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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The Backstory on My Back

Hi, I’m ACC 18 Number 201905123684, I’ve swapped the numbers a little, although it probably doesn’t make any difference. I’m fairly well known.

My back story consists largely of digital files and probably a few manila folders and other storage media in several Accident Compensation Commission, medical, physio, specialist, hospital, surgeon, Occupational Therapist, Pain Specialist offices around New Zealand. They get shuffled from time to time.

Having said that, everyone on my journey has been friendly, thoughtful and most have tried to help me. A few, who I haven’t met, somewhere in the system have the job of helping ACC to not have to pay for my surgery, with considered justification. I’ll talk about that too.

In March 2018, I hurt my back getting ready to set up for the Auckland Cancer Society’s North Shore Relay for Life event. The annual 18-hour relay, raising funds for cancer services which I have completed 6 times. I started with my family in honor of family members who have died from cancer, including my late father-in-law.

Then I got cancer myself, and during the fund-raising process I’m proud to say that over 30 men got tested for Prostate cancer because of my story, but I’m getting ahead of myself. I was given the honour of speaking at the opening, having refreshments in the survivors’ tent and carrying one of the flags in the first survivors’ lap. A humbling and emotional experience.

Trying, unsuccessfully, to awkwardly pick up a bag of tent poles out of a trailer provided at the venue by the organizers, for a 4 room tent, would set off a chain of events that has opened my eyes to the plight of many New Zealanders, who desperately want to work, but can’t, because the health system is underfunded, under resourced and inefficient.I became one of them.

I have a job. I hold a management role at the NZTA, a job I love with an awesome team of people who provide mostly Real Time Travel Information to motorists and travelers around the country.

It’s been 14 months since my injury.

My Occupational Therapist, GP, Pain Specialist and my Manager have agreed that I can work 2 three-hour days a week. ACC funds taxis to get me there as I could be a danger to myself and others, under the daily pain medication regime I’m on. That allows me to do something productive as well as socialize with my colleagues and not feel totally divorced from my work.

It was part of my back to work program, which has stalled since the Orthopedic Surgeon advised me that we had ‘painted our backs into a corner, having tried every alternative to fusion and discectomy surgery.’

I am incredibly grateful that the NZTA hasn’t dropped me under the bus and that I still have a job, although I am not currently able to perform my normal duties.

Over the next while, along with other activities, I’m going to talk about my life, one shared with my family and friends, colleagues and the health system.

I’m going to talk about what happened, about why I still can’t go back to work, why I am still waiting for surgery after 14 months. How ACC don’t want to pay for the surgery, how I can’t afford to pay for the excess if I went private, and my current experience with the Auckland District Health Board and North Shore Hospital, where I was referred as an Urgent Patient on the 9^th of April.

I have not yet been able to connect with the person who makes appointments. When I rang them at the end of April, the hospital representative at the Patient Service Centre said they must see me within 4 months, and it was too early to ring. I was told it wasn’t worth ringing before the end of May and even then, not to get my hopes up. I rang today and left a message on their voicemail.

I have Prostate Cancer.

During the dark days of 8 weeks of radiation treatment, followed by chemicals, I think I had less than a week off work, on the odd day when I was so fatigued that I couldn’t function.

I arranged my radiation sessions to be around 7AM every morning so that I could go straight on to work afterwards, and still be on time. That’s how I roll.

I am now fortunately in remission, and my latest blood test last week showed a good result. The irony is that Cancer is fatal and there is every possibility that one day, hopefully decades away, it will kill me.

On the other hand, chances are very good that after back surgery, I will be a little sore from time to time, manageable with over the counter pain relief. Yet, for cancer I had less than a week off work and with a back injury it has now been over a year!

Mine is a common story, but one with which for the first 40 years of my working life I had no personal experience. I’d heard stories, mostly about people who allegedly don’t want to work, and enjoy living off the taxpayer’s dollar, but there are so many more people like me, who desperately want to work and contribute to society. If you have a look at my profile on LinkedIn you will read that my goal in life has always been to help people.

I consider my work important, a contribution to reducing the pain of traveling on our ever more congested road network by offering information about planned and unplanned events, about expected delays, alternative routes, alternate modes of transport, helping people plan for holiday road trips and much more.

I lead a team of awesome people who really care about you, their customers. It matters to me, but I’m being kept from it.

It’s funny, we talk about the cost to society of people who are needlessly killed on our roads. The cost takes into consideration the contribution they will make to the country’s GDP over their lives. Yet, the cost to taxpayers to get me back to work by providing me with back surgery, is far less than the cost of keeping me away from work.

As I said, mine is a common story, but it’s not one that people like you and I can easily relate to, unless we are directly affected.

Of course, in each instance, it’s not just the patient, it’s our partners, our family, our friends, our colleagues and of course the workload that must be done by someone else, or perhaps not at all.

I’ll try to make the story interesting, maybe even have the odd laugh. But let me tell you, this is no joke. I have gone from being super positive and highly motivated, with a bucket list of things I want to do which I prepared when I found out I have cancer, to being virtually trapped in my home, on the border of depression, not being able to stand, sit or lie down for any length of time without significant pain.

I’ll share an email I sent to ACC after having read a report prepared for them by a specialist, who said that “The patient appears to be doing reasonably well”.

Interestingly, this person who was paid by ACC to investigate my case did not once speak to myself, my GP, my Orthopedic Specialist, my Case Manager, my Pain Manager or my Physio.

I guess ‘reasonably well’ is a relative expression. I’m not dying.

The email is quite personal, but that’s really the point. I am a person.

Anyway, that’s it for now. I’m hoping to hear back from the hospital today and am getting on with other things in the meantime.

You may find my story interesting; you may be in a similar situation yourself. I know I’m not alone. I understand it was stated in Parliament Question Time last week that the number of elective surgeries completed last year was 10,000 ‘elective’ surgeries less than the year before. Reasons included strikes and funding. It’s little wonder it could take months for me to just be able to speak to someone.

Feel free to comment or ask questions. I know I’m not alone here and you may be in a similar situation to mine. I grew up as a fan of New Zealand’s welfare state. I learned that we are the system and that if we don’t stand up for something, no one else will either. I just didn’t know how bad it was.

So, you there. Have you had any experiences like mine? How do you get some action without ruffling people’s feathers and having your manila folder dropped down the list a little? Of course, that wouldn’t happen would it?

I welcome your comments.

 

 

 

 

@Orcon, Should I Stay or Should I Go?

Life used to be so easy when it was just Telecom who looked after landlines. Now when something goes wrong it’s all like, “your call is really important to us and is there anything else we can do for you?” BUT:

Our connection, which is unbundled, (so there is no dial tone and if the Internet is down, so is the phone) started playing up on Friday. Saturday it was on and off intermittently. I rang the nice man at Orcon who said that they would put a monitor on the line and he could see that it had disconnected about 9 times so far that day. So there was definitely a problem.

He said they would monitor it for 24 hours and see if they could find the problem. I was OK with that. I’m not an unreasonable person.

But I never heard back from them and it continued to be on and off all weekend until this morning, as I was trying to sort out emails and confirm my hydrotherapy for midday for my back injury, it all died. No phone, no internet.

So I rang them again and told them I suspected it could have been something to do with the company who looks after our water who had done some repairs for a neighbour and I asked if anyone else had any problems. “No” they assured me, Chorus had not advised of any other problems.

So they said they would try to get someone on to it today BUT:

• If it was on our property, it would cost us $130 for them to locate it.
• If they had to come inside and fix something it would be $230; and
• If I wasn’t home when they had to come in to check it out, and they therefore couldn’t come in, they would charge me $130.

So I had to cancel my hydrotherapy which I had been looking forward to. If you’ve ever had a serious back injury, you know how good it is to be in water and not have gravity pressing down on those bulging disks. The therapy is very important and I am doing it to either avoid serious surgery, or at worst be strong for a speedy recovery if I need it. I don’t need the stress on top of the pain.

 I went up to the end of the driveway to see if there was anything obvious and found an engineer who was working on a fault for my next door neighbour who apparently had reported problems since Friday and also had no Internet or phone!

The problem is that her account is with Vodafone and it seems that the left hand doesn’t know what the right hand is doing. With so many companies busy clipping the ticket of old copper wires, you have to wonder what happened to the ‘Kiwi Share’.

Given that I couldn’t go and do my physio, I got my daughter to stick around so I could at least go for a walk around the block and not get ‘fined’ if Chorus needed to get into the house.

When I got back I learned that yet another neighbour also had no phone. He didn’t report it because he knew that Chorus were working ‘on the line’. But he was with Spark, who don’t share information with Vodafone, who don’t share information with Orcon. It seems that internally Chorus don’t escalate things unless they are widespread, so they treat each call from the various ‘providers’ as isolated events.  My third neighbour didn’t realise that if he didn’t report it, nobody would know he had no phone or Internet and it wouldn’t get sorted.

So he is now ringing Spark and between us we don’t know if there are any other neighbours with a problem.

I did get a nice email from Orcon  saying “We’ve Got This’ and suggesting that I might want to reboot my modem as this often solves ‘problems’. I was thinking more that the telecommunications systems of virtual telecommunications providers might need solving.

I replied to the email from Orcon telling them how annoyed and frustrated I was with all the advice of what everything could cost me, when I know the problem is not on my side of the network. I then got a nice automated response telling me that they usually deal with issues within one working day and there were a couple of websites with “loads of answers for some of the most common questions”.

Next thing you know, as I am writing this, a Chorus wagon comes down my drive with another engineer who apparently knew nothing about the first engineer that had the plinth off, working on my neighbour’s line. No wonder they need so many lots of $130. I can’t imagine the overhead this all takes.

What I also don’t understand is why so many people have to be manually engaged in help-desks (at least one for each brand), manual testing and logging calls whilst not communicating with each other. Why doesn’t the network have some sort of intelligence that monitors lines and reports faults and outages?

I’m not being silly here. My first job was as a Technical Service Officer and I was the guy on the other end of ‘Faults Service’. I was highly trained and given a very thorough knowledge of all aspects of telecommunications. Now that was a long time ago and the systems were already reasonably sophisticated.

It was very easy to run ‘line tests’ and if there was a fault, we could usually see what type of fault it was from the ‘Test Room’ and what type of person (faultman, lineman, cable jointer etc) we would need to send out to check on the problem. The types of tests they do today are not dissimilar because much of the country still uses those same copper cables that haven’t been replaced in many decades.

I explained to the new Chorus representative what had happened. He went and had a look and eventually came back and told me that there was a problem in the neighborhood and that he would  report it to Chorus so they could send the right kind of engineer, probably tomorrow.

He also said that for a small monthly fee I could have a service agreement maintaining the telecommunications system on the inside of my property and house. I have never had a single problem in my house except for faulty Orcon routers! With today’s systems I don’t need to use the slick Cat 5 cable system my house was wired with, everything is wireless. I don’t use any of the other jack points. They are now redundant.

So now, he has told me they will hopefully send someone else out tomorrow!

So what do you think? Should I stay or Should I Go Now. Isn’t it ironic that this song is by The Clash.

I just got a text message saying the first available technician will be booked to look at my problem tomorrow. They had better come before my dentist appointment. They charge a lot more than $130 if you cancel on them.

Am I being unreasonable? Can one of the other Telcos do better? They know how to charge and threaten with additional costs, but what about compensation for me, including mobile data and lost time?

 

Floating to Relieve Back Pain and Stress

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I didn’t want to have Mental Health Week pass without posting something and this is going to become a short series on the benefits of floating in a sensory deprivation tank and my experiences with it. So ignore the next few blogs if you don’t have aches and pains or don’t suffer from stress.

I have been ‘floating’ for years and it amazes me that most people still don’t know it exists or what it does. I started a bit of a journal back in the 90’s about some of my float experiences and have always thought I would share it one day.

I’ve been off work for about 6 months due to a serious back injury and I have been taking a cornucopia of painkillers which means that I can’t drive and I’m often dopy and unable to concentrate for long. I’m doing physio and seeing a back specialist and trying my best to avoid surgery. Anyway, enough of that.

I’ve been going to a place called Float Culture where I lie in a tank like the one in this picture, which contains a solution of Epsom Salts (I think) and water at body temperature. You have a shower, climb in, float, turn off the light and relax for an hour. Typically there is music for the first few minutes while you relax and again at the end so you know your time is up. Sometimes I go into a meditative state and sometimes I fall asleep, and no you can’t roll over and drown.

Lately I have been combining it with massage and for a few hours I have been able to go from pain of around 7 out of 10 to almost nothing. Unfortunately it comes back after a while when gravity takes hold, but during that time it at the very least helps reduce inflammation and you feel like there is no gravity. Gravity is my enemy right now. Imagine having a great massage when your body is already relaxed.

The masseuse, Kim, probably doesn’t realise how much pain I am normally in, but combining her work (careful around the injury) and the float leaves me feeling so free of pain that is difficult to explain to someone who hasn’t been in chronic pain for a long time. Chronic pain and not knowing when it is going to end is extremely stressful, as is not being at work. If you have ever felt work was drudgery or you didn’t want to go, the feeling I have might be a bit foreign to you. I love my job and can’t wait to get back, but I don’t know exactly when I’ll be capable.

Another element of floating is that without any sensory input, not being able to feel where the water starts and ends, is that it is very easy to get into a trance-like state, effectively meditation. The difference is that you don’t need to know how to meditate. I often see people after they come out of their float room and they are radiating endorphins, your bodies natural opiates and often talk about having almost mystical experiences.

I have floated for lots of different reasons over the years, for relaxation, for creativity, to catch up on sleep, to alleviate jet lag (before or after a long haul trip) and, like now, when I have an injury. Whilst the pain came back, I slept all night (about half of the time I’m up for an hour around 2-3AM because of the pain) and my digestive system felt better. I also lost almost a kilo of weight over the 24 hours which is effectively a litre, even though I drank a lot. I didn’t realise I was carrying so much fluid! That helps too because a side effect of the drugs I am on is that you put on weight and more weight and a bad back is not a good mix.

On their site, Float Culture, one of the more recent additions to the floating experience in Auckland has a blog page where people share some of their experiences. I’m going to share a few experiences of my own. So if that interests you, you will find them by following this blog.

If you know anyone who is not claustrophobic and can do with a bit of inner or outer healing, or just an amazing relaxation opportunity, tell them to try it out and let them know you learned about it from me, or if you have had an experience, feel free to leave a comment. If you are not in Auckland, float tanks can be found in most cities around the world, just Google it.

They are popular with elite athletes, creatives, people with cancer and yet most people, including the health industry don’t even know they exist.

So if you’re interested in learning more of my experiences, follow this blog. If not, remember it for a friend.