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(The Conversation)   The current ban on elective surgeries may end up showing they're not all really good candidates   (theconversation.com) divider line
    More: Followup, Orthopedic surgery, Surgery, elective surgeries, Elective surgery, urgent surgery people, recent studies, Hospital, cataract surgery  
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985 clicks; posted to Geek » on 08 Apr 2020 at 12:05 PM (24 weeks ago)   |   Favorite    |   share:  Share on Twitter share via Email Share on Facebook



31 Comments     (+0 »)
 
View Voting Results: Smartest and Funniest
 
2020-04-08 11:29:15 AM  
Pssst. It's in the name. Right there. The word before surgeries. Google it.
 
2020-04-08 11:43:47 AM  
Elective surgery is non-urgent surgery people choose (elect) to have: things like cataract surgery, joint replacement, tonsillectomy, hernia repair and cosmetic surgery.

I've been told I am a very poor candidate for cataract surgery because I am so nearsighted. My retina doc says retinal separation is highly likely.

Joint replacement can literally be a life saver. I know people that after they had it were able to move without pain for the first time in years and start exercising, lost weight, modified their diabetes regimen, et. al. Knew a young woman years ago that had RA and had total knees done at age 25.
 
2020-04-08 12:09:26 PM  
On the plus side, I got to put off that "Happy 50th birthday, now enjoy a colonoscopy!!" appointment just a little longer...
 
2020-04-08 12:26:02 PM  
FTFA:
"cataract surgery, joint replacement, tonsillectomy, hernia repair and cosmetic surgery"

One of these things is not like the other. One of these things does not belong.

As a person who had chronic tonsillitis as a kid, I missed a farking ton of school at a young age because of this. Once they were gone, did not have a problem again.

Cosmetic surgery tho? Yea, sorry toots, your gonna have to stay in the itty bitty titty club. Thats a joke, obviously, its not just tit jobs. Some are very much needed, even if only to help a persons mental health after a bad accident.

If you have ever had a hernia, you know its not at all elective.

gtfo
 
2020-04-08 12:27:25 PM  
In the US, even colonoscopies are elective. Since they're done in our hospital, we have an entire Endoscopy dept. running at bare minimum staff with the others working odd jobs around the hospital @ the same pay rate.

It's not really a bad deal for the nurses, the work they're doing is not above their pay rate.

/I like working there...except I've been working remote for 4 weeks and I'm starting to enjoy it and getting rather spoiled.
 
2020-04-08 12:30:46 PM  
I know this article is about Australia, but the same limits have been placed in many places in the US.  Right now, I'm waiting to find out when I'm going to have an 8.8mm kidney stone removed.  I spent two days in the hospital as I waited to get a stent put in to alleviate some of the fluid backup/swelling/infection in that kidney.  I can function now, but the drugs they have me on to keep me from being nothing but a writhing mass of hurt are screwing around with other things.

No, kidney stone removal is NOT elective.
 
2020-04-08 12:33:21 PM  

Unobtanium: Elective surgery is non-urgent surgery people choose (elect) to have: things like cataract surgery, joint replacement, tonsillectomy, hernia repair and cosmetic surgery.

I've been told I am a very poor candidate for cataract surgery because I am so nearsighted. My retina doc says retinal separation is highly likely.


Ouch!  My wife has cataracts and is extremely nearsighted.  So far they aren't bad enough to consider surgery but this makes me worry about the future.

Joint replacement can literally be a life saver. I know people that after they had it were able to move without pain for the first time in years and start exercising, lost weight, modified their diabetes regimen, et. al. Knew a young woman years ago that had RA and had total knees done at age 25.

Immobility is a killer, whatever the cause.
 
2020-04-08 12:34:35 PM  
It depends on what "elective" means, and in surgery it means anything that isn't emergent (operate ASAP or the patient dies) or urgent (stabilize patient, then operate ASAP).  If you have a week or two before it kills you, it's elective surgery.
 
2020-04-08 12:37:51 PM  
I hope whenever they restart those surgeries, all the REALLY worthless stuff is put at the back of the line.

Cosmetic surgery aside from burn victims is worthless 99% of the time. Same with boobs job aside from breast cancer survivors.

But yeah, two people in my family had one of their knees fixed and it literally changed their life for the better... They literally waited years to have it... and before the surgery they were in severe pain... and I mean SEVERE.... I cant imagine the pain so many have to endure right now because of this.
 
2020-04-08 12:43:09 PM  
The only elective surgery I've had was a vasectomy.  Orders of magnitude cheaper than child-support.
 
2020-04-08 12:50:41 PM  
Surgeries that remove chronic pain should not be considered "elective", unless you are agreeing the opioid epidemic isn't really a big deal.
 
2020-04-08 1:04:30 PM  

common sense is an oxymoron: It depends on what "elective" means, and in surgery it means anything that isn't emergent (operate ASAP or the patient dies) or urgent (stabilize patient, then operate ASAP).  If you have a week or two before it kills you, it's elective surgery.


For instance: Scheduled cancer surgery.....surely there can be no negative impact from a delay there, right?

A doctor friend here in Pa has been informed that "anything scheduled is elective"
 
2020-04-08 1:13:31 PM  

Driedsponge: Surgeries that remove chronic pain should not be considered "elective", unless you are agreeing the opioid epidemic isn't really a big deal.


It's interesting trying to guess what is or is not elective. The two things I'm about to tell you were found out almost by happenstance, and I had no symptoms for either.
Because of what an ultrasound showed, a CT scan was required, had it on Monday. We were looking for a tear in my carotid artery, thank God there wasn't one, pretty sure that wouldn't have been elective surgery because of the risk of stroke, but who knows.
Different CT scans a couple of months ago showed a structure of my small intestine where it's connected (no colon). I have a telemed appointment with my surgeon in a couple of weeks, but I have no idea if I'll have to wait until it gets bad and causes a bowel obstruction because I'm asymptomatic.
Honestly I won't mind waiting for that, but I don't know the risks that apply to my particular case.
I'm not in pain at all.
 
2020-04-08 1:15:53 PM  

Sasquach: common sense is an oxymoron: It depends on what "elective" means, and in surgery it means anything that isn't emergent (operate ASAP or the patient dies) or urgent (stabilize patient, then operate ASAP).  If you have a week or two before it kills you, it's elective surgery.

For instance: Scheduled cancer surgery.....surely there can be no negative impact from a delay there, right?

A doctor friend here in Pa has been informed that "anything scheduled is elective"


Huh. You're on the other side of the state than me, we shall see how the situation I just posted plays out.
 
2020-04-08 1:24:00 PM  

lindalouwho: Sasquach: common sense is an oxymoron: It depends on what "elective" means, and in surgery it means anything that isn't emergent (operate ASAP or the patient dies) or urgent (stabilize patient, then operate ASAP).  If you have a week or two before it kills you, it's elective surgery.

For instance: Scheduled cancer surgery.....surely there can be no negative impact from a delay there, right?

A doctor friend here in Pa has been informed that "anything scheduled is elective"

Huh. You're on the other side of the state than me, we shall see how the situation I just posted plays out.


The guy that told me is a director of blah blah blah for UPMC...
 
2020-04-08 2:27:51 PM  
The problem with elective surgery in America is not rather or not they are needed, or helpful, it is that those who get them or are denied them are done so for the completely arbitrary issue on rather they can afford them or if their insurance company will allow them to get them.

There are tens of millions of Americans right now who would benefit hugely from a belly ban.  Most, if not all, are struggling with life threatening conditions because of their weight, and only a tiny fraction of them will ever be successful through dieting alone, add in that when your are poor, often the same factors that go into making it so that you are not the kind of person who can get a handle on your finances, may also play a huge factor in making it difficult for the same person to get a good handle on what they eat.  This doesn't mean they are a bad person, it just means that they are not as gifted in some areas as the rest of us, but they still deserve a healthy and happy life.  A belly ban for such a person may be a way to get to that life.  It's going to go to Debra though who is on track to lose her pregnancy weight in another nine months of yoga and walking but wants to see results now, and who can pay for it now.
 
2020-04-08 2:37:29 PM  
Surgery should always be the last resort after everything else has been tried.
 
2020-04-08 2:59:20 PM  

Sasquach: lindalouwho: Sasquach: common sense is an oxymoron: It depends on what "elective" means, and in surgery it means anything that isn't emergent (operate ASAP or the patient dies) or urgent (stabilize patient, then operate ASAP).  If you have a week or two before it kills you, it's elective surgery.

For instance: Scheduled cancer surgery.....surely there can be no negative impact from a delay there, right?

A doctor friend here in Pa has been informed that "anything scheduled is elective"

Huh. You're on the other side of the state than me, we shall see how the situation I just posted plays out.

The guy that told me is a director of blah blah blah for UPMC...


My docs/surgeons/tests are all either Presbyterian, Montifiore, or Hillman Cancer center in Pittsburgh. I don't have cancer, I see a blood specialist because last year after 8 iron infusions, the iron in my body did not improve. 6 months on he hasn't found blood cancer or disease/condition for that anomaly, but orders a special blend of iron that is working.
Because of two bad genetic markers for colon cancer, it's vital to get an endoscopy and flex sig yearly to catch things because you don't want to lose your rectum if you were spared that with the colectomy, and those bad mutations puts you at higher than average risk for, currently known, 8 or so other types of cancer. Ain't nobody got time to worry about that, so you just add screening for them yearly - the only one that there is no test for yet is ovarian cancer, and surgical protocol shut me down when I said "Let's take them out, I'm not using them anymore." Stats say not getting it are very much in my favor. I fell out laughing when they told me the one marker because it's call FAP, and they looked at me like I was a lunatic because it's kind of serious lololol. Is the term fapping a Fark thing, or is it an internet and/or used in real life? Familial Adenomatous Polyposis. I just googled that to check my spelling, and apparently it's in the real dictionary, not just UD, but I have never heard anyone use it. Maybe because I'm old enough to sing "will you still need me, will you still feed me."
Anyways, I took the long way around to tell you that right after I posted, I got a callback from leaving a message for scheduling last week asking to schedule my yearly Endo and flex sigmoidoscopy, because I knew they stopped doing them and when they start back up there'll be a deluge of people booking them. She told me that since we're in the realm of the unknown, gastro is not yet scheduling, but she is making a list of people to call back when things calm down; I usually call in June so that I'm on point with my December yearly. So you are correct, and it is going case by case whether the medical provider seems it an emergency or the symptoms indicate an issue that could be benign or very worrying. They're also going month by month at the moment for making regular appointments telemed - I love doing it this way and hope it proves workable enough to be made standard. Because all my docs want blood work, I've had them all send me the orders for it because I'm 5 minutes away from a little hospital that won't be admitting COVID patients, and getting stuck one time is better than 5 or six times - that's my tip of the day if anyone can/wants to consolidate blood work, I even try to do it in the normal timeline, though some tests need to be done closer to your scheduled appt. because certain readings can change rapidly. It's nice when your doc already has the results before your appointment.

Probably the only reason anyone besides you will read all of this (and your reason might just be boredom) is because they're eye catches FAP :-D
 
2020-04-08 3:02:18 PM  

SpaceyCat: I know this article is about Australia, but the same limits have been placed in many places in the US.  Right now, I'm waiting to find out when I'm going to have an 8.8mm kidney stone removed.  I spent two days in the hospital as I waited to get a stent put in to alleviate some of the fluid backup/swelling/infection in that kidney.  I can function now, but the drugs they have me on to keep me from being nothing but a writhing mass of hurt are screwing around with other things.

No, kidney stone removal is NOT elective.


I don't know why I just Googled that to see what an 8.8mm stone would look like. Ouch.

I hope yours is somewhere high on the priority list.
 
2020-04-08 3:07:36 PM  
I need a breast reduction. 36H.  I had already decided to wait until the fall right before covid happened.  I lost almost 200 lbs and yet the boobs are still there.
/Don't all stampede to my profile, there are no pics.
 
2020-04-08 3:12:56 PM  
Also, did a bit of Googling, and found that the American College of Surgeons released their triage list online for elective surgeries. Unfortunately, those of you who are anxious to get a colonoscopy might be disappointed.

https://www.facs.org/covid-19/clinica​l​-guidance/triage
https://www.facs.org/covid-19/clinica​l​-guidance/elective-case
 
2020-04-08 3:15:14 PM  

Loren: Ouch!  My wife has cataracts and is extremely nearsighted.  So far they aren't bad enough to consider surgery but this makes me worry about the future.


I have had two different retina docs in the last 20 years or so (I had a blood vessel pop in the center of my left retina back then). First one changed practices, and I was handed off to the new guy. The first one was pretty blunt, but the second guy has said "Mr. Unobtanium, if you have cataract surgery, you could be farked as far as your eyesight is concerned."
 
2020-04-08 4:00:55 PM  

winedrinkingman: The problem with elective surgery in America is not rather or not they are needed, or helpful, it is that those who get them or are denied them are done so for the completely arbitrary issue on rather they can afford them or if their insurance company will allow them to get them.

There are tens of millions of Americans right now who would benefit hugely from a belly ban.  Most, if not all, are struggling with life threatening conditions because of their weight, and only a tiny fraction of them will ever be successful through dieting alone, add in that when your are poor, often the same factors that go into making it so that you are not the kind of person who can get a handle on your finances, may also play a huge factor in making it difficult for the same person to get a good handle on what they eat.  This doesn't mean they are a bad person, it just means that they are not as gifted in some areas as the rest of us, but they still deserve a healthy and happy life.  A belly ban for such a person may be a way to get to that life.  It's going to go to Debra though who is on track to lose her pregnancy weight in another nine months of yoga and walking but wants to see results now, and who can pay for it now.


In my city/health system necessary procedures/tests/operations are never denied when critically needed because of inability to pay.

Having lived a long life as a gregarious person who has met people from a wide variety of walks of life, I can promise you that your not uncommon confounding perspective  of assigning particular traits and their reasons lopsidedly to poor people is a horribly misguided talking point constantly reinforced by a certain segment of political policy makers, and the disdain of moneyed folks disconnected from or arrogantly dismissive of the causes of our disturbingly rapid freefall into a wide chasm of income equality. Most (not all) poor people today are normal Americans who are not stupid, not lazy, do not lack willpower or make bad choices. The US no longer values most people and try as they might, they are locked out of opportunities to rise up into any comfortable position of middle class, their future is locked into not being able, allowed, to do anything but struggle to maintain a stagnant standard of living. You know most of the reasons why.
I've met or am aware of the vast number of people of every profession being severely obese, even in the medical profession. Addiction, gambling, bad choices, stupid choices, financial havoc exist in every walk of life, be it the brilliantly intelligent or people with challenges.
This narrative is hugely responsible for denying decent wages and the lack of attention paid to child care needs, affordable housing, and wicked denial of all manner of services and needs, necessities that that were in in place and common earlier in my lifetime.
It's greed. Corporations and even smaller businesses worship the shareholders or their desire for a number of wanton possessions, and it's all at the dehuminizing disregard for the workforce.
I am heartbroken and devastated for the completely distopian future that that this pandemic, along with the present horrifying choices being made by those in charge and powerful in a sweeping, rapid, and now unchallenged decisions and policies that will change the US forever, going beyond suppression and through the door of abjectly devaluing the lives of most our citizens.

To paraphrase The Who, I wish I had died before I got old enough to see this come to pass. I'm aware of your profession, so I know you'll get why I stop short of expressing all that needed right now to stop this third world country sh*t. I don't want multiple visits by people from two or three lettered organizations.

I think I'll go see if I can find a fun or interesting topic in another thread, that's enough intensity for today.
Stay safe, and try to be be extra kind to the people who will freak out from stress without violence. What we are seeing for our future is suddenly astonishingly unexpected and cruel, and despair is going to get more common.
 
2020-04-08 4:05:42 PM  

cyberspacedout: Also, did a bit of Googling, and found that the American College of Surgeons released their triage list online for elective surgeries. Unfortunately, those of you who are anxious to get a colonoscopy might be disappointed.

https://www.facs.org/covid-19/clinical​-guidance/triage
https://www.facs.org/covid-19/clinical​-guidance/elective-case


The decisions and guidance on that site will be updated constantly. Thanks for finding it.
https://www.facs.org/covid-19
 
2020-04-08 4:37:04 PM  
Something like 1/2 of orthopedic surgeries are unlikely to have any benefit. This has long been known. We waste literally billions doing surgeries that are pointless and potentially harmful all so some surgeons can pull down million dollar paychecks.
 
2020-04-08 5:20:18 PM  

lindalouwho: Sasquach: lindalouwho: Sasquach: common sense is an oxymoron: It depends on what "elective" means, and in surgery it means anything that isn't emergent (operate ASAP or the patient dies) or urgent (stabilize patient, then operate ASAP).  If you have a week or two before it kills you, it's elective surgery.

For instance: Scheduled cancer surgery.....surely there can be no negative impact from a delay there, right?

A doctor friend here in Pa has been informed that "anything scheduled is elective"

Huh. You're on the other side of the state than me, we shall see how the situation I just posted plays out.

The guy that told me is a director of blah blah blah for UPMC...

My docs/surgeons/tests are all either Presbyterian, Montifiore, or Hillman Cancer center in Pittsburgh. I don't have cancer, I see a blood specialist because last year after 8 iron infusions, the iron in my body did not improve. 6 months on he hasn't found blood cancer or disease/condition for that anomaly, but orders a special blend of iron that is working.
Because of two bad genetic markers for colon cancer, it's vital to get an endoscopy and flex sig yearly to catch things because you don't want to lose your rectum if you were spared that with the colectomy, and those bad mutations puts you at higher than average risk for, currently known, 8 or so other types of cancer. Ain't nobody got time to worry about that, so you just add screening for them yearly - the only one that there is no test for yet is ovarian cancer, and surgical protocol shut me down when I said "Let's take them out, I'm not using them anymore." Stats say not getting it are very much in my favor. I fell out laughing when they told me the one marker because it's call FAP, and they looked at me like I was a lunatic because it's kind of serious lololol. Is the term fapping a Fark thing, or is it an internet and/or used in real life? Familial Adenomatous Polyposis. I just googled that to check my spelling, and apparently it's in the real dictionary, not just UD, but I have never heard anyone use it. Maybe because I'm old enough to sing "will you still need me, will you still feed me."
Anyways, I took the long way around to tell you that right after I posted, I got a callback from leaving a message for scheduling last week asking to schedule my yearly Endo and flex sigmoidoscopy, because I knew they stopped doing them and when they start back up there'll be a deluge of people booking them. She told me that since we're in the realm of the unknown, gastro is not yet scheduling, but she is making a list of people to call back when things calm down; I usually call in June so that I'm on point with my December yearly. So you are correct, and it is going case by case whether the medical provider seems it an emergency or the symptoms indicate an issue that could be benign or very worrying. They're also going month by month at the moment for making regular appointments telemed - I love doing it this way and hope it proves workable enough to be made standard. Because all my docs want blood work, I've had them all send me the orders for it because I'm 5 minutes away from a little hospital that won't be admitting COVID patients, and getting stuck one time is better than 5 or six times - that's my tip of the day if anyone can/wants to consolidate blood work, I even try to do it in the normal timeline, though some tests need to be done closer to your scheduled appt. because certain readings can change rapidly. It's nice when your doc already has the results before your appointment.

Probably the only reason anyone besides you will read all of this (and your reason might just be boredom) is because they're eye catches FAP :-D


Holy CRAP I read that as 1 continuous sentence with an 80's type "valley girl" voice in my head...
 
zez
2020-04-08 6:17:38 PM  

Mikey1969: On the plus side, I got to put off that "Happy 50th birthday, now enjoy a colonoscopy!!" appointment just a little longer...


Talk to your doctor about the "poop in a bucket and poke it with a stick" test. really not sure what's worse lol
 
2020-04-08 7:29:11 PM  

Sasquach: lindalouwho: Sasquach: lindalouwho: Sasquach: common sense is an oxymoron: It depends on what "elective" means, and in surgery it means anything that isn't emergent (operate ASAP or the patient dies) or urgent (stabilize patient, then operate ASAP).  If you have a week or two before it kills you, it's elective surgery.

For instance: Scheduled cancer surgery.....surely there can be no negative impact from a delay there, right?

A doctor friend here in Pa has been informed that "anything scheduled is elective"

Huh. You're on the other side of the state than me, we shall see how the situation I just posted plays out.

The guy that told me is a director of blah blah blah for UPMC...

My docs/surgeons/tests are all either Presbyterian, Montifiore, or Hillman Cancer center in Pittsburgh. I don't have cancer, I see a blood specialist because last year after 8 iron infusions, the iron in my body did not improve. 6 months on he hasn't found blood cancer or disease/condition for that anomaly, but orders a special blend of iron that is working.
Because of two bad genetic markers for colon cancer, it's vital to get an endoscopy and flex sig yearly to catch things because you don't want to lose your rectum if you were spared that with the colectomy, and those bad mutations puts you at higher than average risk for, currently known, 8 or so other types of cancer. Ain't nobody got time to worry about that, so you just add screening for them yearly - the only one that there is no test for yet is ovarian cancer, and surgical protocol shut me down when I said "Let's take them out, I'm not using them anymore." Stats say not getting it are very much in my favor. I fell out laughing when they told me the one marker because it's call FAP, and they looked at me like I was a lunatic because it's kind of serious lololol. Is the term fapping a Fark thing, or is it an internet and/or used in real life? Familial Adenomatous Polyposis. I just googled that to check my spelling, and apparently it's in the real dictionary, not just UD, but I have never heard anyone use it. Maybe because I'm old enough to sing "will you still need me, will you still feed me."
Anyways, I took the long way around to tell you that right after I posted, I got a callback from leaving a message for scheduling last week asking to schedule my yearly Endo and flex sigmoidoscopy, because I knew they stopped doing them and when they start back up there'll be a deluge of people booking them. She told me that since we're in the realm of the unknown, gastro is not yet scheduling, but she is making a list of people to call back when things calm down; I usually call in June so that I'm on point with my December yearly. So you are correct, and it is going case by case whether the medical provider seems it an emergency or the symptoms indicate an issue that could be benign or very worrying. They're also going month by month at the moment for making regular appointments telemed - I love doing it this way and hope it proves workable enough to be made standard. Because all my docs want blood work, I've had them all send me the orders for it because I'm 5 minutes away from a little hospital that won't be admitting COVID patients, and getting stuck one time is better than 5 or six times - that's my tip of the day if anyone can/wants to consolidate blood work, I even try to do it in the normal timeline, though some tests need to be done closer to your scheduled appt. because certain readings can change rapidly. It's nice when your doc already has the results before your appointment.

Probably the only reason anyone besides you will read all of this (and your reason might just be boredom) is because they're eye catches FAP :-D

Holy CRAP I read that as 1 continuous sentence with an 80's type "valley girl" voice in my head...


Lololololthe reason I totally believe you and am not offended, but amused, is that poured out of me like a dam that broke and it didn't even occur to me that it might need edited.
I'm now part of the present day lack of editors, and I hang my head in shame.

Now I'm going to reread it valley girl style out loud, because that promises to have me in fits of laughter!
 
2020-04-08 8:25:12 PM  

Sasquach: common sense is an oxymoron: It depends on what "elective" means, and in surgery it means anything that isn't emergent (operate ASAP or the patient dies) or urgent (stabilize patient, then operate ASAP).  If you have a week or two before it kills you, it's elective surgery.

For instance: Scheduled cancer surgery.....surely there can be no negative impact from a delay there, right?

A doctor friend here in Pa has been informed that "anything scheduled is elective"


That is the definition at my hospital as well. Been working in pathology for almost 20 years and just learned that fact last month.
 
2020-04-09 6:19:40 AM  

common sense is an oxymoron: It depends on what "elective" means, and in surgery it means anything that isn't emergent (operate ASAP or the patient dies) or urgent (stabilize patient, then operate ASAP).  If you have a week or two before it kills you, it's elective surgery.


If it kills me in two weeks, it is not elective to get something done about it. In my view "elective" means "take it or leave it makes no difference to your biological well being".

I can for example forego cateract surgery and not die from having cateracts because there is no continuous general decline of health leading to death (other than regular aging). If I hear I got 2 weeks to live if I don't get a surgery, I will suffer continuous declining health for two weeks that will end up in death. That does count.
 
2020-04-09 12:15:54 PM  

common sense is an oxymoron: It depends on what "elective" means, and in surgery it means anything that isn't emergent (operate ASAP or the patient dies) or urgent (stabilize patient, then operate ASAP).  If you have a week or two before it kills you, it's elective surgery.


Simpler definition:  If it's scheduled it's elective.
 
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