Postponing knee surgery: Wait until you lose your dignity

Waiting for a 64-year-old man to have knee surgery completely undermined his quality of life, so he had to stop working and playing hockey, and he couldn’t shovel his lane anymore.

• Read also: The waiting for elective surgery varies depending on your … ZIP Code

“I felt vulnerable as a person,” admits Daniel Odette, 64. Finally, the Il-Peru native came under the knife last March, after a two-and-a-half year wait.

It ran at the Hôpital du Suroît, in Salaberry-de-Valleyfield, the facility in Quebec with the longest delay. In September 2019, he was warned that there would be a year of waiting, he said. Two years later, he was ranked seventh on the waiting list…and the surgery was finally done six months later.

“Having learned that we could choose to have surgery elsewhere, I would have done it […] It was really unbearable in the end,” sighs Mister Odette.

Although he had established a relationship of trust with his surgeon, the long months of waiting had a very big impact on his quality of life.

“If I didn’t have this orthosis, I wouldn’t be able to stand it [l’attente]He said pointing to the device he had to wear around his knee at all times.

After a year of waiting, he couldn’t live without it. Without the prop, he wouldn’t have been able to mow the lawn, for example.

It was also at this time that he had to completely stop playing hockey, a sport he often plays. Mr. Odette also became more and more frightened when he took steps, realizing that he might not be able to get home if he went too far.

But the worst happened after two years of waiting. The sixty-year-old service manager at a Metro grocery store was struggling to finish his days off.

Daniel Odette

Photo by Journal de Montreal, Chantal Poirier

‘It’s like old’

“I saw myself as a struggling little old man and unable to do his job,” he admits, feeling his dignity affected.

“I’ve always been proud of the work,” he continues. But for the first time in his life, he was looking forward to taking an afternoon break just to rest his leg.

His doctor put him on compulsory leave, to rest his boss and those close to him. But the six months before surgery also means a loss of income.

Today’s recovery period is tough, says Mr. Odette, adding that it would undoubtedly have been easier if he had been younger and had not gained weight due to his sedentary lifestyle over the past few months.

Mr. Odette’s case is far from unique. Orthopedics has been hit hard by the pandemic, as these “non-emergency” surgeries are often the first to be postponed.

20 times more than waiting

Since February 2020, the number of patients waiting for surgery for more than a year has increased from 300 to 6,400, a 20-fold.

Demand for knee braces will continue to increase until 2035 due to an aging population, the Association of Orthopedic Physicians of Quebec predicts.

“Waiting lists are exploding due to the lack of anticipation and care for these clients in the medium and long term,” regrets the President, Dr. Jean-Francois Juncas.

– In collaboration with Héloïse Archambault

More seniors facing deadlines

Quebec’s worst case of cataract surgery delays is in Chateauguay, where the new operating room has been closed for nearly two years.

“It’s nonsense, we have a new ophthalmology department, which has never been used,” pleads ophthalmologist Darquis Richard, who slams into a wall.

According to the latest data from the Department of Health and Social Services, the average waiting time is 40 weeks at Anna Laberge Hospital in Chateauguay, the worst in Quebec. The wait is four times longer than Longueuil, Saint-Jean-sur-Richelieu or Lachine, for example.

Why so many disparities? Answers the captain of ophthalmologists in Quebec d. Samir Lahoud, “Put your finger on the wound.” He regrets that agreements with specialized medical centers (CMS) do not take into account waiting lists.

For its part, the CISSS de la Montérégie-Ouest lacks explanations. If expectations are too high in Châteauguay, it is because the block has been closed during the pandemic and the beaches at CMS are not enough, answers Chancellor Jade St-Jean.

CISSS gives itself 12 months to reach an “acceptable level”. However, Chateauway’s new outpatient ophthalmology clinic, which opened in 2018, was supposed to allow an additional 1,000 cataract surgeries.

Rejected patients

Optometrist Darkis Richard also faces termination of inadmissibility if she tries to direct her patients where there is less waiting.

“I was told I was out of the zone. They don’t want my patients,” she says. However, the law allows the patient to go where he wants.

loss of autonomy

No one will die from cataracts, but it is the elderly who lose their independence. They can no longer drive and lose their activities and friends. It creates isolation.”

Recently, her father needed cataract surgery. But from the start, she was told she would have to wait until 2023, she says.

“I change his glasses every three months, otherwise he won’t see clearly. But you can’t change glasses indefinitely,” she says.

Otherwise, more and more patients are deciding to pay up to $4,000 per eye to have it operated privately within a few days.

The public network has emptied its employees

Doctors fear the government is standing on a slippery slope by relying on private clinics to reduce the huge waiting list since the pandemic.

“The belief that the private sector will save us is the refusal to see the migration of individuals that is causing it,” says GP Joanne Tremblay Beaulieu, of Quebec Physicians for Public Order (MQRP).

“What explains the wait is a lack of human resources to run operating rooms, not a lack of equipment. The bottleneck is that it is understaffed. Not surgeons, but lots of nurses and technicians,”

No more nurses

The doctor sees in her the “chicken and the egg” phenomenon. The more nurses in the private sector, the fewer there are in the hospital’s hundreds of operating rooms. The greater the demand for the private sector, the greater its recruitment.

“We always work with the same nurses, they don’t repeat each other,” she argues.

For its part, the Federation of Medical Professionals of Quebec does not believe that the future of the network depends on the development of specialized medical centers (CMS).

“As long as we don’t go back to pre-pandemic waiting lists, it will be beneficial, believes Dr. Serge Legault, Vice President of FMSQ. If we could get CMS clients back to hospitals, it would be much simpler.”

15% profit

For CHU de Québec health researcher Maude Laberge, the important thing is to avoid an outburst of expenses.

If private clinics could provide a similar service at a lower cost […] I don’t understand why we didn’t do this cooperation with the private sector.

However, the profit margin for the content management system increased from 10 to 15% last year, according to reports duty.

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