Midwife at breaking point after three years of battle with ACC for back injury treatment: ‘I feel like there’s no point in me being in this world’

When Blenheim midwife Nicky Rasmussen suffered a “stupid” fall from her deck three years ago, she never imagined she would be in constant pain, bedridden and wondering if her life would be worth living most days.

She also never thought she’d be caught up in a three-year battle with ACC, which she believes is more to “disprove” her injury than to help her.

And yet here she is – the once vivacious 46-year-old now largely confined to her bed or a wheelchair and living 24/7 in agonizing misery.

On April 17, 2020, Rasmussen tripped and fell off her deck, landing on a railway sleeper in the yard and hurt her hip and left buttock.

She was in a lot of pain but didn’t think the injury was serious enough for immediate medical attention – and given the strain on the health system from the pandemic, she decided to “fight it out”.

But within a few days she knew something was seriously wrong – she couldn’t urinate and the pain increased.

Rasmussen went to the doctor and although X-rays and MRIs showed no significant damage, her ACC claim was accepted.

In June, she was certified “completely incapacitated” due to lower back pain and referred to a urologist for her persistent symptoms.

The urologist diagnosed Rasmussen with a dermatome injury — in which a nerve root in the spine is compressed or pinched — and “some degree of cauda equina” that occurs when the nerve roots in the lumbar spine are compressed, cutting off sensation and movement.

He applied for surgical funding for a procedure to examine the symptoms she had after the fall.

For the next few months, Rasmussen lay in the emergency department in severe pain.

She was also evaluated by a number of specialists – some agreed with the diagnosis of cauda equina and others did not believe the condition was present.

In October 2020, ACC approved a pain management program to provide Rasmussen with “multidisciplinary support, including physical therapy, medication review, psychology, occupational therapy, and services of a pain specialist.”

Then in November, ACC rejected the urologist’s request for surgery because the cause of her pain was “an unrelated health condition.”

A month later, ACC’s medical advisor advised the agency to fund “urodynamic studies, an examination with a rheumatologist, pain management with the pain physician, and ongoing physical therapy.”

In the following months, Rasmussen saw a number of other specialists:

In June 2021, Rasmussen requested that ACC’s decision be reviewed – with the aim of determining whether the call to deny coverage and surgical funding was correct.

The head of the review said there was conflicting evidence about Rasmussen’s condition from a number of experts and further research was needed to determine what was going on and how to treat her.

They overturned ACC’s decision to deny funding for the dermatome injury or cauda equina and directed the agency to conduct further analysis and seek further advice and reconsider their decision.

Nearly a year later, Rasmussen is still in severe pain, still waiting for answers and a shell of the woman she used to be.

“It’s very depressing…absolutely devastating,” she told the Herald.

“I feel like this whole three-year journey has been more about them trying to disprove me than help me.

“Several people say I have this condition and they are trying to refute it… it is heartbreaking.

“They basically fought to refute my diagnosis.

“I’m in crippling pain. I wish I wasn’t… I wish they would listen.”

Rasmussen cannot sit, stand or walk unaided and said her whole life had “unravelled”.

“I used to ride a motorcycle, give birth to babies, ride a bus… I was always so energetic and a very outgoing person.

“It is already an achievement if I can even get into the kitchen to have tea with my family, let alone cook… I have become so dependent, I have just become a different person.

“All my great passions have been taken away from me in one way or another.”

She wanted answers so she could finally get the help she needed.

She felt that ACC “didn’t care about her” and said she was angry and frustrated at the time it took to get a resolution — especially after the assessment.

“I need help, I need to be taken seriously… They forget I’m a person, and I feel like they’ve taken away my dignity.”

Amanda Malu, ACC’s deputy director of services, confirmed that the reassessment of Rasmussen’s injury was ongoing.

“Since the review decision, ACC has sought advice from two clinical experts, a urologist and a neurologist, to determine the cause of Nicola’s symptoms,” she told the Herald.

“They have been unable to confirm that there is a physical injury requiring surgery and have indicated that the cause of her symptoms may instead be neurological.

“We are now seeking an opinion from a neuropsychiatrist.”

Rasmussen has an appointment with that specialist in April.

“As soon as we can confirm Nicola’s diagnosis, we will consider all requests for further claims, including surgical funding, to ensure she receives appropriate treatment,” said Malu.

She said that while the assessment was ongoing, Rasmussen “presumably had cover” for cauda equina.

“Assumed coverage means we can continue to provide Nicola with rights, such as psychological support, while we investigate a final diagnosis,” she explains.

“Nicola has symptoms consistent with cauda equina syndrome, but physical evidence of this condition has not been found in high-tech imaging or other specialist reports. We are seeking further advice on a diagnosis and treatment options from a neuropsychiatrist, this review is posted for April.

Malu said ACC recognized “the impact Nicola’s injury has had on her wellbeing”.

“We recognize that it has taken some time to act on the decision made in the review,” she added.

“The decision was comprehensive and asked ACC to investigate a number of different aspects of Nicola’s claim. These depended on external clinical advice and opinions, all of which took some time.

“While this is going on, we have continued to support Nicola with weekly allowances, domestic help and psychological support.”

Rasmussen spoke to the Herald because she was at her wits end and worried that other people were struggling with the system.

She enlisted attorney Fiona Radford to help navigate the process, saying she would have given up without her — the delays and jargon were just too much.

“I’m a very private person, so speaking out like that makes me anxious…but when I think about the poor people who don’t have family or support and are going through this…it’s no way to live,” she said.

Rasmussen said she struggled with dark thoughts since the injury and often viewed her life as meaningless.

“On the darkest days I think about how I lost everything… I loved my job so much, everything in my life was physical… My last child just turned 18 and I feel like I lost the past three years,” she said.

“I have often thought of taking my own life so that I would no longer be a burden to people.

“I feel like there’s no point in me being in this world, and if this is what the rest of my life is going to be like, I don’t know how to handle it.

“I’ve lost myself, I don’t know who I am anymore… It seems like I’m two different people because when I look back at how I was, she’s a stranger to me now.”

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For more information and support, talk to your local doctor, hauora, community mental health team, or counseling service. The Mental Health Foundation has more helplines and service contacts on its website.