"Meniscus tear investigation"

Chapter 1: POW ED (old site Barker St)

I was carrying bricks on my head, up from the beach. About 50 steps, and I felt something in my knee. My knee became very sore over the next few days. It became swollen and I struggled to walk. I tried to swim it out, and thought it was helping but became worse, and became unable to walk without pain. It fluctuated but the localised pain never went away.

I organised for my NDIS Support Worker to assist me to do much of the following (transport etc).

I went to my GP. The GP referred me to Spectrum Imaging for an x-ray and MRI scan. Spectrum Imaging advised me they cannot do the MRI, as MRI’s for the knees are only covered by Medicare for a certain age and under (I am over this age). I had the X-ray done (which is covered by Medicare), at Spectrum Imaging.

I was told that an MRI is the only way to see a meniscus injury, and decided to go to the hospital emergency department at POW Hospital to see if they would be able do an MRI scan. I went to the POWH ED. I was triaged and when I went in, I recall a staff member said what am I here for. I explained about my knee, that it is still sore to walk and swelling and is potentially a meniscus injury. I explained that I went to my GP who sent me for an MRI and that an MRI could not be done as it is not covered by Medicare. I told them that I had an x-ray though. And asked if the hospital can do an MRI to find out what is happening inside my knee.

The staff member asked to see the x-ray results, but at the time I did not know how to use the Spectrum Online Portal, and neither the staff member, nor I, could see the results. I asked them to wait till I can work out how to get into the portal, but they did not have any patience to wait.

So the Registrar could not see Spectrum x-ray results. I recall the staff member said that I can’t come here for an MRI, MRI’s are a precious resource. I told them that MRI’s are very common if you have $350.

They saw that I could manage walking and I recall said it’s not an emergency, and then said something like, everyone over a certain age in Australia has knees that are past their use-by date.

The staff member said that I should not be there, and as they ushered me out of the ED I believe they said, the public really need to understand that they can’t drink champagne, when they should be drinking beer. I told the staff member that I don’t drink alcohol (which I don’t).

•I was referred to the Orthopaedics Outpatients Department POW, that had a long waiting list. I had an appointment many months later and was seen for less than 5 minutes, more like 3 minutes, my knee not examined, not asked to walk, no follow up, and that was it. Next…patient.

•That was the first experience in ED at POW related to my knee injury. I was also told that they don’t treat chronic conditions in ED. I have not been diagnosed with any chronic knee condition. I called and asked my GP recently and this was confirmed.

Chapter 2: POW ED (new site/ED Redevelopment)

• I went back to my GP and got a referral for a CT Scan of my knee. I was doing gentle swimming/cycling regularly to try to help my knee and although it was still swelling, I was hopeful the exercise might help.

I also accessed some free physiotherapy sessions that apparently Medicare covers. I believe this has unfortunately been detrimental as I have been getting acupuncture and physio on an injury which has become worse. I decided to go into my minimal savings and get $350 for an MRI. I am on government financial support. The more I stand or walk, the worse it gets. I had 2 days recently where I had to stand a large portion of a day. A week later I could not walk without a crutch.

I decided to go to emergency at POW ED, as the pain was extreme. My NDIS support worker came with me. I saw the Spectrum CT scan results when I went to POW ED on this occasion after my Support Worker showed me how to use the Spectrum Online Portal. The results state at the bottom of the details;

‘The menisci cannot be assessed on a CT Scan.’

This Spectrum CT Scan results, was read by a clinician when I went into the ED. An ED nurse gave me some pain relief. Another clinician came and told me something akin to the following that I have a chronic condition, I can walk weight-bearing, I have a chronic condition and they do not treat chronic conditions in ED.

I explained that I had an injury and that no one has looked at the injury and I am in the emergency as I am unable to walk without a crutch, and trying to find out what is wrong with my knee. I told the clinician that I think it is an emergency because the pain is severe and sharp every time I make a step on my leg.

I found the clinician was abrupt and rude and then I recall they reluctantly said that they will get an x-ray then. As if it was a privilege.

The x-ray guy was great, he said he knows what is wrong as soon as he saw it, and said he is not a doctor, and cannot say what it is. He said there is definitely fluid there.

I went back to the area I was in, and the clinician came to me and said something like the following (I can't recall their exact words) I have a chronic condition and they don’t treat chronic conditions in Emergency. I have arthritis, and my GP and Team (what team?!) can sort it out.

(I have never been diagnosed with arthritis of the knees, nor any chronic condition of the knees.)

I believe the clinician has written false statements on the discharge letter, such as:

•There is no history of trauma to the knee

• That my changes are chronic and that the care of my chronic health conditions….

• I have been seen in ED before with a similar problem a few months ago when I was referred to my GP with a likely soft tissue injury on a background of arthritis (I have never been diagnosed with arthritis)

• The discharge letter also states the following

•The CT (Spectrum Imaging) has revealed arthritic changes with suspicion for an associated meniscal injury. This suspected injury has never been investigated by the ED POW on both visits.

It feels like there is something spreading around the swelling area of my knee.

Then it seemed the clinician tried to make me feel privileged to ‘kindly’ receive a referral to the Physio department.

In summary of my own experiences I can say this;

It appears that the ‘Australia’s 10 Year Primary Health Care Plan’ has not been well thought out. I am an NDIS client, I believe I know acutely when a system is broken. And I feel a large part of the NSW Health System has been broken for a long time. More specifically, for the underprivileged/marginalised.

Every bit of medical information regarding the injury was provided by out of hospital services. I feel the hospital has done zero action on my knee injury except relay a narrative I believe they have been told.

In closing I hope that something can be done about any of these issues I have raised and I want to thank the Care Opinion and the POW Feedback phone line, for listening wholeheartedly, when I called them. It has dropped my stress levels by almost 100% and I am very grateful for that.

Warmest regards