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The personal impact of the elective surgery backlog

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Elective surgery was postponed in Australia to cater to the growing number of COVID-19 victims (Image via Pixabay)

The delays in elective surgeries due to the pandemic, while necessary, have been difficult to deal with for those suffering, writes Alyce Sala Tenna.

ON TUESDAY 7 April 2020, I received a phone call from the Alfred Hospital in Victoria as confirmation for epilepsy neurosurgery the following Friday. The objective of the neurosurgery was to control my drug-resistant epilepsy.

The call had been anticipated and tentatively planned since undergoing innovative investigative surgery just before Christmas. Fourteen probes were surgically inserted into my brain to monitor brainwave activity for one week.

Previously, using standard monitoring methods had proved to be very difficult. After years of being unsure where the seizure zone was in my brain, the area was finally confirmed. Doctors were finally able to provide a possible curative solution — epilepsy surgery. The operation had a 50% potential to stop the seizures, however, the possibility to control the seizures with medication was a slim 5% chance.

Probe incision wounds from the investigative surgery (Image supplied)

After receiving the news that I was indeed a surgery candidate for my drug-resistant epilepsy in December, every second of the day dragged while I waited for the hospital to call with a confirmation of operation date. At this stage, I had been diagnosed and suffering the impacts from epilepsy for 23 years — over three-quarters of my life.

In the months that followed, I cleared my email inbox, unsubscribing from all email activity so that I would be alerted with emails only from the hospital. I held my breath in the hope it was the hospital calling every time I received a call from a private number. I barely slept at night and when I did, I dreamt of the operation I had been waiting for since I was a teenager. My impending freedom from seizures potentially awaited me.

In March, the Federal and State Governments announced a hold on any class two or three surgeries. Surgeries were temporarily on hold to redistribute medical resources in the anticipated influx of coronavirus patients in April.

Although my epilepsy surgery had been classified as semi-urgent, it was still classed as category Two. My reaction to hearing the news potential delays to class two and three elective surgeries was like suffering through the operation without anaesthesia, paralysed without anything I could do. Notwithstanding what I was suffering from on an emotional level, my uncontrolled seizures that lingered during this time were extremely dangerous. For example, the day I received confirmation of surgery in April, my partner came home to find me lying on the floor in a pool of my own blood from a head injury I'd sustained during a seizure.

However, I received approval for surgery from the Alfred Hospital amid the COVID-19 pandemic due to a strong push of urgency by the doctors. Weeks after the operation, I am now minus a small portion of my left frontal lobe. I have only experienced two seizures, as opposed to the 20-odd I would have experienced had I not undergone surgery.

First night post-operation from epilepsy neurosurgery (Image supplied)

Australia faced a backlog of 400,000 elective surgery cases according to an international study published in The British Journal of Surgery. Worldwide, the same study projected that the total number of adult elective operations cancelled has been 28 million just in the COVID-19 12-week peak, or 2 million per week.

In May, the Prime Minister agreed to resume all elective surgeries. Now, in a complete circle, Victorian Premier Dan Andrews has announced elective surgeries in Melbourne and regional Victoria are to be postponed, except for category one and the most urgent category two procedures.

Adding to the backlog is the number of people ditching private health care because of cost, job losses and the worsening recession. According to the latest Australian Prudential Regulation Authority, more than 10,000 people have cancelled policies just in the first quarter of this year. Individuals that could be evenly distributing the load to private and public hospitals. Elective surgery will also be reduced to no more than 50% of usual activity across all public hospitals and 75% in private hospitals.

My epilepsy was testing at the best of times, both in my professional and personal life. Any delay to the wait became practicably insufferable. While I'm not arguing the elective surgery ban is unnecessary in Victoria, the delay only amplified the impacts from my epilepsy.

We applaud all those who have and continue to work so hard on our front line to manage the COVID-19 pandemic effectively. However, we now need to think about managing the repercussions to the health system. How will Australia’s health system prioritise the 400,000 plus elective surgery candidates? When elective surgeries are back on, will extra resources be used to operate to catch up on the backlog? Finally, how will each patient be prioritised?

Alyce Sala Tenna lives in Perth, Western Australia. Outside of managing her epilepsy, Alyce works at a consultancy as an environmental scientist.

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