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Frustration with surgery rescheduled

My sister Marilyn with her newest grandchild – Lincoln. Marilyn loves to play with her grandchildren but that time is compromised by severe pain in her hips as she waits for a replacement surgery.
My sister Marilyn with her newest grandchild – Lincoln. Marilyn loves to play with her grandchildren but that time is compromised by severe pain in her hips as she waits for a replacement surgery. - Contributed
TRURO, N.S. —

My sister Marilyn is one of those caring, down-to-earth people who goes about her life helping and accommodating others. Low-maintenance for lack of a better term.

Married to a great guy, she has three grown children, four grandchildren and another who passed away at the tender age of five from cancer. Her love for all is immeasurable.

She is well-known in our hometown of Truro. Mostly from her job at Cameron’s Paints, but also as an athlete and, more and more each year, as one of the main fundraisers and real go-getters with the annual Relay for Life; an event and cause which came very much to the forefront for her – and the rest of my family – after Christian’s passing in 2013.

Marilyn is certainly not the type of person to ask for the spotlight, so it was me who suggested writing about her situation regarding a hip replacement surgery, she desperately needs.

After first being told it was bursitis in her hips approximately three years ago, it was determined she needed the replacement procedure roughly two years ago. Then, after originally being on the wait-list for Halifax, it was suggested she might be better off going to Kentville. She received word last week her surgery scheduled for October was being pushed back to January.

Kentville, ironically enough, is now listed as having the longest wait time on the website waittimes.novascotia.ca/procedure/hip-replacement.

Marilyn is in great pain and unsure what to do about her job which does have a physical element. She could reduce hours but then when she has to draw employment from being off work totally, during recovery, the sum would be greatly diminished.

“And I can’t sleep,” she told me the other day. “I sleep on one hip for a while and then it gets sore, so I turn. Then, after a while, the other one gets sore.

As a person who has had a hip replacement, admittedly in a timely fashion, I can relate to the pain she describes.

“I think the most frustrating thing is that it gets worse every day and they keep pushing my surgery back,” Marilyn added.

“It’s a tough thing; it’s most frustrating for the patients, of course, it also frustrating for the orthopedic surgeon who cares about the patient, who would like to have it done earlier, and it’s frustrating for the family doctor who has referred his or her patient to the orthopedic surgeon and would also like to see their patient taken care of,” Dr. Gary Ernest, President of Doctors Nova Scotia, said.

“We doctors are not happy about the long wait-times. We realize it’s a system issue and all we can do in these situations is, basically, be as supportive as we can to our patients; understand the difficulty they face with the long wait times.”

Ernest noted the province’s aging demographic as a reason surgeries can be put off, adding more and more people are receiving orthopedic procedures as well as other operations.

“In general, there are more types of surgeries being done overall, not just in regards to orthopedics,” he said.

“So the wait times are longer because there are only a finite amount of OR [operating room] services that are available. It’s a question of supply and demand in case of orthopedic surgery, as well as other types of surgeries.”

Ernest noted that also means more demand on hospital beds as folks recover, and that too can play a factor.

Marcy Saxe-Braithwaite is the senior director perioperative/surgical services with the Nova Scotia Health Authority (NSHA). She noted OR scheduling is “complex” and impacted by a number of factors.

“Anesthesia coverage, nursing coverage, surgeon availability, the availability of beds to admit patients to after surgery, emergency surgeries, traumas, equipment issues and more. We appreciate that patients scheduled for surgery prepare physically and mentally for their procedure, and often have to make special arrangements, including coordinating time off work, and arranging for support from family or friends,” Saxe-Braithwaite wrote in an email response to the Casket.

“At times, issues arise that mean we have patients who must have their surgery postponed as a last resort. We certainly regret when this occurs and do strive to rebook patients as quickly as possible, and to avoid postponing the same patient more than once.”

Saxe-Braithwaite added that while she can’t comment on a specific case, the last year has been “challenging.”

“Our data shows an increase in the number of elective cases bumped by urgent/emergent surgeries or bed availability issues. Between April and December of 2018 alone, a total of 73 elective hip or knee cases were postponed provincially due to more urgent cases, such as traumas, or bed availability.

“In terms of our efforts to improve access to hip and knee replacements, we have been looking at various options to avoid this issue as much as possible. This might include scheduling more elective procedures over the summer months where we typically see fewer traumas related to things like slips/fall or motor vehicle incidents, and less demand on our hospital beds related to illnesses like influenza.

“Over the past two years, through our hip and knee action plan, we have seen an overall increase in hip and knee replacement surgeries, with 13 per cent more cases being completed in 2018/19 as compared to 2016/17.”

Randy Delorey, Nova Scotia’s Minister of Health and Wellness and Antigonish MLA, also described the scheduling of surgical procedures as a “complex” process.

“NSHA has been working with doctors and surgeons and, through this process, have made significant improvements in increasing access to orthopedic surgery in recent years, and implementing a new wellness model that is improving care and outcomes for joint replacement patients,” Delorey said.

“However, sometimes scheduling changes are unavoidable for a variety of reasons. I appreciate these changes can be difficult for the individuals affected. Postponed procedures are rescheduled on a priority basis so that Nova Scotians can get the attention they need to get back on their feet as soon as possible.”

Knowing my sister Marilyn, she would appreciate the appreciation; she is just looking forward to getting on her feet without the pain and discomfort of the last few years. The New Year can’t come soon enough.

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