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Jacqueline Biollo,MBA, ICD.D

Elective Surgery | Post Covid by Jacqueline Biollo, MBA, ICD.D

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How long have you been waiting?

Although this question could be asked of many things, by example, ‘How long have you been waiting for me? How long have you been waiting for the bus? How long have you been waiting for your garden to grow?’, etc.

The list goes on and on. But in this scenario, the focus is on elective surgery, post-COVID. Elective surgery, from the Latin word, eligere , meaning to choose, is a procedure, scheduled in advance, because it does not need to be performed immediately, or does not involve a medical emergency.

At the height of the global pandemic, Global News and Alberta Health Services reported that ‘in an effort to create sufficient ICU and inpatient capacity to manage COVID-19 activity, elective surgeries and outpatient procedures [were] being rescheduled’. Now, elective surgeries are resuming across multiple platforms, including mine.

I’m scheduled to have an arthroscopy to treat persistent problems inside my knee. I’ve experienced this type of surgery before, where a very slender telescope with fibre-optic lighting attached to a camera displays the interior of the joint on a high-definition video screen.

My orthopedic surgeon will use the image to guide small, specially designed instruments to treat the problems in my knee. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders.

The decision to suspend non-urgent elective surgery services during the pandemic was undertaken as a means to expand the ability to manage a sudden, unexpected increase in patient volume that would otherwise severely challenge or exceed the current capacity of the healthcare system, through the preservation of structural resources (such as operating theatres, ICU beds, and ventilators), consumables (such as personal protective equipment and medications), and critical healthcare manpower.

Although elective surgeries are now resuming, most health care facilities are functioning at substantially reduced capacity, which translates to an ever-lengthening waitlist. And with a new, highly transmissible variant still circulating, patients may again face even longer waits. Undoubtedly, there remains a totality of consequences of delayed surgeries, both with regard to long-term health outcomes for patients, costs to the health care systems, and society that is being considered. Even if not an immediate life-or-death situation, the suffering of individuals cannot be ignored. The unintended consequences of more complicated surgery, increased use of medications, more difficult recovery, and a reduced quality of life must be addressed.

I applaud the emphasis the health profession has put on assessing the impact of COVID-19, the selflessness front-line medical workers have shown during these unprecedented times, the overall consideration of when and how to safely resume elective surgeries, and how to prioritize patients. The myriad of problems facing the health care system does not have simple solutions, but it does deserve efficient and focused effort to seek and implement some.

 

Years of enthusiastically participating in recreational sports such as rugby, softball, and volleyball took a heavy toll on Jacqueline Biollo’s knees. So much so that she has had over half a dozen elective surgeries, including treatment for a ruptured Achilles tendon. She is looking forward to her next procedure, to remove bone chips from the back of the kneecap and hopefully improve the blood supply to the bone after repeated minor knee injuries. A healthy and speedy recovery is desirable, as Jacqueline is anxious to get back on her rollerblades, and into her high-heeled shoes.

Photo: Eternal Sunshine Photography

 

 

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