WA neurosurgeon shortage delaying surgery for vulnerable spinal patients
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A Perth man's wait for surgery to treat painful pressure sores has exposed delays and specialist shortages in Western Australia's spinal care system.
For Eric Cook, who has a spinal cord injury from a car accident, pressure sores are not just relentlessly uncomfortable — there's a risk they can spiral into fatal infections if untreated.
Two years ago, the 54-year-old developed the wounds from spending too much time in his wheelchair.
Despite the risks to his health, he said he had to wait six months for hospital treatment.
Mr Cook said he was bedridden during one of his family's most treasured milestones — his daughter's first birthday.
"She didn't know what it was like for daddy to be up and about … half of her life I'd been in bed," Mr Cook said.
"I became a stranger to her and that utterly broke me."
Despite enduring months of pain, he was left with no choice except to wait for a surgical spot to become available at Fiona Stanley Hospital (FSH).
After a 1998 vehicle rollover, he was treated at the state's main spinal injury facility, the Shenton Park Rehabilitation Hospital.
But in 2014, that hospital closed and was replaced with the State Rehabilitation Centre inside the then-brand new FSH.
While the new centre was billed as a large, state-of-the-art, dedicated rehabilitation facility, Mr Cook said he found his level of care was diminished.
He said the problem was getting timely access.
"The biggest issue when you have a problem is to get in to see the right people at the hospital," he said.
"With Shenton Park, I could go to some of the nurses straight away who get me appointments with the doctors to be able to get things looked at and then make plans … [now] you've just got to wait your turn."
Since his accident, WA's population has almost doubled in size to 3 million, and the state's health system is under immense pressure.
Unless the sores are life-threatening, they are considered an elective surgery — but plastic surgeon James Savundra says this does not reflect the reality of living with them.
"You can't live a normal life with the pressure injury," he said.
"I think telling [patients] to get out of their wheelchair and into their bed for the next six months is a really bad thing for their mental health [and] for their lungs."
Mr Cook's wife Janet, who was pregnant with their second child at the time, said the situation was stressful.
"[I'm] so exhausted from caring for everyone, chasing emails, hospitals, I get too tired to cook myself food so skip meals throughout this pregnancy," she said.
"I regularly have sleepless nights worrying … it's a constant fear I won't be able to care for him if I have a C-section."
"[There's] not enough specialists and not enough clinics, only a limited number of neurosurgeons [available] who can see a patient," Dr Ryan said.
"[And] they're the same surgeons at three different clinics."
The Health Department said the state had 10 neurosurgeons who had performed 1,019 elective spinal procedures in the past 12 months.
While Mr Cook did not need spinal surgery, he did need the specialist post-operative care he could only receive in the Spinal Cord Unit — which he said he waited six months for.
WA Health told the ABC that as of early October, four people were waiting for a bed in the unit.
The department did not respond to questions about a reduction in capability after the closure of Shenton Park.
He knows ongoing treatment for spinal injuries is a part of life.
But without a guarantee that he will have quick treatment, Mr Cook said he was left with an uncomfortable feeling of uncertainty around what the future will hold.
"It's not a case of if but when," he said.
"[If] I got one in another year's time, I'd go through the same rigmarole.
"I would be extremely concerned if this happened again if I would survive under the current system."
Written by Eleanor Beidatsch, ABC News.
For Eric Cook, who has a spinal cord injury from a car accident, pressure sores are not just relentlessly uncomfortable — there's a risk they can spiral into fatal infections if untreated.
Two years ago, the 54-year-old developed the wounds from spending too much time in his wheelchair.
Eric Cook developed pressure sores after spending too much time in his wheelchair. (ABC News: Nicholas Martyr)
Despite the risks to his health, he said he had to wait six months for hospital treatment.
Mr Cook said he was bedridden during one of his family's most treasured milestones — his daughter's first birthday.
Eric missed his daughter's first birthday. (ABC News: Nicholas Martyr)
"She didn't know what it was like for daddy to be up and about … half of her life I'd been in bed," Mr Cook said.
"I became a stranger to her and that utterly broke me."
Despite enduring months of pain, he was left with no choice except to wait for a surgical spot to become available at Fiona Stanley Hospital (FSH).
Spinal care in WA
Mr Cook said it was not always this way.After a 1998 vehicle rollover, he was treated at the state's main spinal injury facility, the Shenton Park Rehabilitation Hospital.
But in 2014, that hospital closed and was replaced with the State Rehabilitation Centre inside the then-brand new FSH.
Fiona Stanley Hospital opened in 2014 and is now home to the State Rehabilitation Centre for spinal injuries. (AAP: Richard Wainwright)
While the new centre was billed as a large, state-of-the-art, dedicated rehabilitation facility, Mr Cook said he found his level of care was diminished.
He said the problem was getting timely access.
"The biggest issue when you have a problem is to get in to see the right people at the hospital," he said.
"With Shenton Park, I could go to some of the nurses straight away who get me appointments with the doctors to be able to get things looked at and then make plans … [now] you've just got to wait your turn."
Eric Cook is worried about what the future holds. (ABC News: Nicholas Martyr)
Since his accident, WA's population has almost doubled in size to 3 million, and the state's health system is under immense pressure.
Waiting for an appointment
With his pressure sores worsening, Mr Cook needed a surgical bed with specialist post-operative care, but said it was months before one was available.Unless the sores are life-threatening, they are considered an elective surgery — but plastic surgeon James Savundra says this does not reflect the reality of living with them.
Royal Perth Hospital plastic surgeon Dr James Savundra. (Supplied)
"You can't live a normal life with the pressure injury," he said.
"I think telling [patients] to get out of their wheelchair and into their bed for the next six months is a really bad thing for their mental health [and] for their lungs."
Mr Cook's wife Janet, who was pregnant with their second child at the time, said the situation was stressful.
Eric Cook pictured with his wife Janet. (ABC News: Nicholas Martyr)
"[I'm] so exhausted from caring for everyone, chasing emails, hospitals, I get too tired to cook myself food so skip meals throughout this pregnancy," she said.
"I regularly have sleepless nights worrying … it's a constant fear I won't be able to care for him if I have a C-section."
Not enough specialists
Australian Medical Association public hospital doctors' group chair Tony Ryan said the delays in the spinal ward were caused by a shortage of neurosurgeons."[There's] not enough specialists and not enough clinics, only a limited number of neurosurgeons [available] who can see a patient," Dr Ryan said.
"[And] they're the same surgeons at three different clinics."
The Health Department said the state had 10 neurosurgeons who had performed 1,019 elective spinal procedures in the past 12 months.
While Mr Cook did not need spinal surgery, he did need the specialist post-operative care he could only receive in the Spinal Cord Unit — which he said he waited six months for.
Eric Cook waited six months for an operation to relieve painful pressure sores. (ABC News: Nicholas Martyr)
WA Health told the ABC that as of early October, four people were waiting for a bed in the unit.
The department did not respond to questions about a reduction in capability after the closure of Shenton Park.
Uncertainty ahead
After the long wait and 45 days in hospital, Mr Cook went home to his family.
Eric Cook waited six months for surgery on pressure sores. (ABC News: Nicholas Martyr)
He knows ongoing treatment for spinal injuries is a part of life.
But without a guarantee that he will have quick treatment, Mr Cook said he was left with an uncomfortable feeling of uncertainty around what the future will hold.
"It's not a case of if but when," he said.
"[If] I got one in another year's time, I'd go through the same rigmarole.
"I would be extremely concerned if this happened again if I would survive under the current system."
Written by Eleanor Beidatsch, ABC News.
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