Alberta Surgery Option
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| Alberta Knee list wait times |
So what is
the process in Canada and in particular Alberta, to evaluate and if required, get a knee replacement? With government
funded “free” treatment; no doubt magic will happen. Well its not quite like that. As mentioned previously, for AHS funded MRI’s the wait averages 25 weeks, with 90% served at 57 weeks.
Once you have the MRI and then a referral by your MD, the wait time to see an orthopaedic surgeon is over a year. Then, as can be seen on table above, recent wait times are some 60+ weeks for surgery, and that is after you have seen an orthopaedic surgeon and they have determined that your knee is bad enough to meet the AHS guidelines(or their interpretation thereof) for replacement and has placed you on the list. If not, back to the end of the queue. A friend, last year, waited pretty much an entire year for an appointment with an orthopaedic surgeon only to be told “No New Hip For You”, you are not severe enough, you still have 30% use of your hip left, thank you come again. If you do the math, it’s a total of somewhere between 2 1/2 and 3 years to get a knee replacement, maybe.
Once you have the MRI and then a referral by your MD, the wait time to see an orthopaedic surgeon is over a year. Then, as can be seen on table above, recent wait times are some 60+ weeks for surgery, and that is after you have seen an orthopaedic surgeon and they have determined that your knee is bad enough to meet the AHS guidelines(or their interpretation thereof) for replacement and has placed you on the list. If not, back to the end of the queue. A friend, last year, waited pretty much an entire year for an appointment with an orthopaedic surgeon only to be told “No New Hip For You”, you are not severe enough, you still have 30% use of your hip left, thank you come again. If you do the math, it’s a total of somewhere between 2 1/2 and 3 years to get a knee replacement, maybe.
We are 65 years old, maybe 10 good years left, if a person has worked hard and saved
resources over their life they would gladly spend some or all of their children’s inheritance
to get a full 10 years instead of maybe 7. Would likely even dress up in
Maharaja outfits or blackface costumes to have the “privilege” of fee for service
medicine, if that's what it took. One has to figure that the
near term years will also be a helluva lot better than the latter years, so waiting for a government freebee is
not a positive event in the aging game. My experience is stuff rarely get better
as one ages except fine red wine and whiskey.
The government
tasks the surgeons with the godlike job of deciding who gets repairs and who
doesn’t, they are allowed only a specific number of surgeries a year. After
they have reached their quota or, maybe they intersperse the tasks, the Canadian Dr.’s
then can go to the US or Caribbean and do surgeries there while on vacation on for fee basis outside
the Canada health act rigid rules.
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| Taj Mahospital - South Campus Hospital Calgary |
Not sure about the rest of Canada, but in
Alberta we spend billions in capital dollars building world class facilities like the Taj Mahospital/South Campus facility. Then the surgical units are run, at most, 12 hours a day. This is because there is no money to staff them for more than one shift. Completely insane, these facilities should run 24/7 to maximize the
return on the enormous capital investment. Serve the citizens effectively and
economically by operating more time. If fee for service was allowed, could fund a second shift and clear up these absurd wait lists. Possibly consider encouraging medical tourism to replace the oil and farming industry that has been purposefully destroyed by the central Canada government. But no, can't do that because then it wouldn’t be
universal health care, or so some say. They fear someone other than the elite might get treatment before another because they
can pay for it. Couldn’t have that now could we? Government prefers to force our citizens to seek out of country treatment and send the cash offshore. But wait, every time a patient
pays for a procedure, does that not take a body off the wait list for the
“free” treatment? Works well in Europe. Couldn’t doctors do private procedures for fee on a second shift after hours
when government doctors are at home, at the clubs or in the Caribbean etc? Nope
that would destroy “Canadian” medical care. Everybody except certain elites have to appear to have equal access.
Oh
and there are the elite folks who are fast tracked and are above the AHS wait list rules. The politicians,
first
responders (police, firemen, ambulance drivers etc.), professional/high
level amateur sports players, friends of folks in the know in the
system. There
is a long list of queue jumping important folk, which apparently we
could not survive without them getting preferential treatment. How could
we possibly enjoy a hockey match
knowing that a player such as Flames star Johnny Gaudreau had to, hypothetically, wait over two years to
get
medically
necessary procedures? His career would be over, that wouldn’t be
right! There would be riots in the streets on the scale of the Montreal Richard
Riots of 1955. Well maybe not in Calgary, it is a bit more civilized than our
colonial overlords in Quebec. Calgarians however may take to spitting on the ground when turdeaus
name is mentioned like my mother in law did with the mention of Joey Smallwood's name.
One way non-elites can jump the wait list queue is trauma, a trauma injury puts you closer to the front of the queue. A car accident, fall, bad beating or maybe even a good whack with a hammer can shorten your time waiting. In 2005 I experienced trauma, only had to wait 4 days and promise to inject blood thinners in my stomach for 30 days to get "preferred" treatment for a broken Tibia/Fibula from a fall. The system obviously works.
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| Johnny Gaudreau |
One way non-elites can jump the wait list queue is trauma, a trauma injury puts you closer to the front of the queue. A car accident, fall, bad beating or maybe even a good whack with a hammer can shorten your time waiting. In 2005 I experienced trauma, only had to wait 4 days and promise to inject blood thinners in my stomach for 30 days to get "preferred" treatment for a broken Tibia/Fibula from a fall. The system obviously works.
The sad
part is there is no fixing this mess short of complete collapse and restructuring of the medical
“system”. Can’t call it a health system because it isn’t.
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| Lester Pearson |
Lester Pearson’s
government bought a lot of votes of naive Canadians by the passing of the 1966 legislation
inaugurating the Canada
“health” act. This catapulted the elder turdeau to a big majority
victory in 1968.
Even won a few seats in Alberta, that’s how much we like free stuff. The younger turdeau was equally successful promising Pot legalization in
2015. Unfortunately,
you can only buy votes once with each gift given, but you can never take
the
previously given gifts away. Here we are 50+ years later, and the
medical
system in Alberta consumes 43%
of annual operating budget. And we wonder why the schools are crap and
there are pot holes in the road.
But hey! There are a lot of old folks suffering immensely from cancer, heart disease, bronchial disease among other more exotic ailments. They are stoically keeping the “health” care system going just by being a warm (but mostly unresponsive) body for the last few years of life.
Somewhat analogous to the
humans in the 1st Matrix movie. These people were stored in pods where their body heat was used to generate electric energy. The energy was used to power the computer operated
post apocalyptic city. Subtle difference
being the folks trapped in the Canada “health” system are real people, not fictional, their dignity is stripped away when they are warehoused in government facilities largely to keep the medical system operating.
But hey! There are a lot of old folks suffering immensely from cancer, heart disease, bronchial disease among other more exotic ailments. They are stoically keeping the “health” care system going just by being a warm (but mostly unresponsive) body for the last few years of life.
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| The Matrix - Neo wakes up and escapes his pod |
Government always wants to get bigger, now is a fantastic time to do this
particularly in the medical business. With an aging population that has not
taken care of itself, it’s a self-fulfilling prophecy that more government will
be needed to save us. I applaud the folks in the warehouses for not seeking a way out as a rational person would do, rather they
submit to extending their life painfully in order to create jobs for
others. Sadly a lot don't see it coming and when they do it is beyond their control.
There is
little but minimal window dressing effort made by government to promote healthy
lifestyles. The medical system is reactive only to negative events (and at a very slow
pace) and little is done to promote reasonable diets, healthy lifestyles etc,
or on the other hand to discourage unhealthy lifestyles and bad diet behaviour. “Health” Canada is a shill for Big Pharma, apes what the United States does for most
decisions, not at all an advocate for the people.
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| Ibuprofen Gel - Not Available in Canada Pity |
If
you don’t believe me, for example, try and buy
Ibuprofen Gel in North America…. Won’t happen, readily available in
Europe….
Health Canada told me that they do not require it to be produced or marketed in Canada (the EU does require it to be produced and marketed),
patents are expired, apparently no money to be made. Oops, I have
digressed seriously from my topic, some might call it a rant, I should
have placed “RANT ALERT” at the outset, oh well…. I AM sure that some
readers will
call me a NAZI and/or a Racist….. I look forward to your letters!
As can obviously be seen by most practical individuals, the Alberta option for surgery is a Hobsons choice, that is, not a choice at all, you have to look elsewhere.
Outside Alberta Options
The United
States, some provinces in Roc(Rest of Canada), Europe, India, Thailand, Costa Rica, no doubt
others, offer medical services on a fee for service basis for both citizens and
non-residents . Canada has the distinction of sharing the podium with Cuba and
North Korea in being the only countries that do not allow patients to privately
contract medical services. This was enshrined into law by the elder turdeau government as a last vengeful act in 1984, prior to Pierre taking his famous walk in the snow. Maybe the rumors that Justin is Fidel's son have some basis, seems to be a remote connection? Much for Canada to be to be proud of keeping company with Cuba and North Korea. But that is a PHD thesis topic that
no doubt many are already working on, I won’t take that on today.
Of interest,
under Canada’s constitution, provinces control health care policy, direction
and service. However, the federal government controls the dollars that fund it.
The federal government enforces the Canada “health” act, by financially punishing provinces that allow private treatment of “medical necessary” procedures of
patients insured in their jurisdiction. These rules amazingly let provinces
allow fee for service companies to provide service to non-resident customers, i.e.
any Canadian that is not insured under that provinces "health” insurance, or any non-Canadian. This
has opened up a niche business in a few provinces (Ontario for sure, I have also
heard maybe Quebec).
Private clinics, at least one in Toronto, offer knee
replacement service(among others) on a fee basis, but the service is only open
to folks NOT registered with OHIP (Ontario health insurance plan). Residents
from anywhere else in Canada or the planet for that mater, maybe the universe,
can go to Toronto and pay for services, but locals cannot. Go figure.
Alberta's government does not allow this to occur in Alberta. It would appear that Alberta is too stupid to create this kind of medical tourism business to exploit RoC folks
or foreigners looking for options. Maybe Alberta and other provinces are just trying to play by the rules
set out by the central Canada cabal, and that central Canada does not see the rules as
applying to them, only the colonies?...Moving on.
Practical Choices
A few days
of internet searches and extensive reading had me inquiring specifically with hospitals in the United States, British Columbia,
Ontario, The UK, and Lithuania. The UK facilities did not bother to even
respond? (I later learned the UK NHS sends folks to Lithuania to relieve the
wait list in the UK). No surprise in retrospect I suppose. Cambie Clinic in
Vancouver BC got back to me and said they do not do knee replacements,
apparently never did. Cambie suggested I call Centric. Centric out of Toronto were quick to reply as was Mayo
Clinic in Minnesota and Nordothopaedic in Lithuania(Eastern Europe). All
appeared from internet research (for what that may be worth) to be first class
facilities with highly qualified surgeons. I then proceeded to evaluate these three
options with late October service requests to the facilities.
Mayo Clinic Rochester Minnesota
Mayo Clinic Rochester Minnesota
As noted
earlier, Mayo was quick on initial response, but then became a challenge. At best the Mayo staff could be described as unhelpful. After providing requested documents (MRI/XRAY, reports etc) several messages were traded with their goaltender Joanne who insisted that the Clinical Notes provided by Elaine's Dr. were not really Clinical Notes. The Americans felt that more than 1 or 2 pages of bullet points was required to constitute Clinical Notes. The front line staff deemed the notes inadequate and refused to forward the information package to Mayo triage for assessment. After a circular 25 minute telephone discussion I was able to persuade them to forward the information to their triage and see what happened. About a week later on November 11, we received a message that an appointment had been scheduled for November 21. We were to travel to Rochester, pay a $7kUS deposit and spend 5-8 days there for a consultation. It was unclear what might occur at the consultation. I traded two detailed messages with Mayo asking for basic information like "what happens at the consultation?". They responded by accusing me of requesting "advice and diagnosis" which they do not provide by email. I rejected that claim and again asked for further detail. They answered a few minor queries and noted the rest would be dealt with at the consultation. Without reasonable answers, I thanked them for their efforts and cancelled the appointment. They did not provide a specific cost estimate for the knee replacement surgery. The Mayo website however does have a cost estimation calculator that reports a knee replacement cost at $30-40kUS. Mayo dropped off the list
Centric Health Toronto Ontario
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| Centric Health toronto ontario |
Cerntic
responded very professionally including quoting the all in fee up front as $25kCAD. I saw
this as a very practical option and still do if one can figure out after care in the Toronto
area. I traded a number of messages with Sara Mooney at Centric, all very
positive. The flaw, as with Mayo, is they expect you to jump on an aircraft two
days after surgery and go home and seek out your own after care close to home.
They have no ownership in the recovery. In the oil business we unkindly
describe this type of process as "throwing the problem over the fence" to the
next guy, driller to completions guy, completions guy to production, with none
caring about the next in line. Needless to say, a lot of time and money is
wasted due to this lack of continuity and effective communication. This process
is astonishingly absurd in the medical arena(or anywhere). I experienced similar
process in 2005 when I broke my Tibia/Fibula, when released was given little or no
instruction other than should get physio, saw Dr. once after the surgery to remove stitches. One had to plan and arrange their own after
care. Not a health system, a medical procedure system with no follow up. Huge
flaw in AHS process, possibly Machiavellian? Wags/cynics might suggest the process
is intentional to create a larger government health system with the added bonus
of keeping a large part of an aging docile population planning their social
lives around their next medical appointment or blood/urine test.
By November 21 they had all the information requested, previously they had indicated that a surgery appointment could be made as early as mid December. Then 2 weeks passed with no response, a dead line, maybe the contact left? Eventually a new person called and asked for information that had already been provided. By this time we had made our choice, we thanked them for their time.
By November 21 they had all the information requested, previously they had indicated that a surgery appointment could be made as early as mid December. Then 2 weeks passed with no response, a dead line, maybe the contact left? Eventually a new person called and asked for information that had already been provided. By this time we had made our choice, we thanked them for their time.
Nordorthopaedic, Kaunas Lithuania
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| Nordorthopaedics Clinic Kaunas Lithuania |
The Nordorthopaedic Clinic at Kaunas responded immediately with significant detail as to cost, process and timing. Surgery alone was quoted at a cost of €3810, the implant at a cost of €2810-€4000. The completeness of their treatment process description was excellent. Recovery for two days/nights at the clinic post surgery, 3 meals a day ordered off menu from an adjacent restaurant(if you have an appetite after surgery). Then spend at least 7 days for recovery(your choice as to duration) at a spa rehabilitation facility located at Druskininkai an hours drive south of Kaunas. Meals there served at two buffet style kitchens on the premise. The Spa cost being €130/day plus €50 for a accompanying partner staying in same room. This cost includes, up to 3 Physio procedures per day and 24/7 nursing. At last, reasonable process, and affordable price!
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| UPA SPA Druskininkai Lithuania |
The Nordorthopaedic Clinic has a Facebook group that allows sharing of experiences by the patients. Elaine joined the group and found detailed discussion about the Clinic and folks experiences.
Many folks from the UK and Ireland go there for treatment as those countries have wait list issues similar to Canada. Difference being the UK and Ireland fund the offshore procedures, Alberta will return maybe 5% of the cost, and we will also receive a tax credit that may return a bit more. It was very interesting to learn that a number of individuals from Southern Alberta had already had hip and knee surgery at the Kaunas Clinic. Elaine was even able to discuss directly by phone with a Turner Valley individual that had recently had surgery at the Clinic. Very helpful in providing insight and calming fears of the unknown.
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| Vanguard Implant |
http://www.baltic-surgery.com/specialists/orthopedic-traumatologists/juozas-belickas
The
surgeon had decided from review of information that we had sent over that the type of
implant to be used would be a Vanguard Posterior Stabilized device. Drug
and food contraindications were advised. A phone consultation with the surgeon was offered, which we did not take up, could not think of anything material to ask.
Preparing for Surgery
Decision made, it was time to prepare for surgery by getting fitter.
(Not to say Elaine was in poor shape, not at all, but if you can go into an
event like this in top shape it will go much better). It was time to go to the
gym. Elaine went pretty much every day to the gym at the Shawnessy YMCA from
first of December to mid January.
Workouts included cycling, swimming, upper and lower body weights, stretching, isometric elastic band, ball exercises; a broad mix of cardio, weights and stretching. Focused hard work, provided good results, a much stronger leg and dropped close to 10 lbs in the six week lead up. A lot after we set alcohol aside in the New Year 😊…. As of mid January we are both at body weights not seen since the mid 1990’s.
All good, shall see how it plays out at clinic this week. Onward to Kaunas Clinic!
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