Crossing the Finish Line

I’m not one to sit back and wait for something to happen.

When I left off in March, I was at the lowest point in this journey yet. Instead of moving forward, I’d taken a huge step back. A 12-14 month wait for surgery, following not having my referral even make it to the surgeon’s office, which took me to early 2021 at best.

Desperation hit the point where I started drafting plea letters to my surgeon, Alberta Health Services and the Health Minister (these never made it out the door – it happened just as the COVID-19 pandemic was taking hold in Calgary).

Then, a window opened…

Let me take you back. Many may know that Matt was, unfortunately, laid off in late 2018. After almost 14 long (LONG) months, he secured a full-time job and started in January 2020.

At the end of February, he finally got his hands on the detailed booklet for his employee health benefits plan. I am one of those people who takes every advantage of health plans for my preventative health, so I read through it. As I scanned the table of contents, five words caught my attention: Out-of-Province Medical Referral.

In short, the benefit stated that if you receive a referral for a medical procedure (even non-emergency) and have it done out of your home province, the plan will pay up to a certain amount of the medical expenses, given prior approval. The reimbursement amount was enough to make this a viable option for me.

I’ll be straight: I’d never seriously considered private surgery. I am proud to be Canadian and think we have an exceptional healthcare system. In the past two years we’ve had numerous friends and family members diagnosed with cancer, receiving prompt and excellent care. I had an emergency appendectomy in Quebec and didn’t pay a cent. My dad had his knee replaced just a couple of weeks ago.

However, when it comes to elective surgeries, I think there’s a gap. And for those with a condition that does not greatly affect their lives, they can afford to wait. But it had been over a year since I first started trying to have my condition diagnosed and fixed. If I hadn’t taken it upon myself to have my pressure test done in Arizona, I would’ve waited at least an additional five months to be diagnosed (likely closer to a year as my appointment would’ve been scheduled as COVID was shutting Alberta down). And now the 4-6 month wait for surgery had ballooned in to at least a year, likely closer to 18 months, again due to COVID.

Despite a somewhat healthy diet, I gained a significant amount of weight due to not being able to exercise, especially cardio. When COVID shut down the pools, my only source of significant cardio (deep water aquacize) was ripped from me. Otherwise, I couldn’t do more than a few minutes without my calves hurting. Recall: not heeding the pain can cause permanent, long-term damage in my muscles and nerves. Even worse, my mental health suffered. Cardio, especially running, was a tactic I used to manage my anxiety. Without this outlet, my anxiety spiralled (in conjunction with stress over Matt’s long job search) and I started taking an antidepressant for the first time in June 2019 when I broke down crying in my doctor’s office. Waiting another 12-18 months simply wasn’t in the cards if I could help it.

Finding a private surgeon that would operate was difficult; most orthopedic surgeons only do the more common, complicated (profitable) surgeries, like knees. I also got in touch with the surgeon that did my pressure test in Arizona, however with the exchange rate, plus travel expenses, the cost was prohibitive, even with the insurance plan benefit. And thank goodness I didn’t choose that option, as with COVID, while I may have been able to fly to Phoenix on “essential travel,” there is no way I’d want to travel to the US right now. Plus, earlier this year, the Alberta Health Care Insurance Plan stopped reimbursing for all non-emergency procedures outside of Canada – while they don’t give much, it’s better than nothing.

Luckily, I found surgeon who is licensed in Alberta, BC and Ontario. In BC, he operates out of both Kelowna and Vancouver. After inquiring as to whether he’s done fasciotomies, and getting a quote, I finally settled on him as my surgeon.

Matt and I discussed the pros and cons, and I applied for the medical referral benefit with his plan. It took some time to receive a response – likely because they don’t get requests for this benefit often. In the best timing ever, during the week that COVID-19 exploded in North America, I received the pre-approval. Thus began balancing a new COVID-19 work-from-home routine with worrying about my parents still in Arizona and trying to maintain any sort of exercise routine at home plus starting my “private surgery route.”

Why Kelowna? Let’s face it – it’s an easy 8-ish hour drive and we did a little wine touring prior to my surgery as COVID had settled down at that point.

My original surgery date was April 21, but with the shutdown that came shortly after, obviously that was pushed out. Frustrating, but understandable.

We did a video call toward the end of March to cover basics and for me to ask questions of the surgeon. Finally, when his office received confirmation that the Okanagan Health Surgical Centre would be re-opening, I was booked for a June 17 in-person visit with my surgeon and July 14 surgery in Kelowna.

It took forever for June 17 to come – but the month afterward flew. The in-person visit was a chance for the surgeon to actually see my calves, and for me to ask last-minute questions. The week prior to our leaving was stressful. It’s one thing to prep to go on vacation. It’s another thing to get ready to have surgery. And yet another for both at the same time. And, finally, complete mayhem doing all of the above during the time of COVID.

We protected ourselves as much as possible by bringing lunch for the drive out, toast and PB/jam for breakfasts, snacks so we wouldn’t have to grocery shop, and lots of masks. We also ordered take-out more than we ate out, and always ate on a patio.

Aside from the fact that no one told me my surgery was moved up by two hours until I got a phone call asking if I was coming (I’m still not sure what happened!), everything else went as planned. There was a bit of back and forth with the anesthesiologist because I have a mild version of an autoimmune disorder (currently under review – but that’s a different blog post) that can make general anesthesia slightly risky – never a dull moment.

I had a bilateral surgery, which means he operated on both legs at once. Because the pain was identical in both legs, it’s common to do it this way, even if recovery is a bit more difficult. If I had one leg fixed, I’d still have the same issue with the other leg and it would put my return to full “normal” back by however many months or years I’d wait for the second surgery.

We stayed overnight in Kelowna after the surgery – the hotel was a rock star with supplying a wheelchair when I needed one even though I hadn’t thought to notify them prior to my surgery, and letting my parents block part of the parking lot for an hour with their RV on departure day. My parents came out for vacation and moral support, so I was lucky to ride back with them while poor Matt had to drive back himself in our car after a bad night of sleep. However, riding in the RV gave me more of a chance to elevate my legs and move my feet, which decreases the risk of blood clots so soon after surgery.

Now comes the boring stuff. I submitted my receipts for the surgery itself to the Alberta Health Care Insurance Plan – judging by how much was reimbursed after my trip to Arizona, I didn’t expect much, and that’s pretty much what I received. As a matter of procedure, I submitted to my own employee health plan but didn’t see a reimbursement. And then we mailed off the 12-page package to Matt’s health plan – and I received the entire expected reimbursement.

It doesn’t escape my notice that I am privileged that Matt landed a job with a clause in a health plan that I’ve never seen, which appeared at the very time I needed it the most. And we are lucky that we were able to save some money over the past few years, despite hiccups, to use for whatever we weren’t reimbursed.

Travel costs – well, we likely would’ve taken a visit to the Okanagan this year anyway, COVID permitting.

Thus ends the main story of my chronic exertional compartment syndrome and the journey to getting a fasciotomy. Thank you to everyone who has supported, cheered and kept me in their thoughts. It hasn’t been an easy 18 months but I’m proud to have such a strong network to get me through it.

A special thanks to Matt – from the mental and physical health tolls, the stress of navigating both public and private systems, tears, rage, anxiety… not to mention waiting on me hand and foot and managing the household while I was out of commission.

I’ve had to break myself down to build myself back up. I’ve crossed a metaphorical finish line; I can’t wait to cross many more literal ones in the coming years.

Read on to see my post-op musings