Woman living in chronic pain says N.S. health care plagued by sexism, ageism and 'dangerous' apathy

Laura O'Byrne chokes back tears as she recalls walking the woodsy trails of Nova Scotia's South Shore with her two mastiffs just over a year ago, having finally realized her dream of retiring by the ocean.

But now, the 58-year-old spends most days lying down with excruciating pelvic pain in her home in Shelburne County, unable to bend over to tie her shoes and wearing a diaper due to urinary incontinence, often crying about the uncertainty of her health.

O'Byrne said it doesn't have to be this way, but Nova Scotia's health-care system has failed her at every turn.

"It's been a nightmare," she said. "This is straight-up negligence."

O'Byrne has countless fibroids — growths around her uterus, which itself is three times larger than normal — and a large ovarian cyst. 

But she's met a number of roadblocks in treating her issues, including being dismissed by a Nova Scotia gynecologist and denied an out-of-province claim to MSI for an urgent hysterectomy to remove her uterus in her home province of Manitoba.

O'Byrne is one of a number of Nova Scotia residents CBC News has spoken with in recent months who have sought out-of-province services because they aren't able to access care in a timely manner, just as women across Canada face disparities in accessing health care.

O'Byrne's pain started in October 2023. She doesn't have a family doctor, but was seen by a primary care provider who referred her for an ultrasound. It showed she had "too many fibroids to count."

She was referred to a gynecologist in Yarmouth, but waited nearly eight months for that appointment. When she finally saw the gynecologist in May 2024, O'Byrne said the doctor dismissed her concerns, telling her that fibroids don't cause pain. According to the website for Nova Scotia's 811 nurse helpline, fibroids can cause pain in the lower pelvis, the back or legs, as well as a feeling of pressure in the bowel and the constant feeling of needing to urinate.

A subsequent CT scan confirmed O'Byrne also has a large ovarian cyst. During a followup appointment with the same gynecologist in August 2024, O'Byrne requested a referral for a uterine fibroid embolization, a minimally invasive procedure known to shrink fibroids.

"Due to my age, she didn't think that I should get that procedure and that was it," said O'Byrne, adding that the doctor "basically fired me" and told her to find another gynecologist to refer her.

Seeking care outside of N.S.

According to a May 2024 study by the Fraser Institute, the median wait time in Nova Scotia for treatment after an appointment with a gynecology specialist was 33.6 weeks in 2023, the longest in the country.

Unable to fathom the possibility of waiting months to see another Nova Scotia gynecologist, and amid worsening symptoms that brought her to the emergency room four times over the summer, O'Byrne contacted her former gynecologist in Manitoba in early September.

She said the doctor confirmed fibroids and ovarian cysts can cause severe pain and sent a letter to the QEII Health Sciences Centre requesting a uterine fibroid embolization, but the head of gynecology replied that O'Byrne would need to be referred for the procedure by a Nova Scotia doctor.

An interventional radiologist at the hospital did, however, agree to send her for an MRI, which showed in detail how bad the problem was.

Her Manitoba doctor then determined O'Byrne needed an emergency hysterectomy due to her growing fibroids, including one that had reached 8.6 centimetres and was at risk of being cancerous.

She sent an urgent referral to MSI for an emergency hysterectomy to be performed in Manitoba, with travel expenses and accommodations to be covered by MSI. The claim was denied because hysterectomies are a procedure that is offered in Nova Scotia.

"I cried. I was angry," said O'Byrne, who had to pause during the interview because of her pain. "I have lived my life playing sports and hiking…. It's all gone. I can't even pull a weed out of my garden."

MSI told her she could pay out-of-pocket to have the procedure in Manitoba, but she doesn't feel that's right in a country with universal health care.

"Everyone is struggling right now with the cost of absolutely everything. And I'm retired and I don't have any family left in the other province," said O'Byrne. "It shouldn't have gotten to this point."

Throughout her career, O'Byrne worked as a manager in the health-care sector in several provinces including Manitoba and the Northwest Territories. 

"I can say that the level of negligence in Nova Scotia is horrific," said O'Byrne.

"The quality of care is apathetic and it's dangerous…. In the end, patients are suffering, hopefully not dying, but that's certainly going to happen if you're not getting proper care."

In order to have a hysterectomy in Nova Scotia, O'Byrne would first need to find another gynecologist in the province who would then need to recommend she have the surgery.

According to Nova Scotia's website that tracks wait times for medical procedures, 50 per cent of patients in the province received a consult for a hysterectomy with no cancer suspected within 77 days and surgery within 111 days. In cases where cancer was suspected or proven, 50 per cent of patients had a consult within 15 days and surgery within 35 days.

Nova Scotia's Health Department declined a request for an interview. But in a statement, the province said requests for out-of-province care start with a referral from a Nova Scotia specialist, who determines what care is needed and where it can be provided. If it can't be provided in Nova Scotia, the province will pay for the treatment where it is available.

The department added that it is reviewing the processes for evaluating claims for out-of-province travel for medical services.

"Government has also put interim measures in place to provide additional scrutiny on all evaluations to ensure decisions are patient-focused and explore all possible options thoroughly before a claim is denied," the statement said.

Disparities in women's health care

O'Byrne also spoke about systemic sexism and ageism in the health-care system overall, having felt dismissed by many health-care professionals and not taken seriously.

"Being female and being treated as less than, let me tell you, sexism and ageism is alive and well," she said.

The Society of Obstetricians and Gynaecologists of Canada notes that although women make up half of the country's population, significant inequities persist when it comes to their health, a reality known as the "women's health gap."

In a submission to the federal government for the 2025 pre-budget consultations, the society said women spent 25 per cent more of their lives in "poor health" compared to men, according to a 2024 study from the McKinsey Health Institute.

It makes a number of recommendations to improve health care for women, including providing funding to provinces and territories to address surgical wait times for obstetric and gynecological procedures.

"Prolonged wait times can worsen medical conditions and lead to potential complications that could be avoided with more timely intervention," the submission said.

"More creative solutions must be found to ensure that women have equitable access to necessary health procedures for their unique health needs."

O'Byrne has appealed MSI's decision to deny her out-of-province service claim, but she's not holding her breath.

As she repositions herself on a reclining chair — the fibroids and cyst cause too much pain for her to sit upright — O'Byrne said she hopes speaking out will help others.

"I'm normally a very happy person, I'm a very laid-back person, but I'm missing out on life."