Elective surgery on hold...

[Smarticus]

Curiously enough I was thinking about my own elective surgery last night and even replied to a post about it. As if by magic today I recieved a letter (dated 1st of May) from my own hospital, two comments stood out to me:

1. "Remain in your own home where possible, and minimise social contact. The risk of contracting the disease if you come into hospital will greatly increase as the number of cases in hospital rises as the pandemic peaks, and therefore you will be safer at home"

2. "...we will be in touch at a time when we have been able to recommence the cardiac surgical programme. We estimate that this will be after the coronavirus pandemic has run its course."

I am already anxious about my surgery (second time) and if I take this letter at face value, it is not safe in hospital (from what others have said I believe it is) and that there will be no surgery for many months (again, experience from others on here suggest otherwise). So many mixed messages. Are things slowly back to normal or not?? I think I will phone the hospital today...

TTFN

[Midgeymoo17]

Where we stand at the moment with elective procedures is nothing is back to normal and all elective lists across the country are cancelled.

So are hospitals safe?

This is a much more loaded question. All hospitals do have protocols in place for managing emergencies and where a non-covid emergency occurs trying to isolate patients from COVID positive patients. Therefore, if you are having a heart attack and need to be treated today- go to A&E, you will be treated and the risk of coronavirus to life is much less than the emergency.

However, even with separation measures it can be nearly impossible to prevent COVID19 cross infection. I was recently on a webninar with a Congenital Cardiac Surgeon in Italy and as he put it- they only performed cardiac surgery if it was a life/ death situation and patient was not stable in community. (he did 3 surgeries in the peak of the crisis). Despite having the so called "green" zones (i: COVID Free ward, ICU Bay and Theaters) , all patients operated on in the crisis did in fact contract the virus (most likely in the corridors) which could not be split. All patients undergoing the emergency cardiac surgery survived- but ended up in ICU and hospital longer than would otherwise have been.

So bottom line is, hospitals are as safe as possible and if you have an emergency- it is safer to attend the hospital than delay for fear of covid. However, at present hospitals continue to have high numbers of COVID patients and the risk of you contracting it (already vulnerable to a bad infection) is higher than normal and if your care were to be delayed.

[Midgeymoo17 in reply to Midgeymoo17]

I am going to write a small correction to this- as we are past the peak of the virus and are to expect some of the restrictions to be lifted some hospitals have begun to plan for the recommencement of certain routine services or altered version of routine services where it is safe to do so. Therefore, if you have heard of people getting operation dates- either they are emergency/ urgent or they are provisional based on when that hospital plans to start again.

For example, my dad works in a small specialist orthopaedic hospital. They have less than 10 COVID Positive patients and the under government directive had to suspend all cancer treatment- so basically the whole staff are doing nothing.(My dad normally reports 120 x-rays a day currently 4 x-rays). Now testing is available enough, the hospital have decided they have the capacity to call local people to be tested the one day before admission. If negative they will be admitted (and re-tested) and tumours operated on/ have biopsies taken. Patients who have to travel further and can can not attended the day before for testing will not be treated until safe to admit with out testing do so. Decided against restarting chemo just yet. (Geographically Sounds a little unfair but this was to keep the hospital a safe a place as possible for everyone and to reduce back log from cancellations- the alternative as to continue with all procedures cancelled. Fairer but would result in more deaths as everyone waiting longer).

[Smarticus in reply to Midgeymoo17]

Thanks for the information. My hospital says it is unlikely any cardiac surgery until mid/late June and there will be backlogs. It is also dependant on your surgeon, mine knows me and my history and wants to do it himself, otherwise the lists and surgeon availablity may be quite flexible depending on demand. Seems like a case of just sit still and hope for the best. Obviously if anyone has any concerns or feels unwell go into A&E, get Covid or Die, the choice is simple dont delay your health. I find it odd that they have mothballed these Nightingale hospitals, surely they could send the Covid patients there and resume 'normal hospital procedures'? Not just cardiovascular surgey, but there must/will be backlogs and the capacity is there? 2020 is going to be remembered for all sorts of reasons...

[Midgeymoo17 in reply to Smarticus]

Actually this is where the Nightingale Hospitals were a total con. We have a national shortage of Intensive Care Nurses (and nurses in general). If we ship COVID Patients to Nightingale Hospital it needs yo have staff. OK-staff from understaffed normal hospitals go to the Nightingale to care for the COVID19. Normal hospital free of infection and ready to start normal proceedures- but wait..... their are no nurses to care for the patients undergoing normal proceedures. This shortage is most acute in ICU Nurses.

The NHS has tried to do some upskilling of staff but the simple answer is it is just not possible. I mentioned my Dad earlier is a Doctor doing best part of nothing at the moment, he is a world renowned consultant in muscular skeletal radiology and is approaching 70. This means the last time he did direct patient care was in the 1980's. The last time he intubated someone was over 30 years ago. You can not rectify that deficit with a weeks training. The same applies to nurses- ICU nurses have particular skills that they use daily and nurses in other areas/ ward have either never done or do not do as regularly.

Thinking back to my own cardiac surgery this includes: managment of a lung collapsing in the chest, extracting the line in my jugular vein which could have lead to a life threatening bleed, cpap and ventilation mangement. By contrast the nurse I see in outpatients, has specialised in life long managemnt of my heart disease in the community. Very Important and Excellent at what she does but will not have done a simple blood test in about 15 years. If she had been removing my juglar line their would have been a significant increase in the chance I would be needing a body bag. (Interesting point- when I had my surgery it was 1 ICU nurse to 3 beds. It should have been 1 to 1 and that was nothing to do with COVID).

They are closing the Nightingale hospitals because they can not staff them (we do in fact still need the capacity). The anaetheist from my cardaic surgery put on her twitter somthing along the lines of: Do not say the NHS Capacity coped- we did not run out of capacity for COVID Patients as we requisitioned it from others. That is not coping.

While not as serious, I can understand your fustration because I have been on a cardiac surgical waiting list and at present have had treatment for my pelvic floor and a number of outpatient appointments delayed indefinitely because of COVID.