fitness · injury

Sam’s sad knee saga: A struggling system meets the pandemic

I’ve been seeing physiotherapists and sports medicine doctors about knee pain and function since my mid forties. I’m 57 now. It’s been a while.

Advanced knee osteoarthritis has ended my time as a soccer player first, then running, then CrossFit, then cross country skiing, and then Aikido. My sports world has narrowed considerably. I still lift weights and do yoga and ride my bike, but I can only walk short distances and I’m in pain a lot of the time. Lately it’s started to affect my sleep. Wordle helps. Thanks Wordle.

Years of physio, injections, canes, and braces later, in 2018, a sports medicine doctor recommended me for total knee replacement and referred me to an orthopedic surgeon. It was time.

Image description: A photo of Sam just outside Central Park. I’m wearing black leggings, sandals, a sleeveless black jumper and a purse over my shoulder. Also, a knee brace. I’m smiling and the sun is shining.

In August 2019 I went into the hospital and met with the surgeon and his assistant and talked about what the surgery involved, how much recovery I would need etc. Since then pretty much radio silence. There was the usual wait. In Canada it’s a year to 18 months depending on where you live. But then there was the pandemic.

Some friends had knee surgery during the pandemic. Why them and not me? I’m not sure. One had both knees replaced at the same time and while that sounds brutal it has a kind of economy of scale and risk that sounds attractive. Would I be eligible for double knee replacement? I have no idea.

Last summer in 2021 I reached out to the referring physician to check in. I started to have those kind of worries that arise in this sort of situation. Could they have the wrong number? Maybe they lost my file?

The sports doctor has a memorable name. It’s one of those names you can’t quite believe isn’t a joke. It’s “Getgood.” He’s Dr. Getgood at the Fowler Kennedy Clinic in London, Ontario. New xrays determined that now both knees need replacing. They can’t do any more injections because in case I do get called in for surgery that would make surgery not an option. You need to wait months between last injection and surgery.

The clinic said that the hospital kept operating on young athletes throughout the pandemic, less worries about covid I guess. Once things opened up again, there were hundreds of seniors with zero mobility who needed joint replacement. And I see why they need surgery before me. Still, being stuck in the middle and waiting isn’t much fun.

So here I am. As covid continues, the surgical backlog grows. American friends are puzzled. People keep think I’m putting off the surgery because I’m nervous. Not true. I mean, yes I’m very nervous but that’s not the issue.

I’m just waiting.

I’m learning about how waitlists are maintained.

I’m learning about Quebec’s two tier system.

I’m finding the opacity of the system frustrating. I’d like to know where am I on the current surgeon’s waiting list. I’d like to know what the criteria are. I feel like I could make better decisions about my life if I had more information.

Friends suggest I change waiting lists, change hospitals but I’m not sure. Does that mean I go back to the end of the line? Can you be on multiple surgeons’ waitlists? None of this is clear to me.

Through my family’s varied health crises, and we’ve had some dramatic ones, I’ve been proud of the Canadian health care system. But I’m not happy and I’m not proud of where we are right now.

Listen to this episode of The Current if you want to hear more.

“There are thousands of Canadians whose surgeries have been postponed because of the strain COVID-19 is putting on health-care. Matt Galloway talks about addressing this health-care issue, with Dr. Jean-François Joncas, an orthopedic surgeon and president of the Association d’orthopédie du Québec; and Dr. Danielle Martin, a family doctor and the chair of family and community medicine at the University of Toronto.”

At the moment I’m on an airplane. My first flight since the pandemic began. There’s a lot of standing and walking in airports. I’m starting to consider the mobile cart to the gate. I’m staying in the conference hotel to avoid walking too much and I’m telling friends who I’ll see here that I need to eat in or near the conference hotel or take taxis.

Update: It’s very pretty here and I’ve walked a fair bit so far.

Vancouver in bloom

There’s also a 24 hour Peloton Studio at the hotel and bike rental nearby. Don’t worry. I’ll keep moving on two wheels. There’s also a pool, a hot tub, and yoga. I’m a naturally cheerful, optimistic person but if you get the sense that this is starting to wear on me, you’d be right.

Dressed for travel 2022 style

The early mornings are nice here too.

Boats, water, and grey sky with sun just starting to rise

6 thoughts on “Sam’s sad knee saga: A struggling system meets the pandemic

  1. I feel this so hard. In 2005 I needed a foot surgery. At that point there was only one foot surgeon in Ottawa. I was on her list for a consult but couldn’t walk a step without pain and I was 30. I found a surgeon in Toronto and had the surgery four months later only because I had family there for the recovery period and could afford the back and forth for follow ups. A year later I got a call asking me if I wanted to stay on the air list for the Ottawa doc. Seventeen years later I need another surgery. I have done the intake and have been advised it will be over a year before I need the surgeon and then god only knows about when the surgery will happen. Good times.

  2. I’ve known people who had both knees replaced at the same time and others who waited. Two at once makes for brutal rehab and a really tough first few days – but when it’s over, it’s over (more or less). Back-to-back 6 weeks apart is easier but makes the process take twice as long. A longer break in between gives you some time to forget the initial agony (sort of like childbirth, where you initially swear you’ll never do that again, but after a while the benefits of that baby make the agony a more remote memory). If you have to climb a lot of stairs, I wouldn’t do them at the same time. An important thing to remember in the immediate post-op period (when the pain makes you wonder why you did this) is that post-op pain goes away and degenerative joint pain lasts forever.

  3. I worked at the Ortho clinic at UH and I can definitely say that some of the waitlist moving around is determined by the specific surgeon and their workload, emergency surgeries and preferences. Only certain surgeons will do two knees at a time.

    One thing that can bump you up the waitlist significantly is a willingness to participate in any of the clinical research going on. Another thing that helps is to check in often with your surgeon’s administrative assistant and ask questions about what you can do. Sometimes if you are willing to take a cancellation spot last minute, it could be a few weeks away.

    See if you can transfer to the UH clinic instead. Fowler is overun with a focus on athletes and everyone else gets pushed aside.

    1. I signed the form agreeing to be part of any relevant research activity at the time I went in. I guess next step is finding out who the surgeon’s admin assistant is. Thanks!

  4. Sorry to hear about this long wait. It’s really unacceptable, but this is where we are after years of cuts and constrained budgets for health care. Unfortunately you’ve got to make some noise now to get noticed. Get both knees done in the same surgery if you can; my mother did and she was 74 at the time. In the meantime, here is some info on patient advocacy and relations at LHSC; they may be able to answer the questions you have about waitlists, etc.

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