Pain Doesn’t Get Furloughed: Don’t Let COVID-19 Delay Your GYN Surgery

GYN Pain During Covid19

By: Dr. Paul MacKoul, MD

The COVID19 pandemic has had far reaching consequences for women across the country.

Careers, childcare, and lifestyles have all been drastically impacted. So often women are not only more likely to bear the burdens of the household, of child raising, and other societal costs, but their urgent health needs are easily sidelined in times of crisis. Unfortunately for some suffering from painful advanced GYN conditions, such as fibroids, endometriosis, and adenomyosis, their well-being has been put on hold too.

Pain doesn’t get furloughed. Pain does not subside in a show of solidarity with our shock and disorientation in the face of this historic event. Delaying urgent surgery – or worse – accepting their painful condition as inevitable, women often focus their attention on care-giving rather than care-receiving.

The Painful Side Effects of Flattening the Curve

Much energy has been devoted to the efforts to flatten the COVID19 curve, most prominently in the form of social distancing, working from home, and the suspension of all activities deemed non-essential by virtue of their human connectedness – including the suspension of elective surgery.

What is Elective Surgery?

Elective surgery is any surgical procedure that can be scheduled in advance, unlike emergency surgery which must be performed immediately to treat an urgent, often life-threatening condition. The term elective is often misunderstood. Most elective surgeries are not optional as they are performed to treat serious conditions that significantly affect a patient’s health and well-being.

In response to the rapidly developing challenges related to the current health crisis, hospitals have canceled elective procedures. Yet, as the American College of Surgeons notes, “it is not possible to define the medical urgency of a case solely on whether a case is on an elective surgery schedule.” Certainly, some cases can be postponed, however, many of these procedures are associated with conditions that will continue to progress. Gynecological conditions, like fibroids and endometriosis, persist, and in many cases, advance in the absence of surgical intervention. Patients should not ignore cases of debilitating pain or excessive bleeding, since treatment of these are considered critically necessary for the maintenance of patient health.

The Right to a Pain-free Life in the Age of Pandemics

Seeking treatment for your painful condition is not a betrayal of your duty towards the community effort. Everyone feels a greater sense of social responsibility to their community in this pandemic era. In addition, societal pressure and judgement from others is very real. The stress of complying with personal and societal standards while experiencing GYN pain that few understand is stressful and heartbreaking. But we cannot deflect from the real vulnerabilities of women suffering. You may feel as though you are alone and struggling. You are not – we are here to help you.

Suffering through GYN pain in an effort to reduce the burden on a hospital in these difficult times is a choice that you do not need to make.  There is another way, a better way to alleviate your pain without having a procedure in a frontline hospital where the concern for increased exposure to the virus is very real.

Alternative to the Hospitals on the COVID19 Frontline

Every day in the media we are confronted with endless images of patients fighting for their lives in the corridors of hospitals, it requires little convincing to understand why hospitals are now best avoided. The continued rise in Coronavirus cases has resulted in an overwhelmed hospital system, exacting some tough triage decisions from doctors that resemble those necessitated in wars.

With so many procedures canceled at hospitals, the backlog of surgeries continues to grow. Rescheduling of surgeries will not be based on the old surgery schedule, but rather, they will be triaged based on what’s called an Elective Surgery Acuity Scale. Instead of waiting for an indeterminate period of time for your surgery to be rescheduled at the hospital, there is an alternative: The Ambulatory Surgery Center (ASC).

The advantages of the freestanding ambulatory surgery center are especially evident in a time when hospitals remain the epicenters of COVID19. The specialists at the Center for Innovative GYN Care (CIGC) perform surgeries exclusively at our own ASCs which provide a safer haven from hospitals inundated with coronavirus patients.

Innovations Not a hospital comp

Top 10 Reasons to Have Your Surgery at a freestanding CIGC ASC vs. Hospital: 

  1. Avoid overwhelming the Coronavirus frontline and hospitals
  2. No COVID patients; the safety of our patients is our priority
  3. Your Surgery can be scheduled immediately
  4. No hospital waits on surgery day
  5. 1:1 nurse to patient ratio ensuring personalized care
  6. Innovative CICG techniques have lower complication rates than other commonly performed GYN surgeries[1]
  7. CIGC ASC complication rates are lower compared to GYN surgeries performed at hospitals[2]
  8. No overnight hospital stay – recover in the comfort of your home
  9. Lower cost for patients
  10. We are a highly specialized GYN-ONLY ASC versed in the most complex GYN conditions

The Center for Innovative GYN Care is the only ASC in the country with a full-time research team.  Our data confirms that undergoing complex surgeries at ASCs are not only possible, but that our complication rates are lower compared to gyn surgeries performed in a hospital setting.

Delaying Your Healthcare and Well-being IS NOT the New Normal

As a society, we are both inventive and flexible, and can adapt to disruptions and unforeseen circumstances. We have groceries delivered to our doorstep, we continue to work and connect with our colleagues and teams across geographic and time zones, we create a semblance of normalcy. Slowly but surely, we are establishing a new normal during this pandemic crisis.

As a consequence of the collective efforts, the numbers of COVID19 infections are now showing signs of abatement. However, the course of the virus remains largely unforeseeable. As heads of states are beginning to loosen restrictions, an even larger wave is already predicted for the coming fall and winter. Don’t wait indefinitely until the hospital triages your case or the next wave of COVID19 overwhelms the healthcare system — because many GYN conditions, like endometriosis and fibroids, often get worse by delaying care. We can provide you with the urgent care you need – especially in times like these. Delaying treatment for pain and bleeding should not be the new normal.

[1] Dr. Natalya Danilyants, MD, Dr. Paul MacKoul, MD, Dr. Louise van der Does, PhD, L. Haworth. (2019) “A Value-Based Evaluation of Minimally Invasive Hysterectomy Approaches.” Gynecological Surgery. Vol 16 (5). https://link.springer.com/article/10.1186/s10397-019-1057-9

Dr. Paul MacKoul, MD, R. Baxi, Dr. Natalya Danilyants, MD, Dr. Louise van der Does, PhD, L. Haworth, Nilofar Kazi. (2018) “Laparoscopic-Assisted Myomectomy with Bilateral Uterine Artery Occlusion/Ligation.” Journal of Minimally Invasive Gynecology. Vol 26 (5): 856-864. https://www.jmig.org/article/S1553-4650(18)30435-7/fulltext

[2] Dr. Paul MacKoul, MD, Dr. Natalya Danilyants, MD, R. Baxi, Dr. Louise van der Does, PhD, L. Haworth. (2019) “Laparoscopic Hysterectomy Outcomes: Hospital vs Ambulatory Surgery Center.” Journal of the Society of Laparoendoscopic Surgeons. Vol 23(1): 76-82. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6328358/pdf/e2018.00076.pdf

Dr. Natalya Danilyants, MD, M. Mamik, Dr. Louise van der Does, PhD, L. Haworth. (2020) “Laparoscopic-Assisted Myomectomy: Surgery Center vs Outpatient Hospital.” Gynecological Surgery, In Press.