Over the last 8 months, I’ve learnt far more than I ever wanted to about Canada’s–and specifically Ontario’s–healthcare system: hospitals, home care, the patient experience… not to mention the costs involved.
Back in October my husband Dave, who has type 2 diabetes, suddenly found himself battling a badly infected foot ulcer He was signed off work and hooked up to IV antibiotics with regular nursing care at home. But the antibiotics weren’t helping and he was advised to report to the emergency room at the hospital.
After being admitted to hospital (after the expected wait of several hours), Dave was under the care of a vascular surgeon and placed on a stronger, different mix of antibiotics. But the infection was just getting worse. The surgeon advised that a partial foot amputation was the safest option to stem the infection This was a hugely traumatic thing to deal with, but with the possibility of the infection spreading beyond the foot and becoming life threatening, it seemed like the only thing to do.
Surgery was successful and after a week in hospital, Dave was discharged. Our daily life now required a lot of adjustments–accessibility had never even entered into our minds when we bought the house. But at least he was back home and the healing process could begin.
But after a few weeks it became clear that the foot wasn’t healing properly. At a follow-up visit at the hospital, a lower leg amputation was recommended as the best available option and a date for surgery booked. As you can imagine, this was the lowest point. We tried to deal with it as best we could and there was plenty of very, very black humour flying around.
Over the following days I immersed myself in wound care research, looking desperately for alternative options. I came across many different treatments that hadn’t been offered to my husband; in fact they hadn’t even been mentioned. How could it be right that his surgeon just wanted to amputate without trying any of these, without giving things a chance? Dave too was having major doubts, not least because his home care nurse was seeing signs of improvement in the foot. So he decided to refuse the surgery.
Here we are 8 months later and the wound area on the foot has shrunk dramatically, although there’s still a long way to go. After relying on a walker and wheelchair for several months, Dave’s progressed to short walks on flat trails with a cane for support. I’m so proud of him for his determination and positive attitude through all this. We’ve also had a great back-up team: homecare nurse, chiropodist, and the support of family, friends, and work colleagues, who were really there for us during the worst times.
All of this has definitely been a learning experience. So many people have told us that because surgeons are paid per surgery, they’re way too quick to operate and don’t have any interest in wound care. So amputation is–for them–the quick and easy solution.
The availability of healthcare and treatment options can also vary widely depending where you live. Had we been in Toronto, perhaps things would have been different. It seems also that Canada lags behind the US and the UK in terms of advanced wound care. Even living just 20 minutes out of town has an impact; it’s harder to get nursing coverage at weekends and public holidays because no one wants to drive out so “far.”
How much did all this cost us? The surgery, cost of medication while in hospital, and the hospital bed in a shared ward, was covered under OHIP (Ontario Health Insurance Plan). Upgrading to a private ward or 2-person ward wasn’t covered, but we were able to claim this through my work benefits with Sun Life. These schemes typically cover your spouse and children for up to 80% of costs that aren’t covered on your provincial health scheme. Even with benefits, the cost of assorted prescription medications soon adds up.
We had to buy a walker after the initial free rental period, as well as paying for some adjustments for the bathroom. It may be the last thing on your mind during a health crisis, but keep copies of all your medical expenses and any costs involved in making accommodations at home. Try and get prescriptions for as much as possible as you may be able to claim the tax back on these costs later on.
We were able to claim Employment Insurance (EI) sickness benefits, but these only lasted 15 weeks, which is crazily short when dealing with a major health issue. Other options for disability benefits may be available after that (they weren’t to us), but are means-tested. To move onto regular EI benefits, you have to be certified as “fit to work” by a doctor and be actively looking for work.
If you, or a family member, has diabetes, check whether there’s a diabetic clinic in your area. If you have doubts about your family doctor–and after all this we had severe doubts–you can be signed off their list. Just make sure you request a copy of your medical records before you leave. No family doctor is better than a bad one. Dave is now signed up with a nurse practitioner at the local diabetic clinic and we’ll make use of walk-in clinics as needed.
Be sure to do your own research using reputable sources of information and above all, never be afraid to question, or ask for a second opinion.