means pharmacists are fielding more questions about the vaccine.

    One of the most common questions, according to pharmacist Kaylyn Bassett, is whether a person can get sick from the flu vaccine.

    “What people have told me is, ‘Well, you know a week later after getting the flu shot, I got the flu.’ That is a total coincidence,” Bassett said.

    “Keep in mind that it can take about two weeks for the flu shot to actually become effective. So make sure you get it early.”

    With files from Global’s Kim Smith

    Watch below: Alberta has recorded its first flu-related death this flu season. The victim was a person in Calgary. But more Albertans are getting their flu shots. As Su-Ling Goh explains, some say convenience may be playing a role in that difference.

Kelly Ripa won’t rule out Billy Bush, Kardashians for ‘Live!’ co-host

Currently solo Live! host Kelly Ripa, whose former co-host Michael Strahan vacated his co-hosting spot in May, revealed a list of potential candidates for his replacement on Watch What Happens Live on Wednesday.

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She admitted to WWHL co-host Anderson Cooper that he was her top choice to replace Strahan, but also named several others who could potentially take the chair next to her.

Ripa, 46, joked that Cooper was “the one that got away.”

READ MORE: Kelly Ripa returns to Live!, speaks her mind about Michael Strahan departure

“He’s my life,” she said. “He really is. He’s the one that got away and keeps getting away and gets away all the time.”

“We really didn’t set a timeframe for ourselves, we just wanted to wait until we found the right person,” she continued. “What we didn’t anticipate was that we would have such an outpouring of interest. Our list got very long very quickly. We’ve been trying to keep it as narrow as possible, but then people pop up.”

Some of the candidates for co-host that Ripa wouldn’t rule out include Billy Bush (who recently left the Today show amid the Donald Trump “grab her p***y” scandal), the Kardashian sisters, Kathie Lee Gifford, Ramona Singer and even troubled starlet Lindsay Lohan.

WATCH BELOW: The Kelly Ripa-Michael Strahan debacle

‘You changed my life’: Michael Strahan bids fond farewell to co-host Kelly Ripa

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‘You changed my life’: Michael Strahan bids fond farewell to co-host Kelly Ripa

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Kelly Ripa returns to ‘Live’ and opens up about Michael Strahan’s departure



Live! is filmed in New York City, but lately there have been rumours that the show might relocate. Ripa says that’s most likely not going to happen.

“I have not heard that rumour,” she said. “That sounds like a rumour I would start, but I did not hear that rumour and I can’t imagine [it]. We’d have to do the show at 6 a.m. and getting guests to come on at 9 a.m. can be challenging. So, 6 a.m., I think, would be out of the question.”

Ripa was shocked at the initial news that Strahan was leaving his post to co-anchor Good Morning America, claiming she wasn’t told by the network or Strahan about his decision with enough advance notice. She says she was only told about Strahan’s September 2016 move to GMA less than an hour before the news about his promotion leaked to press.

READ MORE: Kelly Ripa comes clean about Michael Strahan Live! departure

Ripa abruptly took a week off of Live! following Strahan’s announcement to deal with what she felt was a slight; she received a personal apology from top executives at Disney and ABC after the incident, who said they “expressed regret for the way Kelly was told the news.”

“I needed a few days to gather my thoughts,” she said, explaining her absence. “After 26 years with this company, I earned the right.”

Ripa said the mishap was important because it opened up a conversation with ABC about mutual respect. Despite it all, she has had time to digest the situation and holds no hard feelings against the show, Strahan, or the executives.

“I’m not dealing with monsters,” she said. “I don’t think of anybody as a monster or out to get me. But sometimes stability and dependability can be misinterpreted as passive. Like, ‘Oh, we don’t have to worry about her, she’s fine. She’s fine.’ And I am fine, but I need assurances that we’re all going to be fine.”

Ripa has been a co-host of the show since 2001 when she shared the screen with Regis Philbin.

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Most common fertility treatments: how they work and how much they cost

This is the latest article in a Global News investigation into fertility in Canada, and the emotional and financial impact infertility has on Canadians struggling to conceive.

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It took Rebecca Nielsen a lot of fertility treatments to become a mom last fall.

The 41-year-old and her husband Kevin, who is a Global News employee, a met in 2009. In 2010, when she was 35, they stopped using birth control. A year later, ovulation trackers and scheduled intercourse became part of their lives.

“Your prime conception years physically are between 18 to 24,” she acknowledged, “when you’re doing everything you can not to get pregnant.

“Then you’re in debt. Then you break up with your long-term boyfriend and need to ‘find yourself.’ Then you find ‘the guy.’”

By 2012, the two had tied the knot but were still struggling to make a baby.

Some couples in this situation turn to naturopaths, acupuncturists or chiropractors who specialize in fertility.

Others try to improve their chances of conception by making certain lifestyle changes (like healthier eating and cutting out certain vices), which sometimes works. Not for the Nielsens, though.

WATCH: How to have a baby: Fertility clinic founders share 5 dos and don’ts

Their family doctor suggested they reduce their stress levels and just keep trying. When a year of that didn’t work, the couple got a referral to the big guns: the Hannam Fertility Clinic in Toronto.

Nielsen estimates she had to go there every other day — either for blood work, ultrasounds or procedures — over the two years that followed. She thinks the parking alone cost her about $3,500.

The whole process cost the couple roughly $100,000, since it was before Ontario introduced fertility funding. A lot of that was reimbursed through Nielsen’s drug plan and tax credits. Family also helped.

As is the protocol with all new patients, the first step is a battery of fertility tests to try and figure out what the problem is.

“For example, if someone comes in and turns out their thyroid is unbalanced, we help them with their hormone level and they’re more likely to get pregnant naturally,” said Tom Hannam, the clinic’s founder and one of its doctors.

“Everything’s linked to everything else.”

In rare cases, if there’s a problem with the uterus or fallopian tubes, surgery might be needed.

In the Nielsen’s case, the test results were inconclusive.

So a series of “chemical cocktails” started off their treatment.

A cocktail of fertility drugs

“I was taking at one point, a vitamin mix cocktail that was a combination of 13 pills,” Nielsen said. “I used to joke you’d hear me walking down the hallways because I had so many pills in my stomach.”

That particular chemical concoction included prenatal vitamins, CoQ10, Omegas, iron, vitamins C, D and B12.

Fertility doctor Ellen Greenblatt, who’s the medical director of the Mount Sinai Fertility and IVF unit, explains there are three classes of fertility drugs:

    Oral  — tablets like clomiphene citrate (aka “Clomid” or Serophene)Off-label — letrozole (a.k.a. Femara, which is similar to clomiphene but it’s “off label,” meaning it’s traditionally used for something else — in this case to prevent breast cancer recurrence — but has been shown to also help treat infertility.) At one point Nielsen was put on HGH (human growth hormone).Injectable — a range of gonadotropins like Gonal-F, Puregon and Menopur.

Gonadotropins

Caitlin Dunne, Vancouver fertility doctor

The drugs taken (and in what dose) are dependent on the treatment, how many eggs a woman has to begin with, where she is in her cycle and what shows up in her blood work and ultrasounds.

For instance, the tests might show the uterine lining needs to be thicker in order to create an optimal environment for embryo implantation. The prescription would be adjusted accordingly.

Nielsen’s “drug cocktail” would sometimes include a combination of pills, patches and injections. Each came with their own side-effects.

“You don’t feel like yourself because you’ve been so pumped of hormones,” she admitted. “You’re tired, you’re lethargic.”

IUI — ‘Sending in the marines’

Apart from fertility drugs, the first line of offence Nielsen’s doctor recommended was intrauterine insemination (IUI). It’s a common treatment for couples with unexplained infertility that can range in price from $1,500 to as high as $4,000 in Toronto, and is often paired with a $500 sperm wash.

“It’s like sending in the marines,” Nielsen said.

“They take the best, smartest, strongest and fastest — the few, the proud, the brave —and send them in on a covert mission and hope they’re successful.”

Human sperm swimming in the fallopian tube approaching an ovum prior to fertilization.

Science Picture Co

Once the model swimmers are chosen, they’re given a little boost and shipped into the uterus through a tiny catheter that Nielsen recalls being only slightly thicker than a strand of hair and feeling no worse than a pap smear.

The hope is that the sperm will make it to the egg and fertilize it naturally.

An ultrasound technician watches a monitor to ensure the catheter releases the “marines” at the right place, while the patient lays back with their feet in stirrups.

“Then you go home and you cross your legs and you hope it takes.”

The other alternative, if there’s male factor infertility or in the case of a female same-sex couple, is to use donor sperm. Sperm is ordered from sperm banks in the U.S., that offer profiles of the donors, and then shipped to a fertility clinic.

Sperm bank. Samples of cryogenically stored sperm being removed from the storage tank. This container is filled with liquid nitrogen, which keeps its contents at almost -200 degrees Celsius. After a sample is removed and thawed, the most healthy sperm cells are selected by a computer imaging system and then used for in vitro fertilisation (IVF) to treat infertile couples. Storage of frozen sperm can preserve a man’s ability to have children if his fertility is threatened by cancer of the testis. Use of sperm from an anonymous donor can also help couples where only the male partner is infertile.

While the effectiveness of any treatment always goes down with age, IUI’s average success rate is said to be 12 to 15 per cent per cycle. It drops to about five per cent per cycle for women around 40, according to Greenblatt.

Nielsen, then 37, tried four rounds of IUI within six months in 2013. They were all unsuccessful.

WATCH: Fertility treatment success rates, explained by Dr. Caitlin Dunne of the Pacific Centre for Reproductive Medicine in Vancouver

IVF, the final frontier

Nielsen hoped for a better prognosis with in vitro fertilization (IVF). It’s the most expensive fertility treatment but also has the best odds.

IVF is paired with the injectable gonadotropins that stimulate the ovaries to produce, on average, eight to 15 eggs (compared to the standard one egg that’s released a month).

Donor eggs can alternatively be used if needed. However, it’s important to note you cannot pay anyone to be an egg donor in Canada. So any exchange would have to be altruistic.

The donor would have to undergo a round of IVF for the eggs to be harvested, so it’s also not cheap.

Harvested human eggs. These eggs will be used for in vitro fertilisation (IVF) treatment.

Fortunately, Nielsen didn’t have problems producing eggs. That first round she “whipped out” 18 of them. The ultrasounds showed her ovaries, which are typically the size of a walnut, grow to the size of chicken eggs.

She compares it to having swollen glands when you’re sick.

“You could physically feel them. They feel really heavy and sore.”

In IVF, eggs are extracted with a needle from a woman’s body. Nielsen remembers being in “more of an operating theater” rather than an exam room for this procedure.

“They sedate you but you’re not completely out of it.”

She recalls “a lady with a light on her head talking to me, saying, ‘everything is good.’”

The “exciting” part for her was finding out how many eggs were retrieved. Of the 18 she produced, 14 got fertilized right away.

There are two fertilization options in IVF. One is for the eggs to be put into a dish and sprinkled with some 100,000 sperm in hopes they’ll fertilize the egg “naturally.”

The other, which comes at an additional cost of about $1,500 and the one which Nielsen opted for, is called intracytoplasmic sperm injection, or ICSI (pronounced ‘ick-see’) for short.

As its name suggests, fertilization occurs by injecting the sperm into the egg to guarantee fertilization. At this point, Nielsen didn’t see the point of leaving that to chance.

Intracytoplasmic Sperm Injection (ICSI) is an artificial fertilization technique. A single sperm is injected into the cytoplasm of an egg, via a microneedle. This technique is used in treatment of severe male infertility.

Getty Images

But fertilization doesn’t mean pregnancy. The embryos need to make it to Day 5 or 6 before being transferred to the uterus (called a fresh transfer) or frozen (called a frozen embryo transfer).

Only four of her 14 embryos reached any of those benchmarks. Two were put on ice (to be thawed and transferred later), and two were put in “fresh.”

None of them took. And there were no answers why.

“The cells may not divide and it may just not work,” Nielsen said.

“You don’t know why it doesn’t work… it just doesn’t work.”

WATCH: The highs and lows of IVF

After that, the Nielsens decided to try one more round of IVF, but this time, they paired it with something called pre-implantation genetic screening (PGS) also known as comprehensive chromosome screening (CCS).

It cost about $5,000, on top of the $23,000 the couple was already paying for the second round of IVF. However it increased their chances of conception to 72 per cent. Other couples may see an average success rate of 60 to 70 per cent with the screening, according to fertility doctor Caitlin Dunne of the Pacific Centre for Reproductive Medicine in Vancouver.

At the time (in 2014, when Nielsen was 39), the test was not recommended as an add-on for “genetically healthy” couples. Dunne says it’s now considered to be “most helpful” for women over 38 who make more than two embryos through IVF.

It involves a small biopsy of cells from what would become the placenta in each embryo. The samples are then sent to a lab, where they’re analyzed for a variety of chromosomal and genetic defects.

“What came back three weeks later,” Nielsen said, “freakin’ blows my mind.”

Of the eight embryos they had analyzed, all but one had chromosomal problems that would have either resulted in a failed implantation, a miscarriage or a baby with Down Syndrome.

The test saved them potentially multiple rounds of “heartbreak.”

Nielsen got emotional when she spoke about the day that “one genetically perfect embryo” was transferred.

“This is the magical part for me,” she said before taking a big breath.

“They put you on the gurney and wheel all the equipment into this room. There’s an incubator and on top of it there’s a flat screen TV.”

As she held her husband’s hand, an image of the embryo they were about to put inside her was put on the screen.

“I may have just seen the first picture of my daughter and she hasn’t been born yet,” she recalls thinking.

An ultrasound of Baby Margaret

Supplied

Nine months later, her beautiful baby Margaret was born healthy, happy and “chatty.”

Nielsen says the past 14 months with her now “super funny” toddler made the emotional roller-coaster and huge financial cost all worth it.

“The crazy part? I want to do it again,” Nielsen said.

“Don’t tell my husband.”

WATCH: Mother shares her advice to couples who are just about to start fertility treatments

The infographic below takes a closer look at the most common fertility treatments,  which can either be used alone (like tablets) or in conjunction with other treatments.

Dunne explains the most common treatment combinations in the video at the top of the story.

Infographic by Deepak Sharma, Global News

READ MORE: How fertility coverage varies across Canada 

Follow @TrishKozicka

Related

  • Surrogacy in Canada: What you need to know

  • 3 birth moms and 2 parents: how open adoption worked for an Alberta family

  • Everything men and women should know about fertility testing

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Prince Harry and Rihanna take HIV tests in Barbados for World AIDS Day

Prince Harry and Rihanna have joined forces to promote the ongoing need for action in the fight against HIV/AIDS.

In light of World AIDS Day, the 32-year-old red-headed royal and 28-year-old pop star took finger prick tests at the Man Aware event in Bridgetown, Barbados, where they both tested negative. “You made it seem like it hurts,” Rihanna said to Prince Harry. “It’s not as painful as you said this morning.”

READ MORE: Prince Harry And Rihanna celebrate Barbados’ 50th Anniversary Of Independence with concert and fireworks

This marks the second time in five months that the young royal has taken a test in public to lessen the stigma surrounding the disease. Back in July, Prince Harry shared a video to the British Royal Family’s official Facebook page getting an HIV blood test.

As part of his 15-day royal tour of the Caribbean, which will wrap in Guyana this weekend, Prince Harry also attended an annual Toast the Nation event in the Barbados capital in celebration of the country’s 50 years of independence, which Rihanna attended.

READ MORE: Prince Harry meets Rihanna as Barbados celebrates 50 Years Of Independence

During the event, the prince read a message on behalf of his grandmother, Queen Elizabeth II, which paid tribute to the people of Barbados: “Prince Philip and I send our warmest wishes to the Government and the people of Barbados. On this day of celebration, I send my congratulations to you on your Golden Jubilee of Independence.”

Prince Harry and Rihanna later shared the stage at a concert Wednesday evening on the Kensington Oval cricket grounds, where Rihanna sang the Barbados national anthem and Prince Harry gave a welcome speech in front of a crowd of approximately 20,000.

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11,500 Alberta open-heart surgery patients potentially exposed to bacteria

Approximately 11,500 former open-heart surgery patients may have been exposed to bacteria during their procedure, according to Alberta Health Services.

AHS is notifying former patients after the Federal Drug Administration, Center for Disease Control and Health Canada reported a potential risk for Mycobacterium chimaera infection with certain heater-cooler units.

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Notifications are being mailed to Alberta physicians and former adult and pediatric open-heart surgery patients who had their procedures done at the Foothills Medical Centre in Calgary, Edmonton’s Mazankowski Alberta Health Institute or the Stollery Children’s Hospital in Edmonton. Potentially affected patients in Edmonton would have had their surgery between January 2012 to present while potentially affected patients in Calgary would have had their surgery between January 2013 and present, according to AHS.

Watch below: AHS said open-heart procedures are not possible without this piece of medical equipment. As such, AHS said it will do everything it can to minimize the risk until the companies who make the equipment come up with a fix.

Dr. Mark Joffe, AHS senior medical director in infection, prevention and control, said the hospital was first alerted by Health Canada about five weeks ago.

When asked why there was a delay in reporting it to the public, Joffe said the procedure for doing that is complex.

“AHS began to review our own situation. We need to be able to support patients, guardians and parents of children who may have had surgery. We need to make sure everything is in place before we put out this notification,” he said.

The risk comes as a result of heater-cooler units that are critical for cardiac surgery. The units are used to warm and cool blood during adult and pediatric open-heart surgery.

“The device has a reservoir that contains water. At the same time, [it] has to maintain its own temperature so it has an exhaust system to keep the machine from overheating,” Joffe said.

“There is a very small potential for water, a very small amount of water, to leak into the exhaust system of the heater-cooler unit and then that is exhausted into the airflow within the operating room.”

Joffe said the circumstances for this potential type of exposure are unique.

“Where there happens to be the growth of this particular bacteria, within that water reservoir, if enough of it happens to leak into the exhaust system of the heater-cooler unit, if it’s directed in the right way into the airflow within the operating room – it could land inside the surgical site, in an individual who’s having a surgical procedure.”

Watch below: AHS says infection is very slow to develop

The machines are only used in three facilities in the province: at the Foothills Medical Centre in Calgary and the Mazankowski Alberta Health Institute and Stollery Children’s Hospital in Edmonton.

Joffe said there is no exact number on how many patients are in Edmonton or Calgary, though the Edmonton program is larger so more patients from the Capital Region may be impacted.

He said there is also no exact number for how many patients are adult and how many are pediatric. He said about 10 per cent of open-heart surgery patients in general in the province are children.

Joffe said there is an extremely low risk of infection to those who may have been exposed, adding it is less than one in 1,000. He said no infections have been identified to date. M. chimaera infections grow slowly and may take months or years to develop.

“On average it develops approximately 18 months after surgery. It could start earlier, [after] a few months. It can even go out to five years after the surgery,” Joffe said, adding it can be fatal.

“This would be the type of infection that will begin slowly, will gradually get worse. An individual with that kind of infection would find their health deteriorating, declines over a period of time.”

Symptoms include fever, persistent and profuse night sweats, unintentional weight loss, muscle aches, fatigue and red, heat or pus at the surgical incision site. Joffe said it cannot be spread by person-to-person contact but it can be treated with antibiotics.

At this point, Joffe said open-heart surgeries are critical and there have always been risks involved with the procedure. AHS will continue using the heater-cooler units and advise patients of the risk involved.

“At this point Health Canada has issued some recommendations that we are following. Primarily, that involves ensuring we are following manufacturer instruction for disinfection, cleaning, maintenance of the equipment. There is a risk mitigation strategy whereby we try to ensure that the machines, these heater-cooler units are positioned in the operating room and the exhaust is directed away from the patient instead of potentially towards the patient,” Joffe said.

He adds manufacturers are expected to come up with a fix for the issue, such as a better filtration system, which is expected in the next few months.