Medical system weak in the knees

Bob Morrissey

I’ve just come to the end of a love-hate relationship with doctors and the Régie de l’assurance maladie du Québec (RAMQ), our province’s version of Medicare.

The love part has to do with a few caring health professionals I encountered during this past month. The negative side has to do with a system that lets a person — in this case, me — suffer needlessly for almost three weeks.

It all started five weeks ago, the day after I had played something I hope resembled golf. When I awoke that morning, I couldn’t walk because of extreme pain in my right knee. At 83, I’m used to sore joints — but nothing like this. I couldn’t put any weight on my foot. And the fact I live alone didn’t help.

At first I tried treating the injury myself — resting and icing the knee for 20 minutes, three times daily. Resting was the easy part because, thank God, I was pain-free sitting or lying down. That was pretty much all I did that week. But I was hardly eating because it was a five-minute struggle making it from my bedroom to my kitchen. Usually I’d phone out for food. Falling down was also a concern.

After five days of this, on Oct. 4, in desperation, I drove to the nearest ER, arriving there at 7 a.m., hoping to beat the rush. I succeeded in finding a parking spot about 40 yards from the main entrance. It took me about five minutes to reach the huge glass revolving door, but after taking just a few steps inside, I couldn’t go any farther.

I froze in the middle of a semi-dark hallway. That’s when I heard a voice behind me yell, “It’s OK, sir, don’t move; let me get a wheelchair.” She was an employee starting her shift. She wheeled me into an almost empty ER, where I registered with my hospital card.

I didn’t have a long wait to be seen. But I was in no hurry — that wheelchair felt as comfortable as my couch at home. And the little walking I did had left me sweating and exhausted.

Twenty minutes later I found myself in a small examination room, explaining my situation to a very weary doctor, who had the good manners not to yawn, although I saw her eyes glaze over a couple of times.

“We’re going to take urine and blood samples,’’ she said, “and then we’ll X-ray your knee. But right now, let’s take your blood pressure.”

“You won’t like the numbers,” I said.

Was I ever right. The look on the doctor’s face when she saw the figures reminded me of the look on my father’s face when he checked my report cards.

The 220 number REALLY got her attention. She asked, “Do you have any chest pain now?” When I said no, she said, “We’re giving you an EKG right now and we’ll give you another one before you leave here today. That OK with you?”

“Only if I’m alive,” I said.

Anyhow, I spent the next nine hours in a wheelchair, watching the ER fill to capacity with mostly elderly people and ambulance patients. I actually enjoyed all the comings and goings after being housebound all week.

They never did take another EKG, but they took X-rays that showed nothing more serious than arthritis. Mild arthritis, at that — and maybe a little tear in the knee. And yet so much pain.

And now they were sending me home, with not even a pain-killing prescription. I had hoped they might keep me overnight and have an orthopedic surgeon examine me the next day and perhaps give me a cortisone shot. I even told an employee, “Look, I won’t even take up a bed or a room; I’m fine sitting right here overnight in this wheelchair.”

She just shrugged.

I was too sore to get up from the wheelchair and too tired to argue my case. An orderly wheeled me to the hospital entrance where, aided by my cane, I struggled to get to my car. By now, it was dark out.

I was pretty discouraged when I arrived home. Two days later, on Oct. 6, the hospital phoned, giving me a follow-up appointment for the next day. I told the receptionist I could barely make it from my bedroom to the bathroom, let alone go to the hospital.

Seems they were more concerned about my high blood pressure, which by now, I felt the hospital was partly responsible for.

I said to the receptionist, “Look, what I really need now is an orthopedic surgeon. I can’t walk; I can’t put any weight on my foot.”

A few minutes later, the hospital phoned back with a referral to an orthopedic doctor 10 minutes from my home in Île Perrot. It was for Oct. 22 — which meant 16 more days of pain and worrying if I didn’t take action.

My kind and helpful condo neighbour suggested I call an ambulance and go to a different hospital. But it’s the ambulance driver who picks the hospital — usually it’s to the nearest hospital or to a hospital that isn’t overcrowded, if one even exists. A friend said, “Just show up at the hospital in a taxi.”

But would a taxi driver be willing to find parking, help me out of the car, and wheel me into the ER?  And what about the drive home? More troubling: Would I receive the same treatment in this hospital as I did in the other?

That’s when I decided to go private. At that point, I thought I might need an operation, especially after the first doctor said there might be a tear in my knee. Going private, I could undergo surgery inside of a month; it could take a year going public. That’s a lot of time to suffer.

So I made an appointment with an orthopedic surgeon on rue Jean Talon on Oct. 18. First consultation was $290. But how would I get there? The answer was in New York: my son Dan.

I flew him in the day before, promising him all the fast food he could eat. He took charge the second he arrived. He did everything I asked — well, except for the sponge bath.

Dan drove me to my noon appointment on Jean Talon and did most of the talking with the doctor. Watching them going back and forth was like watching a tennis match. But there was a hitch: the doctor couldn’t find my X-rays on his computer so he sent me, with Dan leading the way, for more X-rays at a medical complex in Westmount. By now I was REALLY in bad shape.

“When I get the X-rays later this afternoon I’ll phone you with the results,” the doctor said. “We can go from there.”

The call came around suppertime while we were eating pizza. The verdict? Arthritis. Plain old arthritis.

Dan and the doctor had a long conversation and then exchanged several emails into the early evening. He offered us sound advice and four different treatments, all involving injections, the most expensive costing $4,000. Not only that, he’d give the injection in three days. Now that’s what I call service.

Dan didn’t realize I wanted this doctor only if I needed an operation and booked an appointment. He was a little miffed when I asked him to cancel it, and I couldn’t blame him. By now we were both frustrated. We felt like we were treading water. But I knew I needed a doctor closer to home, especially for follow-up appointments.

I still had one option left: the public orthopedist 10 minutes from my home. That I could handle without Dan.

On Oct. 22, I spent five minutes in his office. He checked my X-rays, confirmed it was arthritis, and gave me a painless cortisone shot that went to work almost immediately.

It took me about 18 stressful days to find relief; it should have taken one.