Women seek judicial review after province denies out-of-country surgery request

Two women are asking a Nova Scotia court to review a decision by the Health Department to reject their claims for out-of-country health care.

Jennifer Brady of Halifax has lymphedema, a disease that causes an accumulation of fluid and can cause painful swelling, increased risk of skin infection and sepsis, and hardening of the skin. 

Crystal Ellingsen, of the Spryfield neighbourhood of Halifax, has lipedema, a condition that causes an excess buildup of fat in the legs and arms that causes pain, swelling and easy bruising.

Brady and Ellingsen have both tried treatments other than surgery to manage their conditions, but they say those techniques are only designed to treat the symptoms rather than their cause.

They say surgery is required to limit or stop the progression of their diseases and avoid further deterioration of their quality of life and future expenses to the Nova Scotia medical system.

The judicial review request, filed in the Supreme Court of Nova Scotia on July 22, says the province has told Brady and Ellingsen they need an opinion from a provincially licensed specialist in their conditions that supports their request for out-of-country treatment. But in both cases, they said no such specialist exists.

"It's impossible criteria to meet," Brady says. "Not just hard, but literally impossible."

Brady began experiencing swelling in her legs after undergoing a radical hysterectomy to treat cervical cancer in 2019. The surgery involved removing lymph nodes, which can lead to lymphedema in some patients. 

She has treated the swelling with a combination of compression stockings, a type of massage called manual lymphatic drainage, self-massage and by wearing a pair of inflatable pants for up to three hours a day that moves fluid in the legs to improve drainage.

Despite those techniques — some of which are not covered financially by the province — Brady says she still suffers from debilitating pain caused by the swelling and tissue damage. Once a daily runner, the single mother of two now must carefully apportion the amount of time she spends on her feet each day.

"Honest to God, there's days where the pain, the constant pain, is so bad, I feel like I should just kill myself. Because what else am I supposed to do? Live in constant pain for the rest of my life?"

Last November, Brady ended up in hospital with a skin infection that led to a blood infection — a potentially fatal condition that can occur repeatedly in people with lymphedema.

She learned of a surgery called lymphovenous anastomosis that can greatly improve lymphedema symptoms — for some, permanently. However, the surgery is not available in Nova Scotia, and surgeons who perform it elsewhere in Canada have wait-lists of several years. 

Brady found a doctor in Japan willing to perform the surgery, and asked MSI to cover the cost of about $80,000. She was told she needed an opinion from a specialist in the province supporting her request for treatment, but there is no lymphedema specialist in the province.