adplus-dvertising
Connect with us

Health

The unintended consequences of surgery delays during COVID-19 – CBC.ca

Published

 on


This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.


The sacrifice Canadians have collectively made to flatten the coronavirus curve also includes immeasurable suffering from postponed surgeries, says a B.C. man who lost his mother not to the virus but to cancer.

Min Hua (Jasmine) Yang, 60, started having abdominal pain, fever and then breathing difficulties in January. She went to an emergency department in Surrey, B.C., and was diagnosed with a rare form of ovarian cancer in March.

Her son, Jonathan Hu, 31, said oncologists recommended surgery in early April as the best treatment for Yang’s three, late-stage tumours. But the COVID-19 pandemic lockdown included postponing or cancelling non-emergency surgeries like Yang’s — and an estimated 394,575 others across Canada.

“There is a lot more people who are suffering or dying other than just a number of deaths that you see from the coronavirus,” Hu said.

Canada’s health-care systems made a choice to cancel surgeries and to devote hospital staff and resources to COVID-19.

“We were really frustrated,” Hu said.

Jonathan Hu and his mother Jasmine Yang. He says the family felt powerless watching her deteriorate every day waiting for surgery. (Submitted by Jonathan Hu)

The family “felt powerless” as they watched Yang deteriorate daily during chemotherapy that was not part of the original treatment plan for her sex cord stromal cancer. The surgery was postponed weeks to May 4.

Yang died two days earlier.

“The choice that we made has consequences and we’re living with those consequences right now,” Hu said.

Tough choices

Dr. Iris Gorfinkel, a family physician in Toronto, worries about unintended consequences from those choices for her patients, too.

For example, virtual care excludes the physical exams she performs to quantify the degree of pain a patient has.

WATCH | The complications of resuming surgeries during pandemic: 

Many provinces are starting to resume non-emergency surgeries delayed because of the COVID-19 pandemic, but it’s a complicated balance of trying to clear the backlogs and keeping patients safe. 2:03

“You put your hand on that person’s belly you see immediately they’re not doing well because you can feel how they’re reacting,” Gorfinkel said. “I know from my own practice I’m more likely to order tests because of that uncertainty, which is another cost to the system because I don’t want to be wrong.”

Patients are also left wondering whether delays in tests and procedures made a difference in their care, Gorfinkel said.

It’s one reason why health-care professionals across the country are preparing to do more procedures and surgeries.

Surgery backlog mounts

In May, B.C. Health Minister Adrian Dix estimated it could take up to two years to clear the backlog of 30,000 patients whose surgeries were postponed or not scheduled since mid-March in that province alone due to COVID-19.

In Quebec, Dr. Gilbert Boucher, head of the province’s association of emergency medicine specialists, said the flow of patients sick with medical conditions besides COVID-19 has resumed in much of the province.

The last three weeks, however, have included struggles with finding space, including for patients discharged from hospital who are unable to return home or to long-term care.

At Montreal’s older hospitals with four-bed rooms, many cannot be used while COVID-19 cases continue in the community. One tertiary care centre lost 30 per cent of its beds during confinement, Boucher said.

Hospitals with wards for people testing positive for COVID-19 had doctors and nurses working overtime for the last three months.

An empty operating room is seen in a Maryland hospital in March as hospitals worldwide cancelled elective surgeries to make space for COVID-19 patients. (Rosem Morton/Reuters)

“Those people are getting tired so we just don’t have the staff to staff the operating room and to do the gastroscopy and the colonoscopy and all those follow-up” procedures, said Boucher. “It’s summer for everybody so people do need a little break.”

Safety prioritized

Medical experts say to ramp up surgeries, a “four-sided Rubik’s cube” of prerequisites, known as the 4S’s, first need to align:

  • Screening for COVID-19 safely.
  • Increased staffing capacity.
  • Supplies such as personal protective equipment and medications like anesthetics.
  • Space and systems in place to keep patients clear of COVID-19 before and during hospitalization and for patients and their family members to understand the importance of quarantine in the first 30 days after surgery.

In addition to surgery delays, the COVID-19 pandemic has led to global shortages of some drugs.  

Christina Adams, chief pharmacy officer for the Canadian Society of Hospital Pharmacists, said drug makers have increased production of medications for critical care, such as the injectable anesthetic propofol that’s reportedly chronically short in the U.S.

Patients with COVID-19 who require continuous ventilation need two to three times the usual amount of propofol compared with patients requiring surgery under general anesthesia, Adams said.

She added that Health Canada anticipated global shortages and expedited imports of non-Canadian labelled products, such as from the European Union, to ensure supplies weren’t interrupted.

“Right now, the situation is not bad,” Adams said.

COVID-19 greatly compounds surgery risks

Janet Martin an associate professor of anesthesia and perioperative medicine at Western University and an international team of surgery researchers, estimated that 28.4 million elective surgeries worldwide could be cancelled or postponed this year based on the 12-week peak of disruptions to services in hospitals.

For Canada, the cancelled surgeries include hip and knee replacements and procedures to confirm whether or not someone has cancer.

“That’s exactly for whom we are doing this type of research,” Martin said.

Researchers said they looked at surgery delays during COVID-19 to help people like those living with a knee that is constantly painful waiting for a replacement. (Vincent Bonnay/Radio-Canada)

If hospitals successfully increase capacity by 10 per cent by running operating rooms longer and partly on weekends, Martin figures it will take nearly 90 weeks to clear Canada’s backlog.

In a study published last month in The Lancet, Martin and co-authors followed 1,128 patients in 24 countries who had emergency and elective surgery this year before March 31.

Nearly one in four patients died within a month, the researchers found. For those undergoing elective surgery, the mortality risk rose from below the one per cent to 18 per cent.

One in two (51 per cent) developed serious pulmonary complications, including needing ventilation.

“We were absolutely surprised,” Martin said. “That is far and above what we had ever expected.”

As the increased risks from surgeries due to COVID-19 become apparent from the new data, Martin hopes hospitals will find ways to better protect patients.

Janet Martin said she’s thankful to no longer be in the dark about how risky surgery can be during COVID-19. (Western University)

For his part, Hu emailed CBC News looking for information on how many others in Canada like his mother who weren’t infected with COVID-19 but missed treatment and died.

It’s impossible to know exactly how delays affect an individual patient.

Gorfinkel said while such societal fallout can only be measured in retrospect, there are definitely consequences from postponing routine screenings during the pandemic, such as mammograms or tests to look for blood in feces, which can be a sign of a colorectal cancer or a growth that can easily be treated.

“Would an earlier diagnosis have made a difference?” Gorfinkel said of the questions she’s anticipating from her patients. “Much of the time it may not but the fact is we can’t be certain.” 


To read the entire Second Opinion newsletter every Saturday morning, subscribe below or by clicking here.

Let’s block ads! (Why?)

728x90x4

Source link

Continue Reading

Health

What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

Published

 on

Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Continue Reading

Health

Here is how to prepare your online accounts for when you die

Published

 on

 

LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

Source link

Continue Reading

Health

Pediatric group says doctors should regularly screen kids for reading difficulties

Published

 on

 

The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

Source link

Continue Reading

Trending