Helen’s arthritis symptoms began with 18 months of discomfort, which she could only describe as groin pain. “This became an annoying stabbing pain a few weeks after packing our house belongings and travelling for a year,” she explains.
Arthritis was picked up by her physiotherapist and formally diagnosed after an X-ray and visit to her GP a few weeks later. The GP said the osteoarthritis was already “mild to moderate”. Helen’s physiotherapist gave her exercises to mobilise and strengthen her hip.
“At the time, I was honestly more focused on the adventure of our year than I was with the increasing discomfort. I began to up the medication beyond Panadol & Ibuprofen towards the end of the year as we settled into our new home.”
“I fell into a six-month rapid rollercoaster of pain, nausea, weight loss, limited mobility, and an increasing need for assistance. I struggled with pain and disappointment, which soon became grief.”
“The change of location meant that I had to start the whole doctors’ process again. Fortunately, I found a wonderful GP who put in a first and then second, more urgent, referral as my health deteriorated. I was told to be a ‘squeaky wheel’ and keep asking for help if I wanted to see anything done – none of which is really in my nature.”
“I want to make sure others know where to start in finding support, what financial help might be available, information about medications, and where to get physical aids. Even the importance of strengthening exercises would have been great to know early on”
So, 18 months after the diagnosis of osteoarthritis in her hip, Helen limped into an outpatient appointment with her walking stick, exhausted and tearful. She had a recent X-ray showing her “serious arthritis”. The registrar was sympathetic but admitted there was no guarantee she would be put on a list to receive surgery.
“This was upsetting, so we made the decision not to wait through the public system and chose to find the money to pay for private care. The decision to pay for private care was triggered by my husband seeing the X-ray and deciding he couldn’t stand to see me suffer any longer. I had a private orthopaedic appointment within two weeks and surgery a fortnight later. The public hospital letter arrived in our letterbox on the very day I had private surgery. It stated I had not made the list yet and to return in six months. My husband and I were immediately grateful that we were able to go private.”
Helen’s story begs the question: How can we see that people stuck in the public health system, waiting months or years for surgery, are offered access to information and services to manage their arthritis better while they wait?
“I would like to make sure people know where to start in finding support. I found myself very frustrated that I didn’t know where to begin. I tried to access government financial support and found Green Prescription and the local hydrotherapy pool classes, which improved my fitness and helped my post-surgery recovery.”
Helen’s experience of the public health system leads her to wonder if there is a better way of funding hip replacement surgery to help those in need. The loss of productivity, quality of life, and capacity for social interaction, all take a toll on a person and their ability to contribute to those around them.
“Joint replacement surgery is saved for the most desperately compromised, and often a whole raft of other health issues have spawned by the time they receive help. I wonder if there has been any thought of creating partnerships between public and private sectors (by offering cheaper operations, for example), or some other creative solutions for a shorter wait?”
Fortunately, Helen is fit and otherwise healthy and when she entered the “arthritis world” at just under 60 years old she was curious, highly motivated and computer literate, but despite all that, the frustration of not knowing things was too much at times.
“I want to make sure others know where to start in finding support, what financial help might be available, information about medications, and where to get physical aids. Even the importance of strengthening exercises would have been great to know early on,” she says.
It’s just arthritis, but what about the cost?
Medical costs for arthritis amounted to $1 billion in 2018. Of that, a third were in-hospital expenses (public and private). More than 406,000 people in New Zealand have osteoarthritis and more than 165,000 of them are under 60 years old.
The findings in the recent Economic Cost of Arthritis in New Zealand report have significant implications for how the health system manages arthritis. Some key findings related to health care costs:
- Health sector costs related to arthritis were estimated to be $992.5 million in 2018, equivalent to 23% of total financial costs.
- Of this, an estimated one third is attributable to hospital inpatient costs ($321.0 million). Public inpatient costs were estimated to be $244.0 million, and private inpatient costs were estimated to be significantly lower, at $77.0 million.
- Residential aged cared costs related to arthritis were estimated to be $97.9 million, while arthritis-related pathology and diagnostic imaging costs were estimated to be $96.4 million, and pharmaceuticals costs were estimated to be $69.5 million.
Arthritis can affect anyone at any age, and new figures released in 2018 reveal that more than 670,000 people in New Zealand have a form of arthritis (osteoarthritis, gout arthritis, rheumatoid arthritis, lupus and more than 140 other types), 48% of which are of working age.
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