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‘Just like Iron Man’: Calgary surgeon undergoes experimental spinal surgery

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Bill Graveland, The Canadian Press


Published Monday, February 18, 2019 10:29AM EST


Last Updated Monday, February 18, 2019 10:33AM EST

CALGARY — Dr. Richi Gill’s life changed in an instant.

The 38-year-old surgeon, who helped develop Calgary’s bariatric surgery program, was involved in a freak accident on a boogie board during a family vacation in Hawaii one year ago.

“The wave pushed me down instead of forward in pretty shallow waters. My head hit the ground and ended up breaking my neck,” Gill said following a recent physiotherapy session.

“I don’t have any movement or sensation below that injury level. I do have some use of my arms but not my hands.”

Gill described how he embarked on strenuous rehabilitation at Calgary’s Synaptic Spinal Cord Injury and Neuro Rehabilitation Centre, then headed to Thailand in October for experimental surgery.

An epidural stimulation implant was placed in his lower back. With the use of a small device like a remote control, the implant sends electrical currents to Gill’s spinal cord to stimulate nerves and move his limbs, bypassing the traditional brain-to-spinal-cord pathways.

The implant can be programmed to stimulate certain nerves mapped out by surgeons and therapists.

Gill said his middle of three children, Akaash, thinks the implant is cool.

“He’s very much like, ‘This is just like Iron Man! … We need the suit,” Gill said.

“He’s only seven so I think he might think there’s a suit that’s out there somewhere.”

The smile doesn’t fade from Gill’s face as, strapped into a harness, physiotherapists slowly help him walk with the use of a machine on wheels. Gill isn’t able to move his legs on his own, but by concentrating he is able to make his hip muscles flex and help himself along.

“Right now, realistically, assisted stepping is where I’m at and being able to stand with assistance. Will I be able to walk on my own? It’s a possibility. My main focus is just trying to improve day by day and we’ll see where that gets me.

“It’s definitely fatiguing because each time you try to take a step you have to really focus and concentrate to get that signal to the right spot.”

Gill spent $100,000 for the surgery and travel, since they weren’t covered by health care or insurance. He plans to return to Thailand later this year to have a second stimulator placed higher up on his spine.

His career as a surgeon is over, he said, but he hopes the operations in Thailand will help him regain some hand function and his overall quality of life.

The spinal surgery is also performed in a few other countries such as the United States and Switzerland, but it’s much cheaper in Thailand.

Only a half dozen people in Canada have had it done abroad and the number worldwide is about 30, said Dr. Aaron Phillips with the Cumming School of Medicine at the University of Calgary.

So few procedures having been done makes it harder to get approval from Health Canada or the Food and Drug Administration in the United States, he said.

Phillips has been involved in assessing the procedure for the last nine years.

“I’m just really overcautious about selling these things too early. And, although I am extremely excited about the potential of this therapy, it still needs to pass rigorous tests first,” he said.

“We don’t know if this will work the same way in everyone. We’re still dealing with very small numbers, although the initial findings are promising.”

Ryan Straschnitzki of Airdrie, Alta., the Humboldt Broncos player who was paralyzed from the chest down when the Saskatchewan team’s bus crashed last April, has become friends with Gill through the Synaptic clinic.

Gill has inspired the 19-year-old with his positivity.

“He’s able to do things he couldn’t do before. It’s amazing,” said Straschnitzki.

The executive director of Synaptic has seen a marked change in Gill’s abilities and has visited the medical facility in Thailand.

“Given the nature of Richi’s injury, there was no sensory and no volitional movement below his level injuries. This has allowed Richi to regain some of that function and to be able to command voluntary movement below his level of injury,” says Uyen Nguyen.

“This is not a cure. But from what we can see, this appears to be the most promising procedure for people with spinal cord injuries.”

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As shopping habits change, Ottawa targets credit card swipe fees

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The federal government is taking aim at credit-card transaction fees as shifting shopping habits resulting from pandemic lockdowns have substantially driven up costs for many small merchants.

The budget released this week promises the government will launch consultations aimed at lowering the average charges — known as interchange fees — paid by merchants every time a customer pays with a credit card.

Though federal officials plan to engage with stakeholders, including credit-card issuers and merchants, about possible changes, Monday’s budget also raises the threat of legislation to regulate fees “if necessary.”

This is the third time in less than seven years that the federal government has pressured credit-card companies to lower transaction fees, which vary between retailers, types of cards and payment methods. In 2014, there was an agreement reached with Visa Canada and Mastercard Canada to lower average fees to 1.5 per cent. Then in 2018 a five-year pact was struck that included voluntary commitments to lower average fees to 1.4 per cent, starting in 2020. (American Express struck a separate deal with Ottawa.)

But COVID-19 has rapidly altered consumers’ spending patterns, creating pressure to revisit that deal. Many of the interchange fees that were reduced applied solely to payments made in stores. As public-health restrictions have forced stores to limit access or close, fewer customers are swiping, tapping, or paying in cash. As a result, businesses are bearing the brunt of higher transaction fees charged for online purchases – unless they pass those costs on to customers by raising prices.

“The pandemic has been a huge driver of credit-card interchange [fees] as people have dropped cash and have moved online,” Karl Littler, senior vice-president of public affairs at the Retail Council of Canada, said in an interview. “It is a rapidly growing cost and was a rapidly growing cost even prior to the pandemic.”

The interchange fees paid by Christina Kotiadis, co-owner of Toronto gift store Lemon & Lavender, have gone way up during the pandemic. She built an online store for the first time to process e-commerce orders, and more customers who visit the store are tapping cards to make contactless payments. She also bought a mobile terminal to take payments anywhere in the store, or at the front door, which charges higher fees than the store’s plug-in terminal. For health reasons, she allows customers to pay with cards even for small purchases and absorbs the added costs.

“I refuse to raise prices. I don’t feel good about it. Everyone is trying to stay safe, and I don’t want to raise the fee because they don’t want to use cash,” she said.

Before the pandemic, about 60 per cent of payments at independent grocery stores were made with credit cards, and the rest with cash or debit cards, according to Gary Sands, a senior vice-president at the Canadian Federation of Independent Grocers. Now, more than 90 per cent of purchases are with credit cards as online ordering and curbside pickups become more popular, and the resulting interchange fees are adding up.

“It impacts prices, it impacts the ability of small businesses to stay in business,” he said.

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Ottawa considers taking action against ‘predatory lenders’

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Ottawa will consider lowering the maximum interest rate to stop the “predatory lending” of outfits that make high-interest loans, which anti-poverty advocates say have exploited Canadians during the pandemic.

In Monday’s budget, the federal government announced plans to launch consultations on lowering the “criminal rate of interest,” the maximum annualized interest rate for credit allowed under the federal Criminal Code.

For instalment loans — longer-term credit with high interest — lenders can charge up to 60 per cent annual interest under the usury rules.

Payday loans — high-interest loans that are typically due two weeks later — are exempt from federal rules under a 2007 amendment, if provinces have their own regulations for payday lenders, which all now do. 

Many low- or moderate-income Canadians rely on high-interest, short-term loans to make ends meet or for unanticipated emergencies, leaving them stuck in a cycle of debt, the budget states. 

Anti-poverty advocates have zeroed in on companies like Money Mart, Easy Financial, and Cash Money, accusing them of misleading advertising, not being forthright about the strings attached, and pushing borrowers to take out larger loans at the highest interest rates possible. 

They say the practices are continuing during COVID, when more Canadians than ever are facing financial hardship.

“They’re thriving, because they’re taking advantage of people,” said Donna Bordon, a member of the anti-poverty group, ACORN Canada. “People are afraid of losing their homes, so they borrow money from these places.”

The consultations are a “first step” in tackling predatory lending, Bordon said, adding she hopes they include more than industry representatives, who will sharply oppose any changes.

Despite low interest rates set by the Bank of Canada, poorer borrowers are more likely to lack the requirements to access safer loans from traditional banks. Instead, they seek quick cash from payday lenders, despite the risk of falling into debt they can’t escape.

In Ontario, for example, payday lenders can charge $15 in interest for every $100 over a two-week period — equal to an annualized interest rate of 391 per cent. 

Last July, the Ontario government capped the interest rate that lenders can charge on defaulted payday loans at 2.5 per cent per month. It also set a maximum fee of $25 that lenders can charge for dishonoured or bounced cheques, or pre-authorized debits.

In 2019, the Financial Consumer Agency of Canada found that two per cent of Canadians had taken out payday loans in the previous year. The percentage was even higher for Indigenous people, and low-income and single-parent households.

Last month, NDP finance critic Peter Julian tabled a private member’s bill to lower the maximum interest rate to 30 per cent, and to remove the exception for provinces that regulate payday lenders — measures ACORN supports.

The Canadian Consumer Finance Association, which represents payday lenders, said in a statement that while it’s still reviewing Monday’s budget, it’s opposed to lowering the interest-rate limit.

“Instalment loans are long-, not short-term loans, and they provide an important source of credit for many Canadians who cannot access credit elsewhere,” the organization said.

“Any reduction to the federal maximum interest rate will result in removal of access to credit for those Canadians with lower credit scores who previously qualified at the current rates. The government should not take any action that results in denial of credit to Canadians, or forces borrowers to access credit from illegal, unlicensed lenders.”

A survey of 376 ACORN members published by the group last February found 40 per cent of respondents were turned down by a traditional bank before taking out a high-interest loan. Seventeen per cent said they’re now unable to make repayments due to COVID-19.

The federal government should seek ways to provide alternative lines of credit to low-income Canadians, such as mandating banks to offer lower-interest loans, Bordon said.

Besides setting up a complaints process for consumer lending that’s stronger than the provinces’ systems, it should also consider postal banking for rural areas and small towns, she added.

The ACORN survey found that 70 per cent of its survey respondents had once turned to payday loans. Forty-five per cent had taken out instalment loans, an increase from a similar survey conducted in 2016, when only 11 per cent said they’d taken out such loans. 

ACORN represents low- to moderate-income Canadians. Sixty per cent of its survey respondents earn less than $30,000 a year.

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Federal budget 2021: Ottawa ties end of financial supports to completion of COVID-19 vaccination campaign

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The federal government will extend its business and income support programs until the country’s vaccination campaign is complete, but their subsidy levels will start to drop before the deadline for all Canadians to get their shots.

Finance Minister Chrystia Freeland’s budget, tabled Monday, sets Sept. 25 as the end date for the direct business and personal income supports the government introduced in response to the pandemic. That is in line with the end-of-summer deadline Prime Minister Justin Trudeau set for the completion of Canada’s vaccine rollout. It’s widely expected Canadians could also be sent back to the polls around that time.

The government proposes spending $15.1-billion more to extend the emergency support programs until September and create a new subsidy, which Ms. Freeland called a “lifeline” for Canadians and businesses in her speech to the House of Commons.

The budget also, for the first time, pegged the cost of Canada’s vaccine contracts at more than $9-billion; however, officials were not able to provide any details on that number, including how much has been already spent or allocated.

The Canadian Chamber of Commerce said it was encouraged by the extension of the business supports during the pandemic and cautioned against their hasty withdrawal. “The government must ensure that support is not being removed too early and that the level of support does not decrease too quickly,” president Perrin Beatty said in a statement.

On Monday, neither Ms. Freeland nor federal officials were able to explain why the Canada Emergency Wage Subsidy, the Canada Emergency Rent Subsidy, Lockdown Support and the Canada Recovery Benefit will all decrease before the vaccination program is expected to be complete. The government also did not say whether the decrease is based on metrics such as COVID-19 case counts or vaccination rates.

“No one knows for sure what the course of the virus and new variants will be, and that is why we are prepared to act further and to further extend the supports should the course of the virus require that,” Ms. Freeland said at a news conference.

The Canada Recovery Sickness Benefit and the Canada Recovery Caregiving Benefit are also set to end in September. If the pandemic gets worse, the government will introduce legislation that will allow it to extend those programs until Nov. 20.

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