MILWAUKEE — Hospitals around the state are starting to reschedule elective surgeries that were postponed due to COVID-19.
Ascension Wisconsin, Advocate Aurora and Froedtert all say they’ve begun rescheduling the surgeries in a limited fashion. The surgeries were postponed in an effort to make more space at hospitals in case there was an increased need for COVID-19 patients.
“By cutting back on elective procedures, you preserve personal protective equipment,” Dr. Mark Kaufman, Chief Medical Officer for the Wisconsin Hospital Association said. “The masks, gowns, N95 masks. You maintain capacity of ICU beds and ventilators. You keep your healthcare workforce safe.”
Kaufman says surgeries fall into three categories. True emergency surgery, like an appendix, that can’t wait. Lower down are elective surgeries like cosmetic procedures where it wouldn’t impact a patient’s physical health status to delay the surgery.
Somewhere in the middle are necessary and essential surgeries.
“Cancer follow ups, colonoscopies, diagnostic studies, people with chronic disease, people who need joint replacements, people with discs and chronic pain,” Kauffmann said. “What most hospitals are doing are getting together with physicians, looking at list of postponed surgeries and now prioritizing and picking those that are most important to do first. Always with an eye on maintaining an essential reserve capacity should there be another influx of patients with COVID-19.”
or Brad Hoeschen, he’s going on two months since he partially tore his Achilles while playing tennis.
“It was like lightning up my leg,” Hoeschen said. “It was bad in that instant. It was very bad in that instant.”
Hoeschen says his Achilles is 75 percent torn. He says he was told if it had completely torn, he would have been able to get the surgery right away. However, because it was not, it was declared elective.
“I’m literally hanging on by 2.5 cm,” Hoeschen said. “Frankly, I wouldn’t want to put anyone else at risk. It’s not like I’m jonesing to get this done. I wait.”
Hoeschen is first to take the blame for not having the surgery done. He says he postponed the surgery himself because of his work schedule and spring break plans he made with his son. However, he didn’t anticipate the delays by COVID-19. He’s been wearing a boot on his injured right leg since mid-March; even working Election Day with it.
“We started at 6:00 a.m.,” Hoeschen said. “My son and I were the last ones to leave the building at quarter to 10:00 p.m. My leg was really uncomfortable. But the next day, it was just sitting in the lounge chair, doing work.”
“When I think of elective, I think of procedures and if they were postponed for a really long time, months and years, it wouldn’t ultimately affect the patient’s health status, like cosmetic surgery,” Kaufman said. “I think of someone with a slipped disc, who is having a lot of nerve pain. The longer that nerve gets pinched, the more likely that person is to potentially lose muscle or loss of function in the leg. Yes, it can wait another month or two but ultimately, their health will suffer if you don’t go in and take care of the problem.”
At Columbia St. Mary’s hospital, they started bringing back patients at a 25 percent capacity.
“There are some patients, as a general surgeon, I knew I could wait a couple of weeks to do,” Dr. Gregory Brusko, Chief Clinical Officer for Ascension Wisconsin said. “There are others, from a symptomatic standpoint, from a clinical perspective, I’m not as comfortable waiting the tlong. They’re going to bring them in.”
Brusko says at patients being rescheduled must self quarantine for 10 to 14 days before their surgery. Then, the patients will be brought in and tested for COVID-19.
“Pre-operative testing for every and all patients coming into our facilities,” Brusko said. ” That’s not screening. I want to clarify; pre-operative testing protocols we have in place for everyone coming in.”
If the tests come back negative, they can come in on the day of their surgery and are screened again for symptoms. After the surgery, in some cases, doctors will follow up with patients virtually for less invasive surgeries. All the while, patients will maintain social distancing requirements while in the hospital.