CEC Express Entry application in month 11 and still no decision - do I need a new medical?

[ceceedelay]

As I'm approaching month 11, I have applied for case notes to learn more. An MP is helping but to be honest, they've not really informed me of anything I wasn't already aware of.

My questions/concerns are:

1. Do I need an updated medical examination as mine (although passed according to my profile) expires in September
   
   
2. I want to return home for Christmas so if a decision is made at home while on my second bridge permit (I will need a new one by December), how does that affect me?
   

I get it that these things take time and it's a case by case basis etc. but at what stage does it verge on the ridiculous and what extra steps can be taken? A year? 18 months?