Dr. Lenina Kathleen Howatt

Dr. Lenina Kathleen Howatt provides comprehensive family medical care for a wide variety of health concerns affecting patients of all ages, including but not limited to:

Adult Common Health Issues

• Allergic Conjunctivitis & Dry Eye Syndrome - Primary Care Management: Primary care approach to common, non-sight-threatening eye discomforts.
• Benign Prostatic Hyperplasia (BPH) - Symptom Management & Monitoring: Referral to urology for severe symptoms, complications (e.g., acute urinary retention, recurrent UTIs, bladder stones, renal impairment due to obstruction), or if surgical intervention (e.g., TURP) is being considered.
• Restless Legs Syndrome (RLS) - Initial Assessment & Management: Providing initial management strategies for RLS, including lifestyle modifications (e.g., regular exercise, good sleep hygiene, avoiding caffeine/alcohol close to bedtime), checking and correcting iron deficiency (ferritin levels), and considering pharmacological options (e.g., dopamine agonists like pramipexole/ropinirole, gabapentin enacarbil) for moderate to severe, frequent symptoms that significantly impact sleep or quality of life. Referral to neurology or sleep specialist for complex or refractory cases.

Common Acute Conditions

• Common Acute Skin Conditions (Rashes, Infections, Bites, Minor Burns): Managing various acute dermatological conditions with appropriate topical or oral medications (antibiotics, antifungals, corticosteroids, antihistamines) to alleviate itching, redness, pain, swelling, and discomfort.
• Headaches (Tension-type, Migraine - Acute Symptomatic Relief): Management of acute migraine episodes or severe tension headaches, including advice on abortive medications, lifestyle adjustments during an attack, and strategies for future prevention.
• Upper Respiratory Tract Infections (URTIs - Colds, Flu, Sinusitis, Pharyngitis): Care for acute respiratory illnesses, including advice on symptom management, appropriate use of antibiotics (only if bacterial infection is confirmed or highly suspected), and guidance on when to seek further medical attention for complications.
• Gastrointestinal Infections (Gastroenteritis, Food Poisoning): Helping you cope with acute digestive illnesses by providing guidance on oral rehydration solutions, appropriate diet modification during and after illness, and when to seek medical attention for persistent or severe symptoms.

Joint Muscle Pain

• Gout & Pseudogout (Crystal Arthropathies) - Acute Attack Management & Chronic Prevention Strategies: Diagnosing (often clinical, supported by serum uric acid levels; joint aspiration for crystal analysis if diagnostically uncertain or to rule out septic arthritis) and managing acute gout or pseudogout attacks with appropriate anti-inflammatory medications (NSAIDs like naproxen/indomethacin, colchicine, oral or intra-articular corticosteroids).
• Fibromyalgia & Other Widespread Chronic Pain Syndromes - Primary Care Diagnosis & Multimodal Management: Initial assessment and diagnosis of fibromyalgia or other widespread chronic pain syndromes based on established clinical criteria (e.g., ACR criteria for fibromyalgia), after appropriate investigation to rule out other underlying systemic inflammatory or medical conditions. Developing a comprehensive, multimodal management plan focusing on patient education about the condition (central sensitization, pain neurophysiology), promoting self-management, graded exercise therapy (low-impact aerobic, strength, flexibility, aquatic therapy), optimizing sleep hygiene, stress management techniques (mindfulness, relaxation, CBT principles), pain coping strategies, and judicious use of medications targeting central sensitization and associated symptoms (e.g., tricyclic antidepressants like amitriptyline, SNRIs like duloxetine/venlafaxine, gabapentinoids like gabapentin/pregabalin). Avoidance of long-term opioid therapy is generally emphasized.
• Polymyalgia Rheumatica (PMR) - Diagnosis, Management & Monitoring (Often with Rheumatology Co-Management): Recognizing the characteristic clinical presentation of Polymyalgia Rheumatica (PMR) in older adults (typically age >50 years) – symmetrical morning stiffness and aching in the shoulders, neck, and pelvic girdle – often associated with significantly elevated inflammatory markers (ESR, CRP). Initiating treatment with low-dose corticosteroids (e.g., prednisone 12.5-25 mg daily) which usually results in a rapid and dramatic improvement in symptoms, thus supporting the diagnosis. Vigilantly screening for and differentiating from Giant Cell Arteritis (GCA/Temporal Arteritis), which can co-exist with PMR (or occur independently) and requires urgent higher-dose steroid therapy and specialist (rheumatology/ophthalmology) referral to prevent irreversible vision loss.

Dermatological Skin Conditions

• Psoriasis (Mild to Moderate Plaque Psoriasis - Initial Management): Primary care support for individuals with psoriasis, coordinating with specialist care as needed for more advanced treatment options and comprehensive management of this chronic systemic condition.
• Eczema (Atopic Dermatitis), Contact Dermatitis & Seborrheic Dermatitis: Diagnosing and managing various forms of eczema/dermatitis, including atopic dermatitis (the most common type, often starting in childhood), irritant/allergic contact dermatitis (identifying and avoiding triggers), and seborrheic dermatitis (affecting scalp, face, chest). Management focuses on skincare education (frequent emollients, gentle cleansers, lukewarm baths), trigger identification and avoidance, topical corticosteroids (appropriate potency for site and severity), topical calcineurin inhibitors (TCIs like tacrolimus, pimecrolimus), and antihistamines for itch relief. Referral for patch testing or to dermatology for severe or refractory cases.
• Fungal Skin, Nail & Hair Infections (Tinea species, Candidiasis, Onychomycosis): Diagnosis (clinical, skin scraping/KOH preparation, fungal culture if needed) and treatment of common superficial fungal infections including tinea corporis (ringworm), tinea pedis (athlete's foot), tinea cruris (jock itch), tinea capitis (scalp ringworm - requires oral therapy), tinea versicolor (pityriasis versicolor), cutaneous candidiasis (e.g., intertrigo, diaper rash), and onychomycosis (fungal nail infections). Treatment involves topical antifungal creams/lotions/shampoos (e.g., clotrimazole, miconazole, terbinafine, ketoconazole) or oral antifungal medications (e.g., terbinafine, itraconazole, fluconazole) for more extensive, resistant, or nail/hair infections.

This list offers some examples of common conditions managed in family practice. A diagnosis is always based on an individual assessment by Dr. Howatt. If your specific health concern isn't listed, please contact the clinic to discuss your needs.

• Hypertension & Lipid Disorder Management (High Blood Pressure & Cholesterol): Developing personalized strategies to control hypertension and lipid levels effectively, involving patient partnership in shared decision-making and goal setting.
• Skin Lesion Assessment, Biopsy & Minor Excisions (Benign Lesions): Management of common skin lesions, including simple diagnostic and removal procedures where appropriate within primary care.
• Attention-Deficit/Hyperactivity Disorder (ADHD) Care (All Ages - Initial & Ongoing): Initial assessment and ongoing management for ADHD in children, adolescents, and adults, which may involve diagnostic screening tools, collaboration with schools/families, behavioral strategies, lifestyle coaching, medication management (stimulants, non-stimulants), and referral to specialists (pediatricians, psychiatrists) for complex cases or co-occurring conditions.
• Well-Child Visits & Developmental Surveillance (Infancy to Adolescence): Expert medical care and guidance for your child at every stage of development, promoting optimal physical, cognitive, and emotional health.
• Diagnosis & Management of Common Acute Infections (Respiratory, Urinary, Skin, GI): Providing timely medical care for a wide range of infections, including diagnosis, appropriate treatment (e.g., antibiotics when indicated by bacterial infection), and advice for symptom relief and recovery.

Note: This list highlights some of the key services offered by Dr. Howatt. For a comprehensive understanding of all services, or to discuss your specific health needs, please schedule a consultation.

All services are provided in accordance with the scope of practice for Family Doctors in BC and the ethical and professional standards set by The College of Physicians and Surgeons of British Columbia (CPSBC).

At Dr. Lenina Kathleen Howatt's practice, family medicine is centered on a collaborative partnership to help individuals like you achieve significant improvements in your health, manage ongoing conditions effectively, and enhance your overall well-being. Dr. Howatt frequently works with patients towards goals such as:

• For many individuals, their teenager needing a confidential space to discuss sensitive health concerns like sexual health or mental well-being can be a real barrier. Dr. Howatt's approach focuses on achieving noticeably reducing their reliance on, and need for, urgent care clinics or hospital emergency room visits for conditions that are now being effectively managed or prevented through proactive, continuous, and comprehensive primary care with Dr. Howatt, making it possible for patients to once again enjoy skillfully and creatively cooking a wide variety of nutritious, flavorful, and delicious meals from scratch for themselves, their partners, and their families on a regular basis, finding joy in the process.
• Dr. Howatt supports patients through a really sore throat, difficulty swallowing, and a high fever that might be strep or tonsillitis, aiming for outcomes like having their complex chronic condition, such as advanced type 2 diabetes, congestive heart failure, difficult-to-control asthma, or multi-joint osteoarthritis, effectively managed and well-stabilized through a collaborative, evidence-based plan developed with Dr. Howatt, so they can return to activities such as consistently being a reliable, present, actively contributing, and supportive member of their immediate family unit, extended family network, and valued social circles, fulfilling important roles and responsibilities.
• Dr. Howatt frequently helps patients who are dealing with feeling more anxious, worried, or on edge than usual lately, affecting their daily life. The primary aim is achieving feeling substantially more hopeful and less overwhelmed about managing a difficult or life-altering health condition after comprehensive consultations and collaborative care planning with Dr. Howatt, which often allows them to confidently resume being able to comfortably stand for reasonably extended periods when necessary, for example, while cooking intricate meals, attending a standing-room-only event, actively participating in a workshop, or waiting patiently in unavoidable queues.

Your personalized healthcare plan, developed in discussion with Dr. Howatt, will be thoughtfully designed to help you reach your specific functional, preventative, and wellness objectives. She believes in empowering patients with the knowledge and support needed to take an active role in their health journey.

Dr. Howatt's practice is located at a family medical clinic in Mill Bay, situated in a family medical practice in the central Mill Bay neighborhood of Mill Bay. The clinic is conveniently located near local community centers, schools, and shopping areas and is accessible via major local public transit routes. Ample parking is generally accessible close to the clinic entrance; please observe local signage.

Do I need a referral to see a family doctor (Family Doctor) in BC?

Generally, you do not need a referral to see a family doctor in BC if the doctor is accepting new patients. However, finding a family doctor who is accepting new patients can be challenging. Resources like the College of Physicians and Surgeons of BC website may be helpful in your search. A referral is usually required from a family doctor to see most medical specialists.

Does Dr. Howatt at her clinic offer virtual (video) or phone appointments?

Yes, Dr. Howatt offers virtual (video) and phone appointments for certain types of consultations when clinically appropriate. These can be convenient for discussing some test results, managing stable chronic conditions, or prescription renewals for ongoing medications (excluding controlled substances). However, many conditions requiring a physical examination will necessitate an in-person visit. Please discuss with our reception staff or Dr. Howatt if a virtual appointment is suitable for your needs. Provincial health plan coverage for virtual visits may vary; please check with our clinic regarding any potential fees for uninsured virtual services.

What exactly is a family doctor (Family Doctor) and what is their role?

A family doctor (in British Columbia) is a physician who has completed post-graduate training in family medicine. They are skilled in providing continuous and comprehensive medical care, health maintenance, and preventive services to patients of all ages. This includes diagnosing and treating a vast array of illnesses, managing complex long-term health conditions, offering health education and counseling on lifestyle choices, and acting as your advocate and guide within the broader healthcare system.

How can I find a family doctor (Family Doctor) in BC who is accepting new patients?

The College of Physicians and Surgeons of BC often has a ‘Find a Doctor’ tool or list on their website. You can also ask friends, family, or colleagues for recommendations. Contacting local community health centres or new patient clinics directly may also be helpful. Finding a family doctor can be challenging and may take time.

What should I do if I have an urgent medical issue when the clinic is closed?

If you have a life-threatening medical emergency, please call 911 or go to the nearest hospital emergency department immediately. For urgent, non-life-threatening issues, you may consider visiting an urgent care centre or a walk-in clinic. Our clinic voicemail [(250) 743-3211] may also provide instructions or resources for after-hours care.

How do I get a prescription refilled by Dr. Howatt?

For most refills, contact your pharmacy at least 5-7 days before you run out of medication. Your pharmacy can fax a refill request to Dr. Howatt’s office. Allow 2-3 business days for processing. For certain medications (e.g., narcotics, controlled substances), an appointment may be required. It is best to request refills proactively.

Is seeing a family doctor (Family Doctor) covered by Medical Services Plan (MSP) of BC in BC?

Medically necessary visits to a family doctor are typically covered by the Medical Services Plan (MSP) of BC for eligible residents with a valid health card. Some services (e.g., cosmetic procedures, travel medicine consultations) may not be covered and might have an associated fee. Please confirm with our clinic if you have questions about specific services or fees.

What if Dr. Howatt works in a Family Health Team or group practice? Will I always see Dr. Howatt?

Dr. Howatt practices as part of a team-based practice, which means you have access to a range of healthcare professionals. While the goal is continuity with Dr. Howatt, for some issues, you might be seen by another trusted team member. This approach can enhance access to care. The clinic will strive to have you see Dr. Howatt for complex or ongoing issues.

845A Deloume Rd, Mill Bay Medical Clinic
Mill Bay, BC, V0R 2P2

Phone: (250) 743-3211

Dr. Lenina Kathleen Howatt is regulated by the Health Professions Act (British Columbia) in BC and is a registered member in good standing with The College of Physicians and Surgeons of British Columbia (CPSBC).

Registration Number: J2481

Verify registration with The College of Physicians and Surgeons of British Columbia (CPSBC): https://www.cpsbc.ca/public/registrant-directory/search-result/362223/Howatt%2CLenina

Family doctors like Dr. Howatt are skilled in managing a wide range of health issues. For urgent or life-threatening emergencies, please call 911 or visit the nearest emergency department. It is always recommended to maintain open communication with your family doctor about all aspects of your health, including any treatments received from other practitioners.