Quote:

引用第109楼嘻嘻于2023-04-03 11:16发表的  :
从头看到尾，一直在思考一个问题，那咚妈之前是怎么开车的？看到最后明白了，原来中国驾照也能用 那就是想让你体验一下VR，搞不好以后什么地方就派上用场了。

你的思考非常重要，我改了。。。。
我们初中的时候，语文老师布置的预习工作就是要在读完文章以后提出一个问题！
你的问题就会提醒我忽视的细节，让描述更合理。

我的加拿大签证是随乐哥的学习签证，
一年一签，
一签呆一年，
交了学费就可以申请，
原则上只要乐哥一直在这里读书，
我就可以伴读长住。
当初从上海出发的时候，
我没有被要求体检，
今年续签的时候，
我被要求体检了。

体检大部分是常规检查，
摸摸听听而已，
当时检查的医生还夸我很健康，
可是体检有一项是X光检查，
结果我的胸腔积液就被发现了。
我的胸腔积液是个伴随我多年的老毛病，
2018年下半年不舒服，
熬到2019年住院，
数次CT，住院，积液抽取，检查，
找不到原因，
不做任何治疗。
一直到疫情来了以后，
连医院随访都不去了。
这么复杂的就医历史以我目前的英文水平无法和这里的医生交流沟通，
但目前面临的问题是如果不做深入检查，
我明年的签证就悬了。

体检医生说，
我不得不把你的情况上报移民局，
我相信他们肯定会让你做进一步检查。
所以她开了一张让我去做CT的单子，
让我自己去找我的家庭医生或者找无需预约的诊所，
让诊所医生再安排专科医生给我做进一步检查。
且不说我没有家庭医生，
就算我去了诊所约了CT，
是不是就一定符合移民局的要求呢，
何况做一个CT听说要2000加币，
我要缓一缓，
再想一想。

移民局一改缓慢的工作效率，
很快给我来了邮件，
要求我在8/2之前尽快给他们更多的医疗报告。

我比较了解自己的状况，
担心CT报告无法满足移民局的要求，
其实也是怕花冤枉钱，
作为旅游签我又没有医疗保险。
于是写信给之前的体检机构，
Dear Sir/Madam,
I am Ling Chen,writing to inquire about the next steps for my visa renewal process. I am a mother accompanying my child in Vancouver on a tourist visa, and I currently only have emergency medical insurance and do not have regular medical insurance. I underwent a medical examination at your institution on March 24th, with Dr. Jane as my physician.
Recently, I received a letter from the immigration office as attached stating that I must communicate with your institution again for the next step of my medical examination, or else it may have an impact on my visa application. My family has emailed me medical records from my visits to doctors in Shanghai China starting from 2019.
I am writing to seek advice from the physician on whether it is possible to have these medical records translated and reviewed by your institution, or if I must undergo further medical examinations in Vancouver to ensure that my visa application will be approved.
Thank you for your time and assistance.
Sincerely
Ling

体检机构却回复我电话沟通更好。

于是我只能再写信：
Thank you for your response to my email. I appreciate your prompt attention to this matter.
However, I must apologize as my English proficiency is limited, and I am concerned that a phone call may not be the best way to communicate the details clearly. Therefore, I would like to request if it's possible to communicate via email.
I appreciate your cooperation in this matter and look forward to hearing back from you soon.
Sincerely,
Ling Chen


[ 此贴被咚咚妈咪在2023-04-17 01:20重新编辑 ]

两封邮件后，
有个大咖回复了我的邮件：
Dear Ms. Ling Chen,
I have now had an opportunity to review your file and the additional requirements from immigration. Please call us to discuss this with me. (Kindly call during office hours only and do not leave messages after hours).
Please carefully review the explanations below before calling.
Sincerely,
Dr. Sturwold


What does it mean?
During your immigration medical examination, a medical condition was reported by you or detected by the panel doctor. Immigration has received this information and now wants to make sure that the condition is not severe enough to affect your admissibility. Specifically, they want additional proof that:
1.    The condition does not pose a risk to others
2.    It will not require expensive treatment that may be a burden to our health care system

What do I need to do?
You need to contact us by phone. A visit to our office is often not necessary and the required arrangements can usually be made by phone. It would also be very helpful to to be able to use email to exchange written information. Please confirm that your email address is safe enough to use for confidential medical information.

How much will it cost?
This depends on what is being requested by immigration. You may have to pay for the additional tests or specialist consultations that are being requested. If you have a BC CareCard and a family doctor, it is sometimes possible to have all of this done for free.
You will also have to pay for your panel doctor's time in arranging, reviewing and submitting the additional information to immigration. I will charge you for my time, at the rate of $250 per hour. This includes time spent on face-to-face meetings, phone calls, emails etc. Most cases require less than 1/2 hour, very few more than 1 hour. You will receive an invoice at the end of the process. Kindly confirm that you understand this and agree to it.

这个靠谱，
大咖收费250加币每小时，
好过我自己出门瞎找了。
上次乐哥为了提交summer school的体检报告，
找了个医生签字也花了250加币呢。

于是我回复如下：
Dear Dr. Sturwold,
I hope this email finds you well. First of all, I would like to express my sincere gratitude for your care and assistance in treating my health issues. I appreciate all the effort you have made to help me feel better.
I am writing to you  because I believe it would be more convenient for me to communicate with you via email, as my oral English skills are limited. I hope this mode of communication is acceptable to you.
As you may know, I am currently in the process of applying for a visa extension with the immigration office as I have to stay accopany with my kid studying here. One of the requirements for this application is a medical examination, and I am hoping you can provide me with a clear and concise method of examination that would meet the immigration office's criteria. I am concerned about the financial burden that prolonged and extensive testing may cause, as I do not have insurance to cover the costs.
I have been experiencing issues with pleural effusion for many years, and in 2019, I underwent several CT scans, PET CT scans, and even had pleural fluid extracted for examination at a hospital in Shanghai. The results of these tests ruled out tuberculosis and cancer, and there were no indications of any infectious diseases that could pose a risk to the healthcare system. Unfortunately, these medical reports are all in Chinese. I am not sure if there is a way to have them translated for you.
I understand and appreciate the immigration office's requirements and concerns, but I also hope you can take my situation into consideration. I would be grateful if you could provide me with a recommendation for a suitable examination method that is both effective and cost-efficient.
Thank you for your time and understanding. I look forward to hearing back from you.
Sincerely,
Ling Chen

Dear Ling Chen,

Thank you for your email. I understand your concerns and would be happy to assist you. There is a standard procedure in place when IRCC requests additional medical information. If you would like our office to proceed with your medical furtherance request then kindly confirm that you agree to the terms set out in my email below.  Once you confirm you would like to proceed then I will send you an email outlining the exact request from IRCC and how you may meet those requirements.

Kind regards,
Dr. Sturwold

--------------------------------------------------------------------------------------------------

Dear Dr. Sturwold,
Thank you for your email. I confirm that I agree to the terms set out in your previous email regarding the medical furtherance request.
I understand that there is a standard procedure in place when IRCC requests additional medical information, and I trust that your office will handle my case with professionalism and efficiency.
I am now ready to proceed with the medical furtherance request and would appreciate it if you could provide me with the specific requirements outlined by IRCC and how I can meet those requirements.
Thank you for your assistance, and I look forward to hearing back from you soon.
Sincerely,
Ling Chen

我们愉快地达成了交易！

医生很快发来了具体的操作,为了排除移民局的对我这个申请者会不会造成传染性疾病和破坏加拿大医疗系统的担心，我得去做一个排除结核的检查，以及在3个月以后在同一个X光室再做一次检查。这个费用上会少很多，而且多身体伤害也小。

Dear Ms. Ling Chen,
Thank you for your email. The following is the exact request that we received from Immigration:
“1) A NEW posterior-anterior (PA) chest x-ray examination image and report is required TO BE COMPLETED ON OR AFTER June 24, 2023. This is a 3-month follow-up chest x-ray to help assess the stability of the abnormal findings seen on the applicant’s March 24, 2023 PA view.

2) THREE sputum samples (spontaneous or induced) are required for acid-fast bacilli (AFB) smear microscopy and Mycobacterial culture testing. If available, molecular testing based on nucleic acid amplification should be performed on the first sample when all AFB smears are negative OR on one of any samples with a positive smear. Mycobacterial cultures must be incubated for 6 to 8 weeks and drug susceptibility testing (DST) must be performed on cultures positive for Mycobacterium tuberculosis. The three sputum samples can be collected on the same day at least 1 hour apart OR on 3 consecutive mornings. If the applicant is unable to provide quality sputum samples at the laboratory, attach a PDF document stating “unable to provide sputum samples” in the 601 channel and submit the required 3-month repeat posterior-anterior (PA) chest x-ray examination (image and report) in the 502 Chest X-ray channel.

3) A medical report from a TB Specialist is required. The applicant’s March 24, 2023 posterior-anterior (PA) chest x-ray findings are concerning for possible active pulmonary tuberculosis: Right basal changes of pleural thickening/fluid and basal scarring and atelectasis. Minor changes of the left costophrenic sulcus also noted. There is the possibility of TB. We require a report clarifying /confirming the applicant’s diagnosis and management /treatment needs. The report MUST include the results of sputum testing (three sputum samples [induced, if necessary] for AFB smear microscopy and Mycobacterial culture). If available, molecular testing based on nucleic acid amplification should be performed on the first sputum sample when all AFB smears are negative OR on one of any samples with a positive smear. Please include /attach all pertinent laboratory investigation and imaging result reports. If active pulmonary TB is identified, we require the treatment details (drug regimen, start date, and expected duration) and all follow-up investigation results (repeat sputum testing to confirm conversion to negative, repeat PA chest x-ray images).”

Please note that I will refer you to the local TB clinic today - they will contact you for an appointment and they will also arrange the sputum cultures. 
It is important for the TB specialist report to address ALL the above points.
The attached document contains guidelines for the preparation of the required report. Please provide them with all this information.
At a later stage we will send you the x-ray requisition for the 3 month follow up x-ray to be done on or after June 24, 2023 (it will need to be done at the same x-ray clinic in our building).
Please contact me should you have any questions.
Sincerely,
Dr. Nichole Sturwold

IMPORTANT!
Please make sure that the specialist understands the importance of this report to you. It must cover all the points IRCC are asking about and it must be consistent with the guidelines attached. Unfortunately, about 30% of reports we receive are inadequate and have to be redone, increasing the delay and the expense to you.
Most common deficiencies: report much too brief, report not signed, credentials of writer not clear. (Please do not submit such reports to us).

我希望医生都安排好预约，告诉我直接去检查就好，毕竟我要支付250加币每小时。

Dear Dr. Sturwold,
I hope this email finds you well. I am writing to confirm the process for scheduling the medical examination required for my immigration application.
As I understand it, the Immigration Medical Branch requires a full narrative consultation report from a specialist, which includes history, examination findings, review of investigations, diagnosis, treatment, and prognosis. I have also been informed that all appointments for the required medical examinations will be arranged.
Could you please confirm if this understanding is correct? Additionally, will I receive email reminders when appointments are scheduled, and will I simply need to follow the instructions provided to me?
Thank you for your time and attention. I appreciate your assistance in this matter.
Best regards,
Ling Chen

一番邮件往来就周末了，
就目前就医情况来看，
chatGPT真是太好用了！

想你

你可以总结总结班夫行，照片么分享分享。。。。。

最近总是阴雨绵绵，山上烟雾缭绕。

咚妈太牛了，这么复杂的事情都能搞定。
我用chat翻译了以上所有的邮件才看懂。。

吉人天相，说不定检查一下多年疑难杂症化解了呢。