A London woman injured in a car crash says she’s left with no choice but to pay to see a doctor in the United States after waiting almost two years for a diagnosis from an Ontario spine surgeon.
Sydney Gesualdi was rear-ended at a red light in July 2023, after which she was initially diagnosed with whiplash and tissue damage. In the weeks that followed, the 25-year-old lost the ability to walk, started having trouble swallowing and speaking, and had numbness in her face and limbs.
“None of these symptoms have gone away, and it’s been almost two years,” Gesualdi said. “I’m 25 and I can’t walk.”
She now has to use a wheelchair and wears a neck brace at all times. Gesualdi’s family physician has referred her to eight doctors at spinal clinics across the province, but so far, she’s been denied a consultation.
CBC News has seen the rejections from Toronto Western Hospital, London Health Sciences Centre (LHSC) and Trillium Spine Centre. Wait times and heavy caseloads are cited as the reason for not taking the patient, as well as the condition potentially being outside the scope of practice.
LHSC said in a statement that care teams carefully review each spinal surgery referral and prioritize cases based on medical urgency. A patient’s acuity determines the wait time for spinal surgery, and is evaluated on a case-by-case basis.
A statement from Toronto’s University Health Network (UHN) said there is an increased demand for spinal care and the procedures can be complex, which impacts wait times.
“Not all referred patients are suitable candidates for surgery,” the UHN statement said.
When asked about wait times for spinal surgeries and options for patients, a spokesperson for Ontario’s Ministry of Health said the province has connected nearly 10,000 people to spine surgeries over the last year and is working to improve access to spinal surgeries.
“Since 2018, we have increased the healthcare budget by over 31 per cent, investing over $85 billion into the system this year alone,” wrote Emma Popovic. “Together, the actions our government is taking have led Ontario to achieve some of the shortest wait times in Canada, with nearly 80 per cent of people receiving their procedure within clinically recommended target times.”
Gesualdi says she’s frustrated, in pain and wants answers, so much so that she plans to pay $40,000 to travel to New York to see a spinal surgeon for testing and get a treatment plan. She’s had to fundraise to cover the cost.
The Ontario Health Insurance Plan (OHIP) would pay, but only if the patient has an “out of country” application for medical procedures signed by a Canadian doctor stating the procedure is medically necessary, not available in Ontario and not experimental.
But getting that letter isn’t possible without a surgeon assessing her, Gesualdi says.
“Getting this letter has been close to impossible, and that’s why I’ve sent out so many referrals to these surgeons to try to get them to write this letter, and every single one has refused,” she said. “There seems to be a really big disconnect [in the process].”
System ‘backed up in so many ways,’ expert says
Lengthy wait lists for spinal assessment and care are a devastating problem, said Dr. Hamilton Hall, an orthopedic spine surgeon and executive director of the Canadian Spine Society (CSS).
“In a situation like a car accident or paralysis, the system works very well because it’s predicated on urgent people getting seen first, but if you have a chronic, more disabling but not life-threatening problem … it can take months or even a year before you get seen by a spine specialist,” Hall said.
“Surgery also isn’t necessarily the answer. Seeing a surgeon doesn’t mean you’re going to be cured, but patients need to see the surgeon to be cleared to say it’s not a surgical solution, and then they can turn their attention to other things.”
He pointed out that wait times can’t be solved simply by training additional surgeons, as spinal operations also require other costly hospital resources.
“The system is backed up in many ways. It needs to be improved, and it needs to be a co-ordinated effort by the government, health-care providers and hospitals. Getting that kind of uniformity in medicine is a real challenge,” Hall said.
The Canadian Spine Society is working with specialists to create guidelines on the types of patients who need to be seen urgently and those who can wait.
Meanwhile, Gesualdi says her condition has changed her life. Before the accident, she owned a successful eyelash extension business and now says she barely leaves her house, except for medical appointments.
“I can’t put into words how devastating it’s been for me and everyone in my family, the grief that comes along with missing out on normal life experiences and even milestones.”
