In part two of Lin’s story, she confronts immobility caused by osteoarthritis, and redefines her relationship with the condition through cross border healthcare.
“Not being able to walk without pain is troubling enough, but when movement is your life, as it is mine, it’s devastating,” Lin says as she takes stock of the past year.
“I think what happened was inevitable; a genetic thing, primed to start before I was born. We can’t choose our genes,” she decides.
Lin’s native Scotland is a beautiful country, but also a stoic one. She echoes this as she discusses her family’s history of arthritis, “It was passed down through generations of people who had the mindset, diet and lifestyle to tolerate living with the pain of arthritis. Years ago, it wouldn’t have been a ‘condition’ – and never classed as a ‘disease’. It was just part of older people’s lives. And they got on with it.”
Lin still wanted her future to be as fulfilling as the first two-thirds of her life. In 2010, she had recovered well following her first hip replacement surgery. She felt frustrated that accessing surgery on her left hip had forced her to become someone she knew she wasn’t; dependent, depressed and unable to work fulltime.
Scottish law prescribes a maximum 12 week waiting time for hip replacement surgery, but Lin soon found several months could be a more likely scenario. That prospect was physical and emotionally intolerable. Financially, waiting so long was out of the question because of priority commitments like her mortgage and running her business as a Pilates teacher and body practitioner.
She says, “Something had to be done.”
Planning is everything
It’s unlikely someone with mobility challenges would even consider moving to another part of the country, but living with pain every day can be the catalyst for drastic action. The NHS post code lottery quickly put an end to the idea. Private surgery in Britain was the next option until Lin learned costs could exceed £10,000.
Many people might have given up and thought about reorganising their lives: working form home, doing regular gentle exercise to maintain as much flexibility as possible, taking pain killers and enduring the long wait to see a consultant.
View from Lin’s hospital bed in Toulon
Lin confesses, “I’m not much for waiting so I did what people do when they need help figuring something out – I turned to Google.” She laughs, but is serious about using the internet to learn about accessing EU Cross border healthcare. She soon found advice from one of the four NHS Scotland Safe Havens.
“They were very helpful, looked at my X-ray and assessed there was a good chance I could be reimbursed by the NHS,” Lin says of her face to face visit with Safe Haven. France became the country of choice for surgery because of the proximity and familiarity, but the paperwork involved astounded Lin.
“In France, they offer a choice between state-funded and private care,” She continues. “At first, it’s impossible to discern between the two and to know which form to fill in. As I became more committed to travelling there, the more help I needed from NHS Scotland, and maddeningly, for me, the less they were able to provide.”
“People were only doing their jobs,” Lin says. “It was the institution of the health service, that was once so easy to access, that left me feeling let down.”
With these perceptions of NHS Scotland percolating, it was ironic that a GP ultimately came to Lin’s aid and gave her the information she needed. He was personally interested in the process of patients using EU cross border treatment; why it was so difficult and shared a newspaper article about someone from Glasgow who had had surgery in France. Lin set out to find this person who would become the key to her having the surgery she felt she desperately needed.
The ‘Not So’ Rough Guide to EU Cross Border Surgery
On the face of it, Lin’s journey to France had all the essentials someone needs when they’re off on holiday: a confirmation email and a quote for a 4-night stay in a mid-range hotel. However, the itinerary was very different to a standard trip abroad. Lin had to take note of requirements for pre-op tests and X-rays. On the advice of the clinic, she planned for up to 7-nights inpatient care.
Holistically, there was much for Lin to think about. The surgery promised to calm her worst fears about her joints being unable to cope with the strain they were currently under. She felt confident about rehabilitation.
Like all good travellers, Lin asked for firsthand feedback from others who had made the same journey. This included the ‘man from Glasgow’, Colin, whose story in the local newspaper changed everything for her. His experience inspired her. When she took a closer look at patient feedback about the clinic, she became more confident.
Lin booked her journey to Toulon for early July. Her hip replacement surgery was booked within five days of arrival; plenty of time for her to prepare for her next big skirmish with arthritis.
An Accidental Tourist
The journey to the south of France was more than a hop across the water. Lin travelled from Edinburgh to Marseille. Once there, Laurent, a representative from the clinic accompanied Lin. Hopital Prive Toulon Hyeres was her actual destination but there were many activities on her ‘to do’ ahead of surgery. When she met Laurent at the airport, they quickly struck up an easy rapport, chatting about everything from the practicalities of the surgery to the history of the city.
The remainder of the weekend was left for Lin to enjoy; ideally a time to put the impending surgery to the back of her mind. However, pain was a constant companion. Although she had the freedom to explore at her own pace, fatigue meant the most enjoyable times were spent in cafes, taking in the scenery. By Sunday evening, Lin felt she needed to rest and at the same time, looked forward to her appointments with the anaesthetist and surgeon early that week.
“It was real,” Lin said. “After so many months of feeling like I was going round in circles, I would finally have my surgery and my life back.”
Surgery, challenges to recovery and a glass half full
When Lin was admitted to Hopital Sant Rock Privet for her surgery, expectations for recovery were high. Despite all she had been through, her general health remained good. She credits her commitment to staying as active as possible, even if that meant exercising while sitting.
“It’s so important to move,” she says. “The more you do, the more you’ll be able to do, further on.”
“I was 65; but despite the impact of the arthritis, I still felt OK,” Lin explains. “The procedure for my left hip would be the same as surgery years before on my right hip. A ceramic ball with a plastic cup and metal shaft would replace the damaged joints.”
Midweek, Lin was prepped for surgery: an injection, saline drip, and oxygen mask fitted before being taken into theatre. Her most vivid memory was ‘warm paper blankets’ placed across her legs and promises from the anaesthetist that she would be fast asleep in a second.
Hours later, Lin woke in the recovery room. Her surgeon appeared to share that there had been a small calcar fracture at the end of the procedure. That meant keeping weight off her left leg for at least three weeks. The setback deflated her, but she followed her surgeon’s advice and on her second day in hospital, she met the physiotherapist who would support her in taking her first steps after surgery. He came prepared with a Zimmer frame and crutches for Lin to start practice walking.
“To be perfectly honest,” Lin sighs, “it was a bit of a faff. I always appreciate any activity that will help me remain strong but despite all my efforts, I still didn’t have the necessary strength in my upper body.”
The physio found a way to work around the strength issue by changing her therapy routine. He started with massaging her left thigh before supporting her in walking. Lin learned the technique independently so she could continue at home.
“I was very well looked after in the hospital in Toulon,” Lin confirms, “but when I went back to stay in the hotel, there were times when I was tearful, frustrated, and felt physically unwell.”
Although she was on her own in the hotel, the flow of well wishes from Scotland reminded her she had come through the worst. The surgery had been successful. Recovery was a process Lin needed to follow. She moved to a hotel by the sea and set her sights on dancing again.
Lin says, “I was channeling my grandmother’s courage I think! Interesting to think that perhaps alongside the arthritis passed down is also the inner strength to fight it and cope with the challenges.”
Home
“Who wouldn’t love to spend nearly a month in the south of France?” Lin asks rhetorically on a balmy day in Edinburgh, just a year on from her surgery. She is looking and feeling fit and well. As she thinks back to the time, she mentioned what she learned about humility.
Lin says, “In the last year, I’ve had to accept sometimes, I need help. I was so pleased to see my partner towards the end of my stay; it was like life getting back to normal.”
Being home, taking the familiar taxi journey from Edinburgh Airport through the city, having the reassurance of her partner’s companionship was like drawing the curtains at the end of a long day. Having taken the decision about her healthcare into her own hands, Lin had also secured her future. Soon, after two hip replacements, she would be back in business and pointing the way for people just starting out on their journey with arthritis.
Please visit http://www.sanas-ancientwisdom.com/ to find out more about Lin’s role as an holistic health and wellbeing practitioner.
The performance photo was taken by Maria Falconer and captures a piece called “Carry on Dancing” choreographed for Prime dance company by Steinvor Palsson.
