Health

Canada’s health system gave me a choice: years of disability, or $22k for private surgery

With wait times getting longer by the year, the choice was easy

A photo of a hip x-ray

(Photo illustration by Maclean’s, photo courtesy of iStock)

My hip pain started around 2015, when I was in my mid-30s. It began as stiffness, then a pinch or tweak. My wife Barbara and I live on an acreage in Sturgeon County, Alberta, with our three kids, where we raise a handful of cows and some chickens. So our lives are very active, and I’m also a park maintenance supervisor at a nearby provincial park. That’s a physical job too, maintaining buildings, outhouses and campsites. I wasn’t exactly used to sitting still, and at first I pushed through the pain—I figured it was something minor, and I just did some extra stretching. 

But it got worse. I tried acupuncture, then physiotherapy, and even things like turmeric tea. But nothing helped—eventually, even rolling around with my kids became too painful, and I had to stop playing sports, which had been a huge part of my life. By March of 2021, I started seeing a chiropractor, but we didn’t make much headway, so he wrote me a referral to get an X-ray for my GP to review. That was when things got real. My GP concluded that I had advanced osteoarthritis, and he referred me to an orthopedic surgeon. But just as I might have expected things start working faster, they slowed down. I waited two months just for the surgeon’s secretary to call me back; when she did, she booked an appointment three months out. 

I finally saw the orthopedic surgeon in September of 2021. He said I had the hips of an 85-year-old, and concluded that I’d need hip replacement surgery. But because the lifespan of an artificial hip is about 20 years—and you can generally only replace them once, because they create cavities in the bone, which weaken it—he said I should put off the surgery for as long as possible. In fact, he told me he wanted to see me “crawling on the floor in pain” before putting me on the waitlist for surgery. It was a joke, but it seemed to trivialize my suffering—and I almost was in that much pain anyway.

Soon, even walking became hard—there were times when I couldn’t get out of bed without terrible pain. Getting in and out of the tractor I use for park maintenance and on the farm became impossible on some days. I pushed myself as hard as I could every week, and then ended up on the couch every weekend, trying to recover enough to do it all again. In just a few months, I had gone from being an active, athletic, outdoorsy person to being dependent on others for basic tasks. My wife, kids and in-laws helped with big things, like hauling water for our cows, and even with simple tasks, like bending over to put my socks on. If I dropped a pencil on the floor, I had to call one of my kids over to help me pick it up. 

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I had become functionally disabled. Everything in my life revolved around pain management, and I calculated every movement in my day to minimize pain: walking up and down the stairs, getting in and out of the car, stepping over curbs on the street. My biggest fear was tripping on something. I developed a defensive posture when my kids would run up to me for a hug, stopping them with my arm so they wouldn’t bump into my legs and accidentally make my hips move. Their presence, rambunctious and active, came to feel like a threat. 

The following summer, in July of 2022, I had another X-ray done, and my GP—who was as supportive and helpful as he could be—said my hips were “completely obliterated.” Two months later I saw the orthopedic surgeon again, on a short-notice appointment because the pain had become even worse. He finally agreed to put me on the list for surgery, but the estimated wait time was two years. This is crazy, I thought to myself. I can’t live like this. I was angry at how our “free” health care system worked. Yes, the surgery would be free—when it happened—but I was paying now in a different way, in the time it took for constant trips to the doctor, lost time with loved ones, activities I couldn’t participate in and a dramatically lowered quality of life.

Of course, I know I’m not alone. According to the Canadian Institute for Health Information, the benchmark wait time for a hip replacement in Canada—the target time—is 26 weeks. But barely half of all patients nationwide are treated that quickly, and the figure is even worse in Alberta, with only 38 per cent treated within the benchmark. Younger patients like me are pushed way down the priority list and forced to wait years, even as their quality of life is diminished and their condition deteriorates, making long-term recovery harder. In my case, for example, all my limping around had started to cause muscle atrophy.

READ: State of Emergency: Inside Canada’s ER Crisis

Those numbers have been quickly getting worse, as well. As recently as 2019, 75 per cent of patients looking for hip replacements like mine were getting them within the benchmark time. The trend holds for other procedures, too. In 2019, 70 per cent of patients in need of knee replacements had them done within six months; today that figure is only 50 per cent. Wait times for even life-saving procedures have risen too, depending on the province you’re in. In British Columbia and Nova Scotia, only 85 and 79 per cent of patients, respectively, are getting radiation therapy within the four-week benchmark. That’s down from nearly 100 per cent in both provinces as recently as 2019.

So my wife and I researched our options. We considered paying for private surgery in Canada, which would cost about $30,000 per hip. But I’d have to leave the province, because regulations mean that a private clinic in Alberta can’t charge an Albertan for a procedure like mine. So I’d have to go to Ontario or B.C. That meant I wouldn’t have any outpatient support, like physiotherapy, unless I paid for it as well, in addition to flights and accommodations. 

Around this time, my supervisor at work told me about something he’d heard on the radio about Canadians going to Germany for hip and knee replacements. I googled and found a company called Nordorthopaedics Clinic, in Lithuania, which specializes in medical tourism. We emailed them in mid-September, and they asked for copies of my X-rays to show their surgeon. He replied the same day saying that I was a good candidate for surgery. Then they sent over some dates for openings—the earliest only four days away. I was shocked at how quickly it could happen. There was some risk involved, of course. I’d be getting a life-altering surgery in a foreign country. But my situation had become so dire that I was willing to take the leap.

We booked a date for my right hip, which had given me the worst pain. We love to travel, so we made a trip of it, arriving a few days before the surgery to explore Vilnius, the capital. Then we drove 90 minutes west to Kaunas, where the clinic is located. 

Of course, I was anxious. They were going to cut into my butt muscles and part them “like curtains” to access my hip, remove the old hip joint, grind out the socket of my pelvis, then drive the artificial hip joint into my femur. I’d be under general anaesthetic, and afterwards I’d stay in the clinic for two nights, sharing a room with another patient. Then I’d move into an apartment building with a nurse on call, costing $100 a night. I’d have six days of one-hour physio sessions to get me moving again so I could board my plane home.

When I got out of the surgery, I had some soreness in my femur—apparently, they used a hammer to pound the new joint into the bone, so they kept me hopped up on serious painkillers for two days. But once the drugs and post-surgery haze wore off, it was obvious how much better I felt. On the third day, after moving into the apartments, I was sitting in a chair and my wife asked how I was feeling. I was testing out different movements, and opened up my knees to the sides, which was impossible before. There was no pain at all. “Holy crap, look at this,” I said to my wife.

By the time we got on a flight back home, my hip pain, which had dominated my life, was gone. I could rough-and-tumble with my kids again. One day, my youngest playfully hit me and ran down the driveway. I chased after him and caught him. His reaction was priceless because it was something he’d never seen me do before. Less than three months after my first surgery, I danced with my 11-year-old daughter at a Ukrainian celebration (my family is from the Lutsk area, in northwestern Ukraine), which is something I could never have done before. It made me realize how much I’d been missing with my children.  

READ: I’m a family doctor in Halifax. Here’s why pay-for-service clinics will burden the public system.

In the spring of 2023, I decided to return to do the same surgery on my left hip, which was getting worse. We turned it into a family vacation, and spent two weeks touring Estonia, Latvia and Lithuania, then I went in for my surgery in July. 

I haven’t felt this good in years. It’s amazing how being—or rather, not being—in constant pain changes your frame of mind. My daughter told me I was always grumpy before, and that I’m not like that anymore. I’m skating again after years off the ice, and I’m planning to return to my old hockey team. We also do a lot of skiing as a family. My youngest kid is just getting into baseball, so I hope to do some coaching with his team when the season starts up again. My eldest son and I are going on hunting trips, walking miles through the bush together. I have my life back.

This whole experience has made me extremely frustrated with the state of Canada’s health system. I pushed myself way too far putting off the first hip surgery because I didn’t know there were other options. But there was no need to put myself through that much pain and anguish. The total cost of my two surgeries was about $22,000, and it was the best money I’ve ever spent.  

I know I’m in a privileged position, lucky to have been able to borrow the money I needed. If I hadn’t been able to, I would probably have been looking at going on full disability indefinitely, which would have cost the government a lot of money both directly and in lost income tax revenues, since I wouldn’t have been working. I’m only 44 years old, and to have someone in my position sitting on the sidelines is ridiculous.

As told to Andrea Yu

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