Pediatric surgeries postponed, families exhausted

Theo, 7 years old, has cerebral palsy. He has been waiting nearly four years for a radicellectomy, a surgery that involves cutting nerves in the spine to reduce spasticity and improve motor skills.

October 20 was the big day. He would finally undergo the operation at the University Hospital Center (CHU) Sainte-Justine, in Montreal. Fasting, the boy was tested for COVID-19 and X-rays before the scheduled 8 a.m. procedure. Then, at the last minute, the surgery was canceled.

“The surgeon said to my boyfriend: ‘In the end, it won’t be today, there are no more beds,’ says his mother, Élise Cormier, who stayed at home with their newborn baby. That’s all we know. »

Hope for a better life for Theo gave way to frustration, discouragement and sadness. “It would potentially help him walk,” says Élise Cormier. “Why did we go so far as to be in a gown, do the x-rays and the COVID test and finally realize that there was no more bed? »

The family, who lives in Chertsey, in Lanaudière, had to organize in a hurry to prepare for the operation, the date of which was set the day before the intervention. Theo got up at 4:30 in the morning to be ready. “My son has a moderate autism spectrum disorder,” says Élise Cormier. He experiences a lot of anxiety with medical appointments. He cried all morning [le jour de l’intervention]. It was not the fun. »

The wave of respiratory infections that is sweeping through toddlers is having an impact in pediatric emergency rooms in Montreal, but also in operating rooms. Many babies with bronchiolitis or pneumonia need to be hospitalized, making it difficult to resume elective surgeries that require a hospital stay.

At the CHU Sainte-Justine, the cancellation rate for operations was 6% on average between the 1er September and October 15, according to data obtained by The duty at the establishment. A percentage twice as high as before the pandemic, according to the director of professional services, the Dr Mark Girard.

The doctor explains that half of the surgeries canceled were because the patient had COVID-19 or respiratory virus symptoms, such as fever. “I’m not hiding from you that this leads us to do a littleoverbooking, in the sense that we put a little more patients [à l’horaire] because we know that every morning, there will be one or two who, unfortunately, will cancel at the last minute, ”says the Dr Girard. “With our waiting lists, we don’t feel like keeping people waiting who could get an operation and end up with a medical team and caregivers who could not operate. »

He admits that this reality is “terrible”. “We try to make maximum use of our operating periods, he argues. By doing this, there is always a small risk of cancellation. »

Postponements can also be caused by the absence of nurses from the operating room, due to an infection such as COVID-19 or an illness of their child. And that’s without taking into account the sometimes insufficient beds on the floors to accommodate patients who have undergone non-emergency surgery. “There are certain evenings when we leave at the end of the day, there are 19 patients in our intensive care unit and the next morning, we find ourselves at 26”, cites as an example the Dr Girard.

The director of professional services “regrets” that surgeries are canceled. “It is sure that it is very disappointing for the parents, he admits. What we undertake to do whenever these situations arise is to put [ces patients] as a priority during the next [période] operated by the same surgeon. »

The Montreal Children’s Hospital

Overwhelmed with patients, the Montreal Children’s Hospital postponed 7% of its surgeries between 1er September and October 15, according to data obtained by The duty at the establishment. In 30% of cases, the cancellation was linked to a lack of hospital beds or intensive care, it says.

No non-emergency operations requiring hospitalization were carried out last week because of the “tsunami of viral infections”, according to the associate director of professional services, Dr.r Robert Barnes. “We were able to replace the operating time with day surgery cases,” he says. “That way at least, we can continue to attack our waiting list. »

Non-emergency surgeries requiring hospitalization resumed on Monday. “With a little nervousness”, adds the Dr Barnes.

The hospital tries to schedule surgeries and postponements seven days in advance. “What we don’t want to do is be so optimistic a week in advance that we end up canceling surgeries that morning,” says Dr.r Barnes. “It increases the suffering for young people and families. And our operating theater is underutilized. »

Cancellations have always occurred at the end of the day due to longer than expected cases. But the room for maneuver is thin in the network currently, recalls the president of the Quebec Association of Surgery, the Dr Patrick Charlebois. “In an environment where there’s a bit of agility and a bit more flexibility in resources, you make the case, you finish a little bit later,” he says. But in a context where there’s no bed, no resources, there’s no room in the recovery room, you can’t do that extra thing. »

If these cancellations are understandable, they nevertheless remain “a big source of stress” for families, according to psychologist Marielle Purdy. Especially when the patient is a child. “The parent must manage his own emotions, his own anxieties, but also help his child manage his own,” says the one who has already worked in a pediatric hospital.

Élise Cormier, she hopes that her son will not have to wait another year before having surgery. She still has not received a call from the CHU Sainte-Justine to set a new date.

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