What Your GP or Physio Should Tell you if you Have an Accident in New Zealand.

As you may have seen from earlier posts, I had a back accident 15 months ago and after 4 visits to hospital, the most recent being of 7 days duration, I am still no nearer to getting the surgery my orthopedic spine specialist / surgeon recommended for me and requested ACC to fund.

What went wrong?

I’m going to tell you about 2 critical things. The first is about how I injured myself, by which I mean the primary cause and the second is about who I got referred to.

1. The Primary Cause

My latest accident didn’t seem like much. I was at my 6th Relay For Life in March last year and ready to walk a marathon distance (my goal, which I achieved) over 18 hours.

Setting up prior to the event and prior to heading for the survivors’ tent (I am in remission from prostate cancer), we had a 4 room tent to set up, and the poles and pegs were in a big bag in the trailer that was provided by the organisers to get our gear from the car park to our team site.

It was super heavy. No one seemed to want to get it out, including the guy driving the tractor. So I tried. Unfortunately, my back couldn’t take it and I ended up with a back strain injury that still has me off work today, 15 months later.

I managed to do the distance through the use of medications like Panadeine and I had booked a couple of days annual leave after the event to recover, based on previous years experience. I also had a float and massage the following day, so I didn’t feel too bad after that. A bit sore, but otherwise OK.

A few weeks later, on ANZAC Day, in fact; I remember because it occured on the weekend before the public holiday (a Wednesday) and my wife and I had taken the Thursday and Friday off to go away in the Corvette for a few days holiday.

It had been raining, and on the Sunday before our planned holiday, I mowed the lawn and using the catcher to collect the heavy wet grass. I had to twist on an awkward angle to detach the catcher from the mower, twisted my back again, and the rest as they say was history.

You can read previous blogs but the key point was that whilst an MRI showed damage, ACC weren’t satisfied with the injury having been caused by the incident, they said it was age based degenerative disc disease. They said they would try to see if a previous injury could be relevant that they could tie it to which would convince them to cover the cost of the surgery and herein lies the problem.

A Skydiving Accident

Many years ago I had a skydiving accident. It was a tandem jump and if you have ever experienced one, you know that the customer is at the bottom and the Jumpmaster is on top. When she tried to flare at about 30 feet we got into an air pocket and instead of opening up, the parachute closed down. Instead of gliding to a running stop, we dropped and I took her weight on top of my own, on my tailbone.

It hurt like mad, but I was also flying high on adrenaline from the jump, so I didn’t really feel the pain that much. That night it was very sore, but we went to a big neighbourhood party and I found that bourbon acted as a great pain killer, so I managed pretty well and enjoyed the festivities as long as I didn’t make any sudden moves.

That night there was a bit of a storm and one of our trees was blown over.

The following morning, I was trying to clear branches in our yard, bent down and found I couldn’t straighten up again.

I went to physio who asked what happened and I told my story, the ACC record said “bent down and hurt back while picking up branches in garden”. I had 26 physio visits, was referred to Pilates and was assigned a personal trainer.

I did talk to them all about the sky diving, but it never made it to the ACC records. It therefore registered as a strain.

Another Accident

I was racing my land yacht in a 180 km enduro on 90 mile beach. I crashed at the northern end of the beach, picked myself up and raced back again and had to endure racing through snapper holes around Ahipara Beach, which is like racing on sheets of corrugated iron. Lots of pain, but again lots of adrenaline. For much of the race, I was going at speeds of up to 100 kph on a thin cushion as you can see on the video above, and with my feet sitting on a steering rod so all of my weight was on the lumbar area of my back.

At the end of the weekend it was a 5 hour drive back home to Auckland and a couple of days later, guess what? I was in the garden again, bending over and suffered intense back pain.

Guess what went on my ACC record?

Lots of physio for an injury sustained doing gardening.

So, when the specialist looking for reasons to not approve surgery (me having had every other treatment they could think of, for over seven months), they looked at what I had been referred for (back strain), looked at old injuries sustained in the garden, so probably not significant, all because I didn’t understand the importance of mentioning the crash or the sky diving on the initial ACC form. After all I was getting treatment. That was all I was concerned with at the time.

So What?

I might have got a very different response to my request for surgery if the primary causes of injuries had been clearly recorded, instead of lost to obscurity. Now I am chasing a Review of ACC’s decision not to fund the surgery which is going to be time consuming and expensive.

So if you are injured and covered by ACC, make sure that, irrespective of which straw broke the patient’s back, that the primary cause of injury is documented, even if you are happy that the treatment will fix the problem.

I’m now in a situation after many back injuries, that ACC are claiming age based disc degeneration disease and I am going to have to prove that I did in fact sustain some major injuries and that it was the cumulative impact of those injuries that has me now needing expensive surgery.

If I had made sure they had all the information correctly recorded, it would probably have been plain sailing for me now, instead of 15 months off work, the possibility of losing my job, and a long, expensive and stressful battle to get my back repaired so I can get back to work.

2. If Referred to a Specialist, Make Sure it is one who Operates in Your Local Public Hospital.

I was referred to a very good surgeon by my GP, largely because he is one of the category of trying everything else before getting the scalpel out and doing major surgery, which in my case will involve 2 surgeons for 4-5 hours and a 5-day stay in hospital.

Because of all the drama with ACC (New Zealand’s Accident Compensation Commission), in April I asked my GP (at the recommendation of my surgeon) to refer me to the public hospital. Whilst I have other medical insurance, it only pays (up to) 80% of the costs, which means I would personally be up for around $18,000 that I have to find myself. It could even be more because they won’t know exactly what they have to do until they cut me open.

So I was referred as ‘URGENT’ to North Shore Hospital on the 4th of April this year. I told them I was not working and that I could come at short notice and asked if they would put me on the cancellation list and they said “Yes, we have a cancellation list, is there anything else?”

I rang a few times, mostly talked to voicemail and the first time I spoke to someone they said “It’s only been a month!” To which I responded, “yes but I was referred as urgent.”

This month I had a flare up and spent 7 days in the Orthopedic Ward at North Shore Hospital. They did an MRI, hooked me up with a pain team and eventually once the pain was under control with drugs, they let me go home.

They told me that the stay would not be seen as my First Specialist Assessment (FSA) for which there is an expectation that you will be seen within 4 months of referral. They said that the Orthopedics Team knew about me and I would probably now be seen within 2 weeks. So they scripted 2 weeks of pain medication for me. They said I would get a confirmation letter from the hospital.

So I got out of hospital on the Sunday, waited until Wednesday and rang to find out when my appointment would be. I had to leave a message on their voicemail. I rang again on Friday and again left voicemail.

On Monday this week I got a phone call telling me that they did in fact have a date for me in late August. Today is the 17th of July.

So much for my 2 weeks of pain medication. I should have got the message when the doctor who checked me out of hospital laughed when I said I was expecting to be seen in 2 weeks.

So what?

If my GP had originally referred me to a specialist who also worked on the public health at North Shore Hospital, there is every likelihood that I would have been referred for surgery at the hospital in November last year, and could well have been back at work by the beginning of this year.

Now instead, I am still waiting for a First Assessment, and they will want to decide for themselves what treatment I should have. So while the logic behind my original referral was sound, the end result is that it set me back anything up to a year.

Hindsight is a wonderful thing, but the point I am making is that you, dear reader, may have a back injury like me, or perhaps a knee or shoulder injury from playing sport.

By learning from my experience, you might be able to have a better experience, receiving treatment within the same year of your injury and not jeopardising your employment and having double the stress. 

SUMMARY

Being in severe chronic pain for over a year is horrific. The potential consequences can be many including

• losing your job,
• becoming addicted to pain medications,
• sleep deprivation with all that comes with that,
• becoming stressed to the point of depression,
• having no social life or family life,
• which also results in relationship stress.

Here are two ways you can reduce the risk of experiencing what I’m going through.

1. If you injure yourself doing something major and then aggravate it with a lesser injury. Insist that the cause on the ACC form is the major impact and the secondary injury is clearly shown as secondary. It might not matter now, but in 10 or 20 years it could save you from the horrible 15 months I’ve endured so far.
2. If you need to be referred to a surgeon, even if you have medical insurance, get referred to one who operates from your local public hospital. You may not end up needing to go public, but at least you have viable options and it could save you many months in getting treated.

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3,000 Teen Deaths from Texting and Driving

A study done by the Cohen’s Children’s Medical Center in New York, revealed that drinking and driving resulted in the death’s of 2,700 teens in the US, compared to 3,000 from texting and driving.

How about a quick, honest but anonymous poll:

I was listening to the Peggy Smedley Show this morning while cleaning the bathroom and enjoyed some great interviews in her Distracted Driving Month series. The topics were great, everything from the value of reversing cameras through to why car manufacturers are putting social media technology into their cars.

Anyway, a subject that peaked my interest was comparisons of factors impacting on or causing accidents.Talking or texting on the phone is one that that police and others who examine the results of motor accidents look for by default these days.

Peggy quoted a study (can’t remember which university) where they found that people with a blood alcohol level of .08 performed better behind the wheel than people who were using their mobile phone. If you want more detail, listen to Peggy’s back shows on her website or on iTunes, the latest ones being about Debunking Myths about Cellphones and Driving.

Just putting that into context, most people think that dialing a number (I only dial on my hands-free via voice commands with  Siri, or not at all these days) or sending a txt isn’t a big deal. I see ‘professional drivers’ holding their mobile up to their ear pretty much daily. One would assume they are sober, and mentally alert. I was also going to say relaxed, but if they were relaxed, they probably wouldn’t feel the need to take a personal risk, let alone knowing they are breaking the law; so you could surmise that they are already distracted and their minds are not on the road. Yet the study showed that drivers using their mobile were more distracted and less able to perform than those who were at a blood alcohol level where, according to a Blood Alcohol Chart on Wikipedia, they were at the upper range and would be experiencing:

• Impaired reasoning
• Reduced depth perception
• Reduced peripheral vision
• Reduced glare recovery; and behaviors including

• Blunted feelings
• Dis-inhibition; and
• Extroversion

I really enjoy listening to music when I drive and I have a full subscription to Spotify. I love it. My iPhone FM Transmitter sends it to my car stereo, while charging my phone. I like that. I have been guilty of occasionally looking down at my iPhone for the name of an artist or to skip a track. Our maximum legal driving speed on motorways and highways in New Zealand is 100kmph. Often that is on highways where kids play or cycle on the side of the road. All it takes is for a ball to bounce onto the road, or wandering stock to change things in an instant.

So I thought I’d have a look at the numbers and went to the Unitarium online speed calculator. I worked out that if my eyes were on my phone for 3 seconds (doesn’t sound like much) whilst driving at a legal 100km per hour, my eyes would have left the road  and I would have been oblivious to what was happening on it for 30 meters!

Have you ever done that?

Your indicator is not an extension of your steering wheel!

I had two near misses on the way home from work last night. The first one was on the freeway. A guy two lanes across from me turned into the lane I was turning into after I started my man-oeuvre  into an empty space. He didn’t indicate until he was halfway into my lane. He jumped back when he saw me coming as did I. The difference was I was well ahead of him and indicated a couple of seconds before I started turning my wheel.

Don’t people think about their turns any more, or that there might be other people on the road. Sometimes you might have a car or a motorcycle in your blind spot, but not when they are in front of you.

Or beside you which was the case in the second incident last night. It was a 2 lane 60km per hour road and the car in the lane exactly next to me, not in front or behind, just shifts straight into my lane, indicating as his hand reached the arc that allowed it to connect with the indicator in mid term.

I slammed on the brakes, and fortunately the car directly behind me must have seen it coming because he also managed to avoid crashing into my rear end.

So I got home safe and sound, but continue to wonder at the number of people who either don’t indicate at all, or are half way through their turn or lane change when they finally get around to it. It’s a wonder there aren’t a hell of a lot more accidents.

We focus a lot on learner drivers, but I think we should also retest experienced drivers, perhaps once every 10 years. Would you pass a randomly required driving test tomorrow?

What could go wrong if you leave your mobile on during an air flight?

The engineer sitting next to me dropped his head in disbelief and then shook it from side to side with an air of disappointment and dismay. I followed his gaze back to  the flight attendant who was leaning into the window taking photos with her mobile of the stunning sunset from the empty front row seat on the port side of our Air NZ ATR 72 flight in the final minutes of our descent into Auckland yesterday evening. I looked back at him and said “I was thinking the same thing.” Having had a conversation with him about our reliance on computers in transport these days.

This is not the flight I was on last night, nor the same type of plane.

As she was clicking with the volume turned up making a loud camera shutter emulation sound, I thought back to earlier in the flight when one of the flight attendants did her first PA not long into our 1 hour domestic flight. The PA came complete with the GSM bleep a phone makes when it is too close to a speaker; you know, the noise your mobile phone computer makes when you have your it too close to the speaker as it connects to the telecommunications network.

This got me to thinking about the number of people I see on flights who put their phones into flight mode before take off, but don’t actually switch them off, despite being instructed. It seems that a very large percentage of people don’t actually switch them off before they go into their pockets. Most of us have probably done that at some time, not thinking further, even though the instructions are very clear, flight mode, then switch off.

Farther into the flight, we had broken the clouds as I asked a flight attendant, serving mineral water into the plastic glass I was holding out for her, if I could now use my Kindle, which was dutifully in flight mode. I had to say Kindle several times, which she didn’t seem to understand, so I asked if we were at cruise altitude so we could use safe electronic devices. “No.” she replied after a little thought.

On her next PA, there was that GSM ping-ping again, as the flight attendant began another PA, telling us that the coffee service would be delayed due to unexpected turbulence. It was briefly interrupted and the pinging stopped, perhaps as she moved her mobile farther away from the microphone.

I was looking forward to the PA to tell me that electronic devices in flight mode could be used, so I could enjoy one of the books I recently purchased for my Kindle. It never came. The next PA, again with the GSM pings came on to say we were heading into our final descent again, was to tell us to stop using and switch off all electronic devices.

I was most disappointed because there had been some stunning cloud formations on the flight home that I would have loved to have captured. This is why my attached pic is from a different trip, I took with Air NZ last week.

So back to watching the flight crew attendant taking photos just before she strapped her self in for landing. I discussed the situation of fly by wire and the fact that there were rumors that the American Federal Aviation Authority were going to relax their rules on using mobiles during take off and landing, that they suspected it wasn’t in fact dangerous. With both of us having a degree of engineering training, we understood the concept of signal induction, which was of course the cause of the tell tale bleeps on the PA, which suggested that he phone might not have been switched into flight mode at any stage during the flight.

As we landed, we were pleased to be on the tarmac safe and sound,  but we thought back to the missing Malaysian Airlines plane and I remarked “Whether it is safe to use your mobile or not, imagine if the plane had crashed and it was your mobile they found that was still switched on?”

It amazes me that passengers flout the rules as if they know better than the Aviation Authorities with “I’ve flown a thousand times and I’m still here.” When it is the professional flight crew who flout their position in front of passengers in order to get that great sunset shot, several minutes after having told everyone to turn their devices off, that might be taking it too far.

I didn’t get to read my Kindle eBook, because she had never told us we could turn our devices on. I looked around several times to check if anyone else was using a tablet or other device and they weren’t. What was interesting to me is that not a soul said a word to her about having her mobile on and using it, despite having told passengers that the rules were that we couldn’t. What if her mobile had cause interference during a wing over or other maneuvering of the plane? You might not be reading this blog.

Do you switch off all your devices during flight when instructed. Did you realize they have to be not only in flight mode but be switched off?

 

 

 

 

Returning Veterans in noncombat car crashes (Read Time 1:33)

Motor vehicle crashes are part of every day life and I have an interest in what causes them and how to reduce them. I’ve been listening to a podcast by Dave Wallace, the Traffic Safety Guy, called Highway to Safety.

From a Bradley to a Civy Street

Something I have heard of previously but isn’t front of mind in New Zealand because we are a small country with a small defense force, is what happens when you take someone who has spent 18 months in a combat zone, where they literally have to make split second decisions, and when they come home they pop into the family car to go out for a drive.

When we learn to drive, we learn to look out for animals, for kids running our from behind a bus or an SUV or for drivers of other vehicles driving their cars in an unusual manner, all of which are common day occurrences.

Now take hardened, combat ready veterans who have seen innocent looking situations turn into death traps, where sub second muscle memory instinctive and instant actions can save lives. That family pet lying on the side of the road at home could be a sleeping pet, but in the combat zone, could be a booby trap.

According to a 2009 Army study, quoted in the podcast, Iraq and Afghanistan veterans are 75% more likely to die in car crashes than the general population. In fact from 1999 through 2012, 4,423 active military personnel died in non combative crashes.

I can’t imagine what it must be like re-integrating between or after terms of duty, but it makes total sense that there is a problem and it is being addressed. A Home Safe, Drive Safe campaign is being adopted by the various sectors of defense in training offered to service people when they return home.

As you will hear in the brief PSA video by Nascar driver Richard Petty, more returned veterans die in their first year back home in motor vehicle crashes than for any other reason.

This is something I have never considered. We hear about all sorts of adjustments people have to make, but next time I hear of a returned soldier who has had a serious accident as a consequence of responding to a situation that would for most of us be a non event, I’ll be wondering if the have had that part of the debrief and are conscious that they are not in a war zone.

So from someone who has never been in that situation, but enjoys living in a free democratic country, I say “Thank you for your service, we want you to stay alive, safe and well.

If you have a story about this topic, I would welcome it if you would like to share an experience or comment.