Seeing people in the position that I was in years ago and it’s like
you just want to shake them and go
“It’s fucking wrong! Don’t do it!”
Surgery can do so much damage.
Sure, yeah, I’ve done lots of operations that I now know to be ineffective.
No I don’t continue to do any of them.
Having said that, many of the operations that I’m doing now, may later be shown to be ineffective.
At 18, I had a lateral release
a month later, I had it cleaned out.
About 18 months further on, I had my first arthroscopy,
about 18 months later again, another arthroscopy.
Another 18 months later, another arthroscopy.
I had a patella-femoral replacement.
By the time I was 31, I’d had 11 knee surgeries.
It sort of first started when I was 13.
I remember playing junior football.
Trying to kick a goal during a game.
And I dislocated my kneecap.
Before his first surgery at 18,
Rhys tried physio
to treat his constantly dislocating kneecap and the osteoarthritis that it led to,
but they couldn’t help him.
The experts were telling me surgery was the way to fix it and this was the best way to do it.
My first surgery had a massive impact on me and everything I did at the time.
I lost 15 kilos in about four weeks.
I had to quit my job, I had to quit sport,
everything that I had done day to day prior to surgery, I could no longer do anymore.
But that was just the beginning of long ordeal.
Thirteen years on and another 10 surgeries later
his quality of life had deteriorated.
The pain I was in was unbearable.
Not being able to sit in a comfortable position, not being able to stand in a comfortable position,
being in that pain just is incredibly draining.
The constant haze of being on pain relief,
it just sucked the life out of you.
At 31 unable even to make it to work without excruciating pain
Rhys was ready to give up.
I was very heavily depressed at the time.
I was suicidal.
I felt there was nothing left in my life to turn to.
Because everything that I enjoyed, everything that I loved to do was taken away from me.
If a surgery has been shown to be ineffective or no better than placebo,
it should not be offered to the patient.
Professor Ian Harris is an orthopaedic surgeon at the forefront of a new push in medicine:
to find out whether the operations he and his colleagues do everyday
actually work.
There’s better levels of evidence than our own eyes,
and that’s properly blinded, controlled studies where
one patient will have the real surgery and another patient will have a placebo
and nobody knows who had what.
Professor Harris looked at the more than 9000 orthopaedic surgical procedures
that took place across three Sydney hospitals in a year.
His findings were shocking.
Half of the procedures
thousands of operations had never been through clinical trials
to find out if they were better than not operating at all.
And of the half that did have published research
in 50 per cent of cases, the evidence actually showed that surgery is not more effective
than other non-surgical options.
So that gives us two problems: there’s a gap in the evidence,
we don’t have an enough evidence for a lot of what we do and there’s an evidence-practice gap,
where we have evidence that it doesn’t work, but it hasn’t translated into practice, yet.
Which means to this day in hospitals all around the country
Australians are going under the knife in procedures that are at best unproven
and at worst actually known to be ineffective.
There’s been very few operations that have been subjected to a placebo trial.
In the whole of history, the number is in the dozens.
That’s because even placebo surgery is risky.
And the ethics of cutting someone open and sewing them back up again,
without actually trying to fix them
is murky.
What’s more ethical: doing an operation,
if we don’t know if it works or not,
doing it all over the world and doing millions of them, with potential harm
Or, taking 100 of those patients,
operating on 50 of them,
giving 50 of them placebo and finding out whether that operation works or not,
before we do it on everyone.
It’s so scary that surgeons are so willing to get in there and cut people open
without investigating these far less invasive methods first.
It was a phone call to my brother that helped me turn the corner.
My brother works in sport science field.
I said
"Was there anywhere to turn from here?"
"I don’t know where to go and I don’t know what’s left I can do.”
I hear a couple of breaths and then
“Fuck fuck fuck fuck fuck!"
"How come I fucken haven’t thought of this? Fuck."
"I think I know someone who can help you.”
That someone was Christian Barton, a young gamer changer physiotherapist based in Melbourne.
He said I wasn’t the worst patient he’d ever seen, but I was very close to.
He explained that it wasn’t going to be a short process and it’d take a few years.
The two things that Christian sent me away, after the first consult with,
was a basic taping method
and he also gave me a list of basic exercises.
As a result of that consult, I was off all pain relief in three days and out of pain in a week.
After 60 thousand dollars and 11 surgeries
at least four of which have since been proven ineffective for someone with his condition
what saved Rhys from taking his own life,
was a bit of strapping tape and pilates.
Going from constantly being in pain, constantly being unable to move,
to being given a new lease on life. It was a huge weight lifted off my shoulders.
Even in a week I was doing things that I hadn’t done in years.
While going pain-free was almost a miracle for Rhys
his proudest moment came two years later.
Two years and twenty-two days, actually.
I went over to Peru and hiked the Inca trail.
For me that was, that was massive.
Just ask the surgeon:
“Am I going to be better with the surgery compared with not having the surgery?”
It’s a really simple question that nobody asks.
“What’s the evidence that I will be better with surgery than if I don’t have it?”
My quality of life is completely different to what it was three or four years ago.
I can do all the things that I used to sit back and watch my mates do, now.
I don’t have full functionality, but I have a lot
And it’s great to be able to
be included, to do all the things that I was never able to do.