Elective surgeries delayed, canceled across Wyoming as hospitals remain full
Jess Fahlsing was recovering from a long-needed surgery received at Ivinson Memorial Hospital. While the procedure had gone smoothly, it had been an intense one-the kind where patients usually stay hospitalized overnight in order to stay comfortable and to begin a safe recovery. But Fahlsing wasn't able to receive that kind of care. There were no hospital beds available.
Fahlsing had their uterus removed to improve their quality of life.
"I need it for heavy and painful cycles which are to the point where I've missed days of work and really days of my life."
Before the surgery, every trip and activity required planning and Fahlsing had to bring supplies, medications and iron supplements wherever they went. And recently, they'd been a bit of a homebody, trying to avoid any last-minute sickness that could delay their surgery. Fahlsing described their life as being somewhat on hold as they waited for the procedure.
"There's been a lot of build-up to this and that's all I've been able to focus on for months now. I've more or less planned my life around the surgery."
This kind of surgery is what's known as an "elective" or "non-emergent" surgery. It's an important operation, but it can be delayed a month or two or longer.
All things considered, Fahlsing is one of the lucky ones who was able to have surgery. The same cannot be said for many others.
Jeffrey Chapman is the chief medical officer at Cheyenne Regional Medical Center - one of the many Wyoming hospitals that have had to limit what procedures they can perform.
"For almost five weeks we've only been doing urgent and emergent cases," he said.
From Sheridan to Casper to Rock Springs, hospitals are monitoring their capacity on a day-to-day basis. In Campbell County, the hospital system canceled all elective surgeries earlier this week. And at Cheyenne Regional, Chapman said they have to make decisions about which surgeries can wait and which cannot.
"If there's a significant risk they will have a medical complication or die, then we will do the case," Chapman said. "If it's something that if it waits 30, 60, 90 days, we don't feel there's a great chance they could have a significant medical backlash, then we are not doing those cases unless it can be done on short notice and without being admitted."
The hospital tries to anticipate how many beds will be available, and what staffing levels will look like. But the unpredictability of COVID-19 makes that a challenge.
"Most people don't want less than a day's notice to say, 'oh, you can have surgery tomorrow,'" Chapman said. "So we are able to do some of that but a lot of that is just a logistical nightmare for the patient."
"It's important to note that if citizens of Wyoming had stepped up to the plate and everybody got vaccinated, we wouldn't have a hospital full of COVID - therefore we could do all our surgeries; therefore, we'd have beds for our patients that get sick and end up in the emergency room. This is avoidable with vaccination. All of this."
So people across Wyoming are putting their lives on hold, dealing with the pain of a faulty hip that needs replacement, a uterus that needs removing, or a bladder that needs fixing. There are even some cardiac procedures that fall under the banner of "elective" surgeries.
There are many reasons these are being delayed.
"Like I say, it's kind of a perfect storm," Chapman said.
Many Wyoming hospitals are facing staffing shortages. At the same time, those hospitals are filling up with mostly unvaccinated COVID patients and even non-COVID patients with serious conditions. And in the United States, where one's insurance greatly impacts one's healthcare decisions, lots of people are trying to fit in any procedures they need before their deductible resets in January.
"It sounds strange, but it's a reality that people have deductibles," Chapman said. "So in every place, their surgical volumes for non-emergent cases go up in the November-December time frame because people have deductibles paid off."
But Natrona County Health Officer and Infectious Disease Specialist Mark Dowell said elective surgeries would still be happening if COVID patients weren't overwhelming hospitals.
"It's absolutely COVID," he said. "This never happened in my 30 years in Wyoming until COVID hit. Nothing like this. We never had to do anything where we had to postpone or cancel elective surgeries at all."
Dowell said it's true that the majority of patients in most Wyoming hospitals are there for reasons other than COVID. But COVID, specifically, is causing difficulties.
"You have your baseline population, having their heart attacks, their strokes, their pneumonia, their broken hips that need a hospital bed 365 days a year," he said. "But if you add 60, 70, 80 patients on top of that, then you don't have any place to put elective people."
At smaller hospitals, you don't need 60 COVID patients to tip the balance. Those in the medical field say it could take a dozen or fewer.
Dowell said hospitalized COVID patients require a longer stay than most others. And it's more preventable.
"It's important to note that if citizens of Wyoming had stepped up to the plate and everybody got vaccinated, we wouldn't have a hospital full of COVID - therefore we could do all our surgeries; therefore, we'd have beds for our patients that get sick and end up in the emergency room," Dowell said. "This is avoidable with vaccination. All of this."
Wyoming is one of the least vaccinated states in the nation. Health officials say upping the vaccination rate would reduce transmission, put fewer people in the hospital and relieve hospitals of this extra burden.
If hospitals weren't so full, Jess Fahlsing could start their weeks-long recovery in the comfort and safety of a hospital bed. But instead, they will be home, dealing with pain, and managing meds, with only the help of their mother.
But at least Fahlsing can get on with life.
"I also expect to have a feeling of liberation along with feeling more at home with my body," they said. "That feels so close and yet still so far to me. So, I'm really just looking to having my life back."