Cassie Walde is, in many ways, a typical young woman: she has her own apartment in Burnaby, she's recently started taking college classes, and she's excitedly planning for her future.
But Walde, unlike most young 20-somethings, spends much of her free time going to doctors' appointments and dealing with ongoing pain and discomfort - and writing letters to lobby the provincial government to help with mounting medical bills for extensive dental work she needs to have done.
It's an uphill battle, she says, and one she knows she may not ultimately win.
"I know I'm not the only one who's made this argument, and I've been told not to expect (the government) to change their mind, but I feel like I have to try - I have to keep going," she said.
Two years ago, Walde had a life-changing accident that left a large portion of her jaw completely shattered. Since then, she's faced hospital stays, reconstructive surgery and bone grafts to repair the damage, all of which was covered under her provincial MSP coverage.
But to get seven new teeth to replace the ones she's currently missing in her mouth will cost her about $35,000 out of pocket because they're classified as "dental" and not "medical," despite the fact that her doctors have argued that the teeth are a medical necessity since her bone grafts will continue to degrade and need to be redone repeatedly without them.
She currently has an infection in the bone graft, and the graft itself will disintegrate over time without new teeth to keep it in place.
But the teeth, without which she also can't chew on that side of her mouth, have been deemed cosmetic, she says.
She's been hesitant to go public with her story, because the details surrounding the accident are hard for her to talk about and may spark judgment from those who encounter her.
"I'm hard-working, I'm responsible, I'm not stupid, and I want to contribute and be part of the world," she says.
But two years ago, Walde says she made a bad decision that altered the course of her life.
She and a friend had purchased a product called salvia, a species of sage that belongs to the mint family, in a Vancouver shop. When smoked, it can produce a high that may include hallucinations and out-of-body experiences, though it may also produce little more than a slight "buzz" depending on the person and situation.
In Canada, it meets the definition of a natural health product but hasn't been technically authorized for sale. Though the federal government has said it will move to make the product illegal, it isn't currently, and it's readily available at smoke shops and online. A Health Canada survey in 2010 suggested that nearly seven per cent of Canadian youth had tried salvia at one time or another.
Walde said she had previously tried it a couple times with friends but, one day while home alone and feeling down, she decided to have some.
She remembers feeling an overwhelming anxiety and walking to the bathroom - and then she woke up, on the sidewalk three floors down from her apartment window.
"It was terrible. I was just screaming for help, and I knew right away what had happened," she recalls.
She was taken to hospital, where scans showed that her jaw was "basically dust." She required a tracheostomy to allow her to breathe and had to leave school and move back in with her family while she recovered.
Walde acknowledges it was her decision to take salvia but says it's not representative of who she is today.
"Compared to who I was two years ago, I feel like I've become a lot more responsible - I'm interested in what's going on in the world, and what's happening in society. And I need some help to get things back on track," she said.
Walde said her family has been "wonderful," helping to organize fundraisers in her hometown of Chilliwack to help with some of the initial costs associated with various procedures.
"I don't come from a very wealthy family, but they've been very, very supportive," she said.
Now she's hoping to find a little support from the Ministry of Health.
She recently wrote to the ministry, asking for her case to be reviewed in hopes that at least a portion of the "cosmetic" dental work could be covered under medical expenses.
"I would just hope that they could assist a little bit - or even acknowledge my argument, and spend a little bit more time on (my case)."
She said the letter she received back seemed more like a form response, outlining the ministry's inability to cover dental work.
"It just didn't even touch on my argument that the attention I need should be considered a medical one," she said, adding that it felt like the letter hadn't even been read by the health minister himself.
A Ministry of Health spokesperson confirmed to the NOW that a letter had been received from Walde and that a response had been sent. They didn't comment on her individual case but did send the NOW a statement about MSP coverage as it relates to dental work.
"The Canada Health Act directs the provinces to pay for health care services when an insured medical service is provided by a licensed physician. The Act also directs the provinces on what dental services the provinces should pay for; however, this coverage may only be provided under very limited circumstances," the ministry wrote to the NOW. "In accordance with the Canada Health Act, the Medical Services Plan (MSP) provides cover-age for oral surgery procedures which may include extractions, jaw deformities and facial trauma when surgery is medically necessary.
"MSP is unable to extend our provincial medical coverage to pay for general dental procedures such as extractions, restorations, dentures, appliances or prostheses and oral surgery that may be done in a private dental facility. If a medical condition requires implants and the patient must be admitted to the hospital, then the MSP would cover the surgical placement fee and the general anaesthetic. However, the cost of the metal implant itself and any denture that is to be attached at a later date is always the responsibility of the patient. Dental implants are not covered by the Medical Services Plan of British Columbia or any other province."
MLA Kathy Corrigan told the NOW that she'd like to see the case re-examined, noting that without the new teeth implants, Walde will need to have bone grafts redone over and over, which will cost the system money over time.
"I'm not suggesting that dental care should be universally covered, but I do think you need to look at exceptional circumstances," she said. "You do have to have protocols in place and you have to have rules, and there is always an area that is grey and, to me, this falls into that area."
As to the events that led to the injury, Corrigan said that shouldn't limit the care that Walde qualifies for, noting that people who are injured in all sorts of situations receive medical care.
"I think you have to separate what kind of care someone needs from the circumstances of how they got there - that doesn't change their right to the care," she said.
Corrigan said the unique nature of the ongoing medical complications in Walde's case indicates that there may be some room to have her treatment funded, at least in part.
"I'd be objective about what is the appropriate and effective thing to do. - It just doesn't make any sense to - pay more later, over and over again."
