InternalBrace is my 1 window of opportunity to save the ACL

May 17, 2018

wait time: 58 days

time remaining to avoid removal: 4.4 weeks 

I set my alarm for 2am, still pursuing every possible avenue – InternalBrace is my 1 window of opportunity – hoping to find a way I can do this without travel.

 

20180517 2 27 travel on short notice.JPG

2:13am

The Mackey Clinic emails me the details they need, followed by a 2:27am email

“As per last email if you could provide your details, I will check theatre slots for you.  So don’t worry about booking a consultation yourself.

In situations where a patient is traveling, as you are, the consultation, pre op assessment and surgery date – will be over 3 days usually.   Are you able to travel at short notice ?”

 

3:56am

I reply

“I have the (MRI) pictures and am unable to open without PACS; Please let me know if you use the PACS system for viewing. 

I am contacting Alberta Health tomorrow as they said this should not be a requirement.

Also, is it preferable to work on increasing range of motion in preparation for surgery ?

(currently it is stiff; MRI does not show retracted tissue; cannot straighten leg, have increased range to straighten >2.5cm.  cannot bend all the way back - concerned bending may cause synovial fluid to erode any clot present)

Reviewing the studies on the Arthrex site, curious if this is still in trial phase stage - I'm still on board for it, just curious as the 2yr study results mentioned more results are needed.

Thank you, looking forward to this”

  • I’d been using a small stack of books below my #knee to push down to, and was removing them to gain range.  It seemed exciting to make progress until I measured 2.5cm - which isn’t much.

I also mentioned Dr Difelice and asked what other surgeons may provide current options.

 

20180517 6 38 Mackay reply.JPG

6:38am

Mackay Office

“I would encourage early mobilisation as it will accelerate post op recovery.  Logistically Greg Difelice would be easier to access, although we use different variations on the same technique.  Although surgery is cheaper here, travel does add up. 

I would normally encourage patients to take a 2 week vacation here before returning home, with DVT precautions – although there is still some associated risk.”


9:06 am

I send the requested info and reply “Travel on short notice is expected for this, let me know what the openings will be so I can work backwards and plan flights.”

Adding to my evaluation is the timeliness of having the procedure done which reports better outcomes the sooner it’s completed.

 

20180517 10 16 em ON.JPG

10:16am

I receive a reply from Tribe Medical to my email to find a rep Arthrex who can identify where this is offered in Canada

I look up Calgary orthopedic surgeons and am curious who is the most forward thinking that would be using current methods.  Also figuring out how I can get the MRI report translated so I understand the technical / medical verbiage clearly.  Searching what non-delineated ligament means…

Also the attenuation rate to determine how long I have.

 

23:57pm

I reply:

“Curious what you meant by different variations of the same technique; if they have names let me know I'll look them up - if too complicated we can discuss in consult.  

I did a bit more digging and have identified a Jesse Shantz and Andrea (Andy) Veljkovic who can do this in Canada, however private health care is not allowed in Alberta so I have to fly regardless, in their case to Vancouver.  Curious if you know them.  I can ask what technique they use if this is important, or any other question you suggest.  Depending on when we theatre availability in Scotland … they said they can provide some follow up in Calgary after, and earliest they could do procedure is May 30.  

I'd like to have an idea of theatre dates and cost for procedure in #Scotland so I can calculate the exchange.  I have no problem staying for at least 2 weeks as you suggested.  Please let me know how time sensitive this is, and if May 30 is further off than desirable - if so it may be in my best interest to pursue a more expensive yet timely option to improve potential outcome.

I've figured out how to open the images, the program that does this is called Onis Viewer available free here:

http://www.onis-viewer.com/ProductInfo.aspx?id=19

now I'm figuring out how to set up a 200Mb transfer to you.”