Precautions Surgical Centers Are Making During COVID-19

Precautions Surgical Centers Are Making During COVID-19

The operations at non-urgent surgical centers across Canada and the US all came to a halt for surgeries deemed elective back in March and early April.  Most of them are slowly resuming surgeries, and they are taking even further measures to reduce the chances of spreading COVID-19.

Outpatient surgical centers in Canada and the US have always had very strict guidelines on how to keep their patients safe.  Infection rate is something that is actually tracked so the cleanliness of these facilities has always been a priority.  To further enhance this protocol, areas outside the operating room, such as countertops, faucets and sinks, and/or waiting areas, are now being cleaned at least twice a day.

To further prevent exposure, most facilities have required a mandatory COVID-19 test prior to surgery, unless it is something emergent and there is no time to check for this.  A health screening questionnaire is required 1 day prior to surgery and most are repeating it on the day of surgery.  If you fail the questionnaire, then the surgery will be rescheduled.  

Many facilities ask that you wait in your car and call you when they are ready for you to enter.  Drivers and visitors are prevented or limited in staying at the facility in the waiting room.  An exception might be if the surgery is for a child, however, the parent would be subject to the same protocols and health screening questionnaires as the patient.  The nurse or surgeon contact your companion after the surgery is done to let them know how the surgery went and will give them another call once the patient is ready to be discharged. 

Increased safety measures for the staff have also been implemented.  Many facilities are requiring temperature checks of all employees prior to working their shift.  All staff, including administration, are to wear face coverings and make sure any persons in the building are maintaining social distance.  

Each facility will vary on what protocols they are taking as some states and provinces have specific guidelines that must be followed.  If you are scheduling a private surgery through Health Vantis, we can provide the details on what that facility is doing to further keep you safe.  

Health Vantis

www.healthvantis.ca

877-344-3544

info@healthvantis.com

The Effects of Waiting for Surgery Amid COVID-19

The Effects of Waiting for Surgery Amid COVID-19

It has been reported through a recent study that over 28 million surgeries around the world could be cancelled during the 12 week peak of COVID-19.  It estimated an additional 2.4 million cancellations would happen for each extra week of shutdowns.  The backlog could take 45 weeks or longer to catch up.  This number could become longer depending on the length of time it takes for countries to open back up as well as a possible second wave this fall.

While the cancellations were necessary, they will have a substantial impact to the patient.  Anytime you delay a necessary surgery, you put your overall health and quality of life at risk.  This includes non-essential surgeries such as a hip replacement or spine surgery.   These may be deemed non-urgent, however, the more time that goes by before having a necessary surgery, the more likely you become disabled.  

Canada has always had a wait list for many kinds of surgeries.  The impact of the pandemic is still unknown.  We do know that it will likely create not only a financial burden, but could create increased health issues as well.

Some of the effects from waiting for your surgery in Canada can be:

  • Loss in wages.  It is estimated in Canada that prior to COVID-19, the amount of wages lost in 2019 was about $2.1 billion.  This equates to an average of $1,963 for each of the estimated 1 million + Canadians waiting for treatment.  With the shutdowns and delayed surgeries, it is now estimated this grows to $6.4 billion in lost wages or $5,972 per person.
  • Increased chance of making the medical condition or the injury worse. If a doctor determined surgery is needed for your condition, it is most likely the case.  Waiting to have the surgery varies greatly depending on what needs done.  Something deemed non-essential, such as an orthopedic surgery, can result in issues with long term, non-reversible effects if not dealt with in a reasonable amount of time.  
  • Increase chance of opioid dependency.  Being in pain can sometimes require a prescription pain medication.  While opioids have recently been limited, they are still being given on the short-term.  The longer you are on these, the higher chance you have of developing an addiction.  
  • Depression.  It’s safe to say that if you are in pain, your mood can change quickly.  Being in constant pain can not only drain your motivation and spirit, it can also cause you become immobile.  This is never good for your health, let alone mental health.  The frustration of not being able to feel well and inability to live your life as you’d like can cause you to slip into a depression.

If you find yourself in a position where you cannot wait any longer, give us a call.  We have several private options back open and available to do your surgery.  You can reach us at 877-344-3544 or info@healthvantis.com

Health Vantis

www.healthvantis.ca

877-344-3544

info@healthvantis.com

To Mask or Not to Mask?

To Mask or Not to Mask?

Back on May 20th, Chief Public Health Officer Dr. Theresa Tam made the announcement that she was recommending Canadians wear a face mask/covering where physical distancing wasn’t possible.  Wearing face masks is not something Westerners are used to.  It’s almost a stigma to have one on, however, in East Asia and China, there is no shame in wearing a face mask.  In fact, it has been going on there since the pneumonic plague in 1910 and is seen as a sign of civic responsibility to do so.  If someone is seen not wearing a face mask during a public health emergency, it is greatly frowned upon and people are actually afraid of that person because they would be considered to have low civic responsibility and disrespect.  

Now that things are slowly opening up, we will be exposed to more human contact than we’ve had in the past 2 months.  Social distancing is a new term for us and we are still trying to understand what is acceptable and what is not.  Based on what Dr. Tam has suggested, if you are not able to distance yourself in a situation where you will have 2 meters space, then the recommendation is to wear a non-surgical face mask.  An example would be if you routinely take the train to work.  You cannot guarantee you will be able to keep a 2 meter distance with someone else.  In a situation like this, it makes sense to wear a covering.  If you take your own car to work, you would not need to wear your mask as you were driving.

COVID-19 is a new virus.  We are learning more and more about each day.  We already know you can be asymptomatic.  Even though you feel well, you may be a carrier without even realizing it.  By wearing a face mask in situations where there will be close contact with others, the chances of spreading it are decreased significantly on both ends.  Not only are you protecting yourself, you are also protecting the more vulnerable such as a senior or immunosuppressed individual.  While it is not mandatory, it does show that you are willing to make a difference in combating this virus and are respectful of others around you.  Plus, it is a temporary inconvenience and there are some pretty cool looking face masks being made out there!

Health Vantis

www.healthvantis.ca

877-344-3544

info@healthvantis.com

Stress and Elective Surgery in COVID-19 Environment

It is a well-known fact that most people going to surgery experience a certain increase in stress and anxiety anticipating their procedure. With longer wait times and more uncertainty in the current environment, the situation becomes even more stressful. Everyone out there who is waiting is important and deserves to be seen as soon as possible.

Elective surgeries are a bit of a misnomer, and the name only sounds like a person has a choice whether or not to do it.  In reality, what that means is that a procedure is not life-threatening or urgent, and can be scheduled. However, we also know that long medical wait times create unneeded stress and anxiety.  We have to now manage it too, on top of our other anxiety about today’s world.

Studies show that less stressed patients report better outcomes. There are a few things you can do to lower your stress level related to waiting for surgery.

Here are some things to consider while waiting:

  1. Stay in touch with your doctor, physiotherapists or chiropractor. Ask them what you can do now. Most doctors can provide phone consultation, and some physiotherapist and chiropractors can help by phone or online instructions on how to exercise safely.
  2.  Discuss a different pain management plan with your doctor if your pain level increases significantly.
  3. Try to stay physically active. Depending on your mobility, it may still be possible to go for a walk. Walking is a great stress reducer.
  4. Do some exercises at home. If able, sign up for online yoga classes – some offer chair classes from the comfort of your own home.
  5. Research your private options and get your medical records reviewed. Doing can provide you with actionable items and you are not obligated to go private route if your surgery is rescheduled locally in a timely manner.

If you have any questions about exploring your private surgery options, we are here to help. Toll-free 1 877- 344- 3544.

Private Surgery After Covid-19

With medical wait times increasing for elective surgeries due to Covid-19 restrictions, some of you may be searching for information about your potential private options. Below is an update on what is being done or considered being done at the private surgical facilities we work with in the US.

As you already know, some of the southern United States lifted a number of restrictions. Depending on the state, many are resuming elective surgeries. Certain safety provisions and requirements must be met. Those are mandated by the state’s Department of Public Health.

Each facility we work with is accredited not only by the state (which is a requirement) but by another accrediting body in the US. We reached out to two of them, AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities) and AAAHC (Accreditation Association for Ambulatory Healthcare) to ask what they have in place.

AAACH advised that they have a number of resources available to their members on their website, but that they defer to a state department of public health for further guidance on reopening as those will differ from state to state.

AAAASF offered a similar answer and added that they conduct onsite resurvey and that they ask all facilities in their resurvey year reopening to submit policies and procedures to ensure that all infection control and patient safety requirements are in place.

Health Vantis is keeping an eye on the states governments announcements and their public health departments directives. So far, we see that there are several things that are being mandated by each opening state, such as pre-op COVID testing requirement: negative Covid-19 test results within 48h or 7 days, depending on the state. Some require staff and doctors continuous testing as well.  Another one is sufficient supplies of PPE to be stocked at a facility and enhanced cleaning protocols.

We are also keeping in touch with all the facilities we work with so that we get pertinent information on their developments. It is not clear yet how soon we will be able to send someone for medical travel. In our next blog we will talk about when it will be safe to travel for medical reasons.

Meanwhile, there are certain things you are still able to do remotely:

  • Reach out to your physiotherapist or chiropractor to ask them what exercises you can do at home. If your condition changed, be sure to mention all the details.
  • If your condition worsens dramatically, contact your doctor to tell them the new information. Most family doctors are able to do a phone consultation or a virtual appointment.
  • Consider your private options for the future. By getting a medical records review done with Health Vantis you are not obligated to proceed. However, should you decide that your post-COVID wait time is too long, you will be ready.

When Is It Safe to Travel for Medical Reasons?

Just yesterday our top public health officer, Dr. Theresa Tam, said that we need to approach opening the border with the US with extreme caution. If you are looking to get your surgery done in a private manner your choices of private medical facilities in Canada are limited. The closest destination is the USA.

Here are our considerations of why people may wait or may go to get their private surgery in the US. In this blog, we assume that there are no travel restrictions between the two countries. It may take a while to get there.

Before considering travelling for a private surgery one must consider travelling in general. It can be done by car or plane. Travel by car may be perceived as safer, as you are only sharing the space with 1-2 people.  Canadians will try to stay as close to home as possible, understandably so. There are just a couple of private surgical facilities in this country and we are keeping in touch with them to determine if and when they reopen, we can advise our potential clients. For now, we still offer second opinions, phone consults and review of medical records in a virtual or remote manner.

Travelling by air will require some assurance from the airlines that it is done in the safest manner possible. Transport Canada now requires that all guests have a non-medical mask or face covering during travel. Air Canada is implementing a plan to have mandatory temperature checks, more personal space, electrostatic cabin spraying, and PPE for its crew and customer service. WestJet provides seat distancing, fresh air into the cabin every 2-3 minutes and hospital quality filters, and limited food and beverage service.

Certain measures have to be in place from the hospital’s perspective to even consider doing private surgeries. Sufficient stocks of PPE, anaesthetic drugs, ventilators and COVID-19 pre-op testing are among the musts.

All the above listed are external reasons for a person to feel safe to be able to travel. There are internal reasons as well. Those are based on each individual particular situation and habits. It may depend on how severe your issue is and how long you are willing to wait. People that are more risk-takers will start travelling sooner. Those that are more averse to risk will stay and wait, monitoring news about medical travel and its results. Once there are a couple of successful travel cases, we will see more interest in travelling for medical reasons.

For now, we are still able to offer remote second opinions, consultations and review of medical records. Those action items can provide you with more information about your condition and will give you a head start should you choose to go the private route. For more information call us toll-free 877 344 3544.

Newsletter May 2020

How Long Will You Be Waiting for Your Elective Surgery?

Canadians deal with medical wait times even with no pandemics.  In the past few weeks, all the healthcare resources were directed towards treating Covid-19 patients, rightfully so, and an estimated 100,000 patients had their elective surgeries cancelled or postponed. People are patiently waiting in pain to find out when they will be seen by a specialist or when their new surgery is going to take place.

Last week brought in some positive news. Some provinces are starting to call cancelled patients to evaluate and possibly reschedule. According to this article, BC is to restart its elective surgeries on May 18th. They estimate that it will take them up until June 15th to come back to the same capacity as they were pre-COVID-19. The province cancelled 30,000 elective surgeries. It may take up to 2 years to catch up, with maximizing their operating room capacity and extending surgeries to happen on weekends.

Ontario Ministry of Health released directives to help hospitals and regional centres plan for a gradual resumption of cancelled surgeries. Although no date was given, each hospital has a responsibility to evaluate its resources and adhere to the released framework. The emphasis was given to the word gradual. As a requirement, 15 % of acute care should be reserved (or made available on a moments notice). According to the document the surgeries are only to resume if the hospital has had a stable number of COVID-19 cases and has:

  • available space and this space was evaluated in the context of physical distancing, so no care in the hallways
  • supplies of PPE, medications, swabs and reagents are available
  • health human resources are available and are not affecting urgent and emergent care

Alberta resumed their elective surgeries on May 4th and is expecting to have 26,000 to 30,000 urgent and non-urgent surgeries performed over the next six weeks. New Brunswick started rescheduling priority elective surgeries on May 11. Manitoba and Prince Edward Island are following suit, but no certain dates have been announced.

Many news reports stated the difficulties of reopening and all the challenges that may arise with its safe implementation. In this article, the issues of asymptomatic COVID cases, the availability of PPEs, anaesthetic drugs and ventilators are raised. Everyone scheduled for surgery will have to get a negative COVID-19 test within a certain time frame prior to the surgery. So that is an additional burden on the testing centres.

All the above is promising, and one can hope that the wait will not take years. While you are waiting to hear back from your doctor’s office, there are some things you can do.

  • Reach out to your physiotherapist or chiropractor to ask them what exercises you can do at home. If your condition changed, be sure to mention all the details.
  • If your condition worsens dramatically, contact your doctor to tell them the new information. Most family doctors are able to do a phone consultation or a virtual appointment.
  • Consider your private options for the future. By getting a medical records review done with Health Vantis you are not obligated to proceed. However, should you decide that your post-COVID wait time is too long, you will be ready.

Private Surgery After Covid-19

With medical wait times most likely increasing for elective surgeries due to Covid-19, some of you may be searching for information about your potential private options. We wanted to give an update on what is being done or considered being done at the private surgical facilities we work within Canada and the US.

As you already know, some of the southern United States are lifting the COVID-19 restrictions. Depending on the state, some are allowing elective surgeries to take place. Certain provisions and requirements must be met. Those are mandated by the state’s Department of Public Health.

Each facility we work with is accredited not only by the state (which is a requirement) but by another accrediting body in the US. We reached out to two of them, AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities) and AAAHC (Accreditation Association for Ambulatory Healthcare) to ask what they have in place.

AAACH advised that they have a number of resources available to their members on their website, but that they defer to a state department of public health for further guidance on reopening as those will differ from state to state.

AAAASF offered a similar answer and added that they conduct onsite resurvey and that they ask all facilities in their resurvey year reopening to submit policies and procedures to ensure that all infection control and patient safety requirements are in place.

Health Vantis is keeping an eye on the states governments announcements and their public health departments directives. So far, we see that there are several things that are being mandated by each opening state, such as pre-op COVID testing requirement: negative Covid-19 test results within 48h or 7 days, depending on the state. Some require staff and doctors continuous testing as well.  Another one is sufficient supplies of PPE to be stocked at a facility and enhanced cleaning protocols.

We are also keeping in touch with all the facilities we work with so that we get pertinent information on their developments. It is not clear yet how soon we will be able to send someone for medical travel.

 

 

How Long Will I Be Waiting for My Elective Surgery After Covid-19?

Many Canadians are asking this question. We deal with medical wait times even with no pandemics.  Now that all the healthcare resources are directed towards treating Covid-19 patients, rightfully so, those who had a surgery cancelled or postponed are facing a lot of uncertainty, more than ever. They are patiently waiting in pain to find out when they will be seen by a specialist or when their new surgery is going to take place.

So, how long? Here is what we know from the recent articles published in the media. This article states that after the SARS epidemic in Toronto in 2003 when elective surgeries were suspended for a number of weeks, it took months. It doesn’t state how many months or how many surgeries were postponed. CBC News estimated close to 100,000 patients had their surgeries delayed. Sounds like a lot, but we really can’t tell what that means in terms of catch up time. It is possible that hospitals are able to catch up quickly.

However, many news reports state the difficulties of reopening and all the challenges that may arise with its safe implementation. In this article, the issues of asymptomatic COVID cases, the availability of PPEs, anesthetic drugs and ventilators are raised. Most likely everyone scheduled for surgery will have to get a negative COVID-19 test within a certain time frame prior to the surgery. So that is an additional burden on the testing centers. What we see in the US, those states that are reopening their elective surgery require a negative test within 48h to 7 days, depending on the state.

Provincial governments and healthcare professionals are keenly aware of this situation. The process of addressing the wait times will have to be gradual. There is a potential, some say, inevitable, of the second wave of COVID-19. Our healthcare resources are tied. We have to be patient. That doesn’t mean just sit and wait. Here are some things you can do.

  • Reach out to your physiotherapist or chiropractor to ask them what exercises you can do at home. If your condition changed, be sure to mention all the details.
  • If your condition worsens dramatically, contact your doctor to tell them the new information. Most family doctors are able to do a phone consultation or a virtual appointment.
  • Consider your private options for the future. By getting a medical records review done with Health Vantis you are not obligated to proceed. However, should you decide that your post-COVID wait time is too long, you will be ready.

In our next blog, we will talk about private surgery after COVID-19.

If you have any questions regarding your private surgical options in other provinces or in the US, please reach out to us toll-free 877 344 3544.

Microport for Hip Replacements

Hip replacement surgeries are very common.  Many people experience numbness and weakness after the surgery.  New technology may be able to eliminate this with a new technique called Microport.  

Doing an anterior approach has become a popular way to do hip replacement surgery.  The anterior approach was designed to preserve the muscles that prevent dislocation of the hip post surgery. During surgery, an incision is made over the cup and the hip is typically dislocated. This allows for the ball to be cut off easily before putting the implant in. Although, by doing the incision over the cup, it makes it harder to see the ball part of the hip.  

Dr. Matt Seidel has come up with a way to avoid this.  He has developed a technique where a cannula, a thin tube, can be placed through an incision in the groin.  The advantage to moving the incision allows the surgeon to clean out the cup without having to put an incision right over it. This approach avoids dislocation of the hip during surgery by cutting the ball off first and then removing it from the socket.  

Microport also provides a lower risk of cutting sensory nerves, which would cause numbness.  It moves the procedure away from the femoral nerves that lower the chances of weakness even further.  Doing a more natural incision allows for fewer wound complications and reduces pain levels by quicker healing.  

If you are interested in this technique, contact Health Vantis and we can connect you to a surgeon trained to do this technique at 877-344-3544.

Health Vantis

877-344-3544

www.healthvantis.ca

Dreal- New Spinal Technique

A new technique called Dreal was developed for posterior unilateral thoracic discectomy.  Dreal is a curved high speed drill that assists in thoracic discectomies.  It removes disc material that can normally be difficult to access, quickly and thoroughly, providing a large clean bony surface for the discectomy.  This reduces removing too much bone and results in a better outcome.

This procedure also allows for the removal of calcified and soft disc fragments without manual maneuvers.  In traditional surgeries, this would require forceful maneuvers done manually by the surgeon, which could manipulate the spinal cord.   By eliminating that, it improves patient outcomes, reduces complication rates and allows for safer treatment of thoracic disc herniations. The design also allows easier, safer access for the surgeon to reduce the chance of trauma, resulting in a better outcome for the patient.  By being able to quickly and precisely remove the bone, operating time is reduced.  This in return reduces complications and/or infection.  

While this is still a fairly new technique and not available in Canada yet, it is available in the US. Contact us for details to find out if you are a candidate for this kind of procedure at 877-344-3544.

 

Health Vantis

877-344-3544

www.healthvantis.ca