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.

Advertisement

We Will Remember Them – Our ANZAC Soldiers

We are not a militaristic nation, we Kiwis. However we have a proud fighting tradition, standing up for democracy and human rights all over the world. We lost many men and women in the World Wars and on many other fronts such as Viet Nam and Korea. Once a year on ANZAC Day, we remember them and those who have fallen since, in Afghanistan, East Timor and other fronts. In RSA Clubs around the country the dwindling numbers of vets and their families have a beer, share a yarn, have a dance and a sausage roll and club sandwich and share the ANZAC Prayer.

“They shall grow not old, as we that are left grow old. Age shall not weary them, nor the years condemn. At the going down of the sun and in the morning, we will remember them.”

Then they play the last post, we stand proud and we remember.

Laying the Kings Wreath 2011

My late father in law was a few months from his final rest after a terrible fight with cancer. He served in the Air Force in Guadal Canal and other locations during World War II and my mother in law was a Wren. You should have seen her march in the parade, as erect as she would have been in her youth. Now we are left with photos and memories, not only of our people, but of their reunions with their fellow service people, remembering the fun times and remembering the fallen and the horror as the nights went on. The things that they could only discuss with those who had shared the experiences. The things we civilians can’t appreciate because we weren’t there. The trenches, the mud, the desert, the beaches, the waiting, the camaraderie, the fear, the relief, the moments of respite, the people in the countries where they served, who looked at them with gratitude and relief, coming home with their cobbers, coming home without their mates.

Today is ANZAC Day and we remember our lost and respect those who remain. I’m proud to be a Kiwi, even though I am an import. In some ways more so because, while I haven’t experienced war first hand, I was born in Holland and the Allies rescued our country from the ravages of 5 years of occupation.

When I was in the USA again last year, I was humbled by the respect shown to all veterans in all places. Everywhere I went, I met and shook hands with people who had served. Everywhere I went, people thanked them for their service. Every concert I went to, we stood and people were thanked for their service. Of course the numbers of people who have served in the USA are so many more on a ratio than in New Zealand. They are more visible as well. While there is a lot of negativity towards US involvement around the world, I have to wonder with a shudder what our world would be like if they weren’t there. I also think about the fact that we are talking about individual people, with partners, children, parents, who are stepping outside of their lives to do the right thing for their country. They all have their own stories.

That’s what motivated me, after 6 months of research, to write the song Another Stretch in Iraq, my Christmas song for 2007. I remember performing it in a ‘biker friendly’ bar in Florida, seeing a couple of 6 foot something men coming to the stage and thinking “I’m going to get beaten to a pulp” as the came towards me with tears in their eyes. But no, they came to thank me and welcome me into the arms of their Desert Storm ‘family’, saying that I had taken them straight back to their Bradleys and MRE‘s.

Yet, as I sit here in my lounge and watch the ANZAC commemorations in New Zealand, I am reminded that we, at the bottom of the planet, far removed from all the fronts and global politics, do serve. We tend to be in peacekeeping forces these days rather than at the front lines, but you will find Kiwis in most countries where there is freedom to be preserved. We fight for human rights. We take global responsibility as we can and we care fiercely about freedom and democracy. To a large degree we do that because of those who lead by example, who took arms and piled onto planes and ships and those who didn’t come back.

We will remember them. We do remember them. Even if our eyes aren’t wet every day as they are this morning. We remember them and we honor them by trying to do the right thing for the future of our children.

The ANZAC Currency is approved

Yesterday evening agreement was reached between the NZ Prime Minster, John Key and the Australian Prime Minister Kevin Rudd, to create a common currency. In a joint statement they said that this had been on the table for many years and successive governments had decided to see how the Euro fared as a shared currency. Given this success they have announced that within one year of today, there will be a new shared currency between Australia and New Zealand called the ANZAC Dollar, or ZAC for short.

There will be a commemorative ZAC Dollar silver coin minted next month as a collectors item. Given the relationship between Australia and New Zealand, whose soldiers fought side by side in 2 World Wars, the commemorative coin will be minted on two sides. One side will feature Sir Charles Upham, possibly the most decorated Kiwi, with a Victoria Cross & Bar, Greek Medal of Honor and African Star. The other side features Australian War Hero, Alfred Shout, who earned many citations including the Victoria Cross, Memorial Scroll and Kings Message.

The existing currencies of each country will be phased out over a 2 year period and from 25 April 2010, the date of the ANZAC Day commemmoration, either currency will be accepted in both countries until the new currency is released.

“This will herald a new era of a close relationship that has existed for over 200 years”, said John Key  from his Beehive Office in Wellington, where he quipped that he had of course not been around at that time. He went on to sayb that in these difficult economic times, a joint currency would have a stabilising effect on the local economy.