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Orthopedic patients face long waits for surgery at Lions Gate Hospital

Under the surgical 'restart' plan, North Shore patients needing hip and knee replacements are near the back of the line
Azza Sedky

When the province announced recently that cancelled surgeries would restart in the province, North Vancouver’s Azza Sedky was initially hopeful her knee replacement would be among them.

But Sedky, whose March surgery was cancelled by COVID-19, said instead she’s been given the bad news that under the surgery restart plan, orthopedic patients like her will likely see an even longer wait than they would have faced under normal circumstances.

“I’m hobbling around. I’m in pain,” says the 72-year-old retired professor, whose work teaching at Capilano University had her standing on her feet for many years.

Sedky said she went to orthopedic doctors for years, and tried anti-inflammatory injections until finally they told her surgery was the only option.

“I’ve had knee issues for as long as I can remember and I was ecstatic when I had my operation set for March 27,” she said.

Before the pandemic closed operating rooms, Sedky had a two-month wait for surgery at Lions Gate.

But now, her surgeon has told her the wait will likely be much longer – possibly well over a year – as orthopedic surgeons at Lions Gate have had their operating time cut by two-thirds for the next four months.

Prior to the COVID-19 shutdown, the eight orthopedic surgeons at Lions Gate got nine operating room slots per week, but now that’s been cut to three, according to a letter sent to patients by surgeons.

“We currently have 1,020 patients awaiting surgery and this number will continue to expand drastically without resource allocation,” wrote the surgeons’ group.

Other types of surgery have been given increases in operating room time, they added.

Dr. Victor Jando, the medical director who represents the Lions Gate orthopedic surgeons, said prior to the pandemic, orthopedic surgeries made up the largest number of surgeries within the surgical department at the hospital.

But now, in addition to cutbacks in operating room time, the orthopedic surgeons have had the number of beds for patients who need to recover in hospital cut back from between 20 and 25 to four per week.

Jando said the surgeons understand the difficulty faced by the province in prioritizing surgeries.

But patients who listened to Health Minister Adrian Dix were led to believe there would be “a very rapid increase in a return to normal delivery of elective surgical practices across the board,” Jando said. The reality is quite different for some patients. “In our case ... there actually has been a significant decrease.”

LGH
A COVID-19 outbreak at Lions Gate Hospital last month meant more cancelled surgeries, resulting in a more difficult restart at the North Vancouver hospital. photo Mike Wakefield, North Shore News

Dr. Dean Chittock, vice-president of medicine, and quality and safety for Vancouver Coastal Health, said Lions Gate Hospital has faced special challenges because of the COVID-19 outbreaks at the hospital, which limited surgeries to emergencies only. That meant the number of surgeries delayed at Lions Gate – including some considered urgent – was disproportionately large, said Chittock.

As surgeries restart, those urgent surgeries – like cancer surgery, surgery for urgent vascular conditions or cases in which delaying surgery could result in a significant or critical deterioration – are at the front of the line.

That pushes surgeries like hip and knee replacements farther back.

Since surgeries restarted at Lions Gate in May, operating rooms are up to about 90 per cent of capacity in terms of hours, said Chittock, although that still translates into fewer surgeries because of COVID-19 precautions.

One of the eight main operating rooms, for instance, is a pressurized room designed to keep airborne particles contained so surgeries on COVID-19 positive patients can be performed.

Surgical planners are still hopeful surgery wait times can be hurried along.

“We’re purposely having to be conservative in our estimates about when normalcy is returned,” said Chittock. “There is still this wild card of dealing with [COVID] cases in the community.”

For now, Sedky is stuck waiting – and hoping she gets moved up the list.

“The only thing I can do is aqua-sizing, and the pools are shut at this point. Physically I’m deteriorating,” she said. “It’s affecting me emotionally and mentally. I bet I’m not the only one.”