Health services are closed – patients react

30 minutes, the operation that has given Thomas Lislerud (52) and several other chronic pain patients their lives back. The offer is now closed.

Just over a year after the Cardiothoracic surgery department at Ahus began offering the operation, it is over.

Reason: Capacity

“The department cannot prioritize this offer against the department’s other tasks,” writes Ahus in an email to VG.

– I cannot believe that they can do this, says Thomas Lislerud from Sarpsborg, who works as a system developer in a computer company.

For him, the operation changed everything.

– Now I can do everything I want, work, meet friends, fish, carry shopping bags, clean the house or just sit on the sofa and relax. Eight years of pain are over.

Round dance in the healthcare system

Before Christmas, VG wrote about Thomas Lislerud (52) and Kristin Duun-Gavare (41), who have both lived with disabling pain for many years. Pain that suddenly cut like knives in the stomach, before they spread like a spasm in the body and overpowered them with a violent feeling of not being able to breathe.

– I wanted to climb the walls to escape. At the same time, I couldn’t move a millimetre, says Lislerud.

Their stories are almost the same.

They have been sent from one specialist after another without anyone finding a cause for their pain. Duun-Gavare was examined for fibromyalgia, cancer, endometriosis, arthritis, gallstones, neck prolapse, Crohn’s disease, sciatica, irritable bowel syndrome. Even the gallbladder was operated on. But even then the pain did not go away.

Only when they were examined with dynamic ultrasound by a medical team at the Apex Clinic in Oslo, did they get an answer. The examinations showed that they had a loose rib that was rubbing against the nerves that run along the ribs.

The diagnosis is called slipping rib syndrome.

– Between each rib are blood vessels, muscles and the intercostal nerve. When the rib rubs and pushes on the nerve, it can cause intense pain, explains physiotherapist and musculoskeletal specialist Kjetil Nord-Varhaug at the Apex Clinic.

The pain follows the nerve pathways out towards the back, abdomen and chest, and can become so intense that in professional circles they are referred to as suicide-inducing.

– It has been reported that some people have taken their own lives, said surgeon Henrik Aamodt at the Vascular/thoracic department at Ahus University Hospital to VG this autumn.

Despite the great pain loose ribs can cause, these patients are often not caught.

– Many doctors and therapists don’t even know that there is a diagnosis called slipping rib syndrome, says Nord-Varhaug.

Suicidal pains

Both Thomas Liserud and Kristin Duun-Gavare were referred to surgery at Ahus, where a surgical team has specialized in treating the diagnosis for the past two years.

Using a simple technique, the loose rib is lifted up and sewn to the next one, so that the nerve has more room and that moving or loose ribs no longer irritate nerves and vessels. The procedure takes 30 minutes. A little anaesthesia, entered via a small incision in the skin of about five centimeters and a few stitches.

– For us it is a small and simple intervention, for the patients the effect can be enormous. Years of pain are gone, thoracic surgeon Henrik Aamodt told VG this autumn.

Last year, he and surgeons Rune Eggum and Frode Reier-Nilsen operated on 12 chronic pain patients with slipping ribs at the thoracic department at Ahus.

Thomas was operated on in May last year, Kristin in November. Both say they have been given a new life.

After VG wrote about the diagnosis and treatment, the number of inquiries has exploded.

– Last year I referred one to two patients to Ahus, since December I have referred around 30. The wait has become up to a year, says Nord-Varhaug.

Not capacity

But a couple of weeks ago the letter arrived:

“From 1 February 2023, the Cardio-Thoracic Surgery Department, Ahus will stop the treatment offer for “Slipped Rib Syndrome”. This is because the department cannot prioritize this offer against the department’s other tasks.”

In an e-mail to VG, Frode Olsbø, head of the vascular/thoracic surgery department at Akershus University Hospital, elaborates on the following:

“The vascular/thoracic surgery department has a large number of patients to be treated within the package process, as well as a large number of vascular surgery patients” and writes further that “the department does not have unlimited resources for either personnel, outpatient clinic capacity or operating capacity”.

The patients will not be referred to other hospitals and what happens to all those who are queuing for surgery or have been referred for surgery is unclear.

– I no longer have a treatment center to refer to, says Nord-Varhaug.

He understands that a large influx of patients following VG’s cases has resulted in many patients now seeking help for ailments they have had for many years.

– The patients continue to visit us for diagnostics and investigations and we have a dialogue with both Helfo and those responsible for treatment abroad at the various health institutions to find alternatives because many of these patients have been ill for many years and cannot afford for private operation abroad.

For those who have finances or health insurance, there are alternatives in England. The cheapest costs 30,000 for surgery plus travel costs.

What now?

Kristin Duun-Gavare despairs on behalf of all those who are now not receiving the help she received.

– It is completely incomprehensible that when you finally get an answer to years of suffering, when you get a diagnosis, and it turns out that there is a treatment – in Norway!, then the offer must be discontinued.

VG has tried to find out what rights and opportunities these patients now have. Department director Torunn Janbu In the Norwegian Directorate of Health, specialist healthcare services, responds as follows in an email:

“Ahus must itself assess what offers they can provide to various patient groups who are referred to the hospital.”