New Patients – Start Here

Get started in our clinic right now – no need to wait

  • Once we receive your referral you can participate in EVERYTHING our clinic offers

  • Wait-time for your individual consultation with one of our doctors is up to 15 months

  • So, the only things you can't do until your one-one-one visit:

    • Can't get a prescription – but you can still attend in participate in the Group Medication Visits

    • Can't get paperwork filled out by one of our doctors

  • Note: with your limited energy, don't try to do everything at once – pace yourself – this page will help you organize your journey

See FAQ to find out about
The options are overwhelming – What should I do FIRST ?
STEP 2: determine if you have MCAS

  • MCAS (Mast Cell Activation Syndrome) is commonly associated with ME/CFS, FM, and Long COVID

    • The symptoms often overlap with ME/CFS and FM

    • Things that suggest you might have MCAS

      • Allergy/histamine type symptoms

      • Food, medication, and environmental sensitivities

      • Skin issues (e.g., hives)

      • Gut issues

      • Bone pain

  • You can:

    • Learn more about MCAS by watching a presentation on our ME TV

    • If you think there is even a slight chance you have MCAS after watching the presentation:

      • You do NOT need to be referred to an Allergist/Immunologist

      • Book a Group Medication Visit on Diagnosing MCAS – Therapeutic Trial of Triple Therapy (contact Bruno or Pamela)

      • Book a Group Medical Visit to:

        • Review the results of therapeutic trial

        • Determine what to do next

STEP 3: determine if you have POTS or Orthostatic Intolerance (OI)

  • Orthostatic intolerance (OI)

    • Symptoms when upright (sitting or standing) – especially lightheadedness

    • But, it's not only lightheadedness

    • Your fatigue and brain fog may be worse when upright

    • Or you might need to lie down to feel rested 
(sitting isn't enough)

    • OI can be a manifestation of the dysautonomia seen in LC, ME/CFS, and FM

  • Orthostatic Intolerance (OI) in LC, ME/CFS, and FM can be caused by:

    • Postural Orthostatic Tachycardia Syndrome (POTS)

    • Orthostatic Hypotension (OH) – drop in BP on standing

    • Orthostatic Intolerance (OI) with normal BP and HR

    • POTS and Orthostatic Hypotension (OH) commonly occur together

  • How to investigate Orthostatic Intolerance (OI)

    • The NASA Lean Test, and postural blood pressure – BP lying down and standing up

    • You do NOT need tilt-table testing

  • What to do next if you have Orthostatic Intolerance (OI):

    • Start by watching presentations on our YouTube channel: ME TV

    • If you still think you have POTS after watching the presentations:

      • Do the NASA Lean Test (yes astronauts get POTS)

      • Do postural blood pressure (lying and standing)

  • You can start salt for POTS and Orthostatic Hypotension (OH)

    • Download the handout on the use of salt

    • Don't use salt if you have hypertension (high blood pressure)

  • Next steps

    • Book a Group Medical Visit (GMV) to:

      • Review the results of the NASA Lean Test and postural blood pressure

      • Determine what to do next

    • Learn about the Physiotherapy Management of POTS (non-medication)

    • Book a Group Medication Visit for POTS, Orthostatic Intolerance, and Dysautonomia

    • Consider participating in the Dysautonomia and POTS Group with Dr. McKay and Trineta Mohan Bhojwani, Physiotherapist


FIRST THINGS FIRST – Top Priorities

  • Step 1: watch the Family and Friends Presentation on our YouTube Channel

  • Step 2: determine if you have MCAS

  • Step 3: determine if you have POTS or Orthostatic Intolerance (OI)

  • After the first 3 steps, consider...

Next – Are you hypermobile ?
Next – Register for the Core Group: Living with ME/CFS, FM, and Long COVID

  • Click here to find out more about Core Group

  • You can participate in either Dr. Arseneau's or Dr. McKay's groups

  • You will receive a Medeo message announcing when the next groups start

  • Core Group is ~16 weeks long and repeats about every 3 months

  • Here is an infographic about Core Group created by one of our patients:

  • While waiting for Core Group to start, you can participate in some shorter groups:

  • See a list of all our offerings

  • You will receive a Medeo message announcing when new groups are starting

Next – Book a Group Medical Visit

  • Group Medical Visits are follow-up visits, so you need to call or email to book (i.e., there will not be Medeo messages)

  • They occur several times a week

  • You can participate with Dr. Arseneau or Dr. McKay

    • Contact Bruno to book with Dr. Arseneau

    • Contact Pamela to book with Dr. McKay

    • See bottom of page for contact information

  • Format

    • 1 hour Zoom virtual visit

    • ~10 patients per visit

    • You can ask questions and learn from other patient's questions

  • You can do a Group Medical Visit any time you have a question

Next – Start attending weekly special lectures

  • Medeo message invitations are sent every week

  • See the schedule for the next few months

  • About half the sessions are recorded for ME TV – our YouTube channel

  • Note:

    • OT/PT, Dietician, and Naturopath session are NOT recorded

    • These sessions repeat on a rotation

  • We've covered over 100 topics so far ! – with more added all the time

Next – Consider participating in a Group Medication Visit

  • Medeo message invitations are sent every week

  • Usually, we cover 2 topics a week (topics repeat every 5-6 weeks)

  • See a list of topics and find out more

  • There is a presentation called, "Help! Too Many Choices – Help Me Choose a Medication" that gives an overview.

  • Note:

    • You won't be able to get a prescription until you have your one-on-one visit with Dr. Arseneau and Dr. McKay

  • But...

    • You can participate for education

    • You can ask your Primary Care Provider to prescribe

    • You can download medication handouts to bring to your Primary Care Provider

What if I'm not interested in prescription medication

  • Many of our patients prefer a non-pharmacological approach

  • The options include:

    • Supplements:

      • Dr. Morello, naturopath, does Special Lecutures on a yearly basis:

        • Mitochondrial Health

        • Gut Health

        • Pain – a Naturopath Approach

        • Q&A Session

      • Consider micronized PEA supplement

        • Over 200 studies showing benefit with pain, inflammation, brain fog, leaky gut, and MCAS

        • Download PEA handout

    • Medicinal Cannabinoids:

    • Trigger Point Injections (TPI)

      • TPI can be helpful with Myofascial Pain Syndrome (MPS) and related conditions

      • To learn more about MPS and TPI, watch a presentation by Dr. Dhanoa on ME TV

      • We usually refer patients to:

      • You can ask your Primary Care Provider to refer you

      • Note:

        • Many doctors across BC are trained to do TPI – ask your Primary Care Provider if they know any who are closer to you

    • Some patients may want to try what we call, "The Medication for People Who Don't Like Medication"

      • Low Dose Naltrexone and Low dose Aripiprazole are prescriptions medications but many patients who prefer a non-pharmacological approach still consider trying them because:

        • We use very low doses

        • Fewer sides effects at these doses

        • Patients like the way they work – they don't mask symptoms but instead improve brain health

    • If you are considering other non-traditional treatment options we suggest you watch:

I still have questions about my journey – What should I do ?

  • Contact the clinic for any questions:

    • Contact Bruno for Dr. Arseneau

    • Contact Pamela for Dr. McKay

    • See below for phone / email

Address

1622 Woods Rd.
Bowen Island, BC
V0N 1G2

FAQ

Frequently asked questions

For
Dr. Ric Arseneau
Dr. Lana Dyment
Dr. Lucia Ma
Dr. Liz Nicki


Contact Bruno
Ph 604.418.5194
Fax 778.800.2094

Bruno@DrRicArseneau.ca

For
Dr. R. Jane McKay

Contact Pamela
Ph ‭236.833.8842‬
Fax 778.800.2094

Pamela@DrRJaneMcKay.ca