After waiting for open-heart surgery for more than a year, a St. John’s man has now turned to hospitals outside his home province for the treatment he needs.
Jack Eastwood said the care he’s received from his cardiologist, his family doctor, and Eastern Health has been topnotch, but one of his arteries is 90 per cent blocked. He needs a coronary bypass to fix it, and the possibility of a health catastrophe weighs heavily on him daily.
“Every day I’m thinking, what happens if I have an incident while I’m walking with my friends? Should I go out in the woods by myself?” he said.
Along with those what ifs, come compromises: Eastwood said he is supposed to limit some activities, such as walks in the cold, or shovelling snow.
“I might have an incident and that could be serious,” he said.
The long wait
Eastwood’s bypass is an elective surgery, one doctors have deemed a patient can safely wait for at home. Cases that need to be monitored more closely are deemed urgent, with those patients admitted to hospital to be monitored and treated as quickly as possible.
I’m not trying to jump the queue. I would just like to get on with life.– Jack Eastwood
Eastwood was put on an Eastern Health wait list in November 2019 and told that his surgery would hopefully be done in six months.
“Then we had Snowmageddon, and then we had COVID, and everything shut down and nothing has happened since,” he said.
In August, as cases of COVID-19 dwindled, Eastwood checked with Eastern Health again.
“My cardiologist said it didn’t look like my surgery would be done until sometime after Christmas, and in a letter they sent me they said that if I didn’t get it in six months, I could seek to have the surgery done outside of the province. So that’s what I’m doing,” said Eastwood.
He has contacted hospitals in Quebec and Ontario, and has had positive feedback from one in Montreal and another in Ottawa. The latter, he said, is considering if it can take on his case.
“So at the present time I’m a little bit hopeful,” said Eastwood. ‘I’m not trying to jump the queue. I would just like to get on with life.’
A growing list
Eastwood isn’t the only one waiting.
Late last winter, when Eastern Health stopped all elective surgeries to build capacity for a possible surge of COVID-19 patients, its wait list for elective heart surgeries grew.
The health authority did restart such surgeries in the spring, but as the pandemic continues, Eastern Health’s Clinical Chief of Cardiac Care Dr. Sean Connors confirmed the wait list for elective open-heart surgeries in Newfoundland and Labrador has increased from 120 to 170 patients.
He said all urgent and emergency patients continue to be treated.
“We encourage all of our patients to be in touch, very closely, with our cardiac surgery coordinator and we will admit them to hospital if we think that someone is not doing well, or shows any of these red flags, it’s time to get in the hospital,” said Connors.
Part of the reason for the continued wait is that the entire health care system is in overdrive, trying to catch up with thousands of medical procedures postponed by COVID-19.
“Because of the pandemic and the influence that had on what we could do in the OR [operating room] and personal protective equipment and so on, we probably found that there were about 90 patients that we lost our OR slot for,” Connors said, adding staff are working to catch up on those patients.
While Connors said there is always a risk that a heart patient’s condition could deteriorate, health professionals are good at determining who needs treatment first.
“When it comes to your heart, sometimes things can occur unpredictably, but we do our best. We know what represents high risk,” he said.
“In all the jurisdictions I’ve worked in, yes, if you are at home waiting for surgery, sometimes there are some bad outcomes. But it happens extremely rarely and we think we do a good job of triaging who needs to be in hospital and who doesn’t.”
More help on the way
Staffing is also an issue, as Eastern Health currently has fewer heart surgeons than in the past. The health authority said it has three cardiac surgeons as of this fall.
“For open-heart surgery, we have an ideal cadre over the years of probably between two and five cardiac surgeons but recruitment and retention is a challenge, if you look at any program around North America” said Connors.
Eastern Health said it has recruited a cardiac surgeon to begin work in December and is “actively recruiting” for another one.
Connors said staff at Eastern Health are going above and beyond to catch up with the backlog of cardiac surgeries, procedures and testing.
“We feel well supported here at Eastern Health by both our staff and administration. The staff are volunteering. We are doing evenings. Some are doing weekends,” he said, adding that is all happening on top of regular duties.
Connors said that if people need care, they can get it, and he worries fear of COVID-19 has kept some people away from health care facilities.
“During the height of the pandemic the people we saw were so sick. The types of heart attacks we saw were much more severe,” he said.
Connors said people were staying away either out of fear of the virus, or fear of being a burden on the health-care system, and neither of those were true.
“If you don’t feel well come in. We are here. So please don’t think twice about coming to the hospital.”