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Scheduling Surgeries and Procedures

July 6, 2020

Note: Since this event was recorded, COVID-testing procedures and other safety measures have been updated. Learn more >

Dr. James Wittig’s message to patients is “it’s safe now, don’t delay your health care anymore.”

Speaking from his position as the chairman of Orthopedic Surgery at Morristown Medical Center and the medical director of Orthopedic Surgery, Orthopedic Oncology and Sarcomas Surgery for Atlantic Health System, Dr. Wittig addressed the public in a live Community Conversation event held on Facebook on Wednesday, May 27, the day after New Jersey reopened certain types of scheduled surgeries and procedures.

“We call them scheduled surgeries, because elective gives a false sense that it’s not necessary surgery. These are all necessary,” he explained, adding that it’s just the timing of surgeries that is flexible.

Dr. Wittig advised patients to contact their physicians if they need to have surgery, adding that there are safe pathways for care in our hospitals.

A small population of patients with COVID-19 remain. They are located in separate units with negative pressure rooms. All nurses or physicians and other health care workers taking care of those patients are wearing N95s and taking the strictest precautions, he said. Our facilities undergo very strict cleaning procedures.

Dr. Wittig, who practices orthopedic oncology and takes care of many sarcoma patients, has seen the negative impacts of delaying health needs or ignoring symptoms.

“It’s been tough getting toward the latter weeks, particularly the last couple of weeks, because I’m seeing patients who initially neglected their pain and other symptoms, and now are presenting with very big tumors or very big cancers that would have probably been much smaller had they been detected a couple months ago.”

What’s the first thing a person who needs a surgical procedure should do?

If you know that you need a surgical procedure, you’ve probably seen your surgeon at some point. Dr. Wittig advised contacting that surgeon again and setting up an appointment, whether through telemedicine or a direct office visit. He also recommended keeping in communication with your primary care doctor.

What should patients with a scheduled surgery expect?

Patients who will be undergoing surgery must not have active symptoms of COVID-19 and will be tested for the virus, according to Dr. Wittig. Patients will quarantine for a few days before the COVID-19 test, which will be performed about 72 hours before surgery, and quarantine between the test and the procedure.

During this period, patients will be asked to try to isolate themselves from their family members, ideally wearing a mask, and not to have contact with anyone not living in their home.

How is it determined which procedures happen first?

“To a certain extent, that’s up to the individual doctor,” Dr. Wittig said, though “we’ve defined the first six weeks as a period to get caught up with patients who’ve had to postpone their surgery and have been waiting a couple of months.” Individual surgeons will be reaching out to see which patients are in the most pain or have urgent needs, he said, then scheduling appropriately that way.

What happens after surgery?

“I think most doctors’ opinions is that you’re always best off being home whenever you can be,” Dr. Wittig said. For example, about 85% of patients go home after total joint replacement surgery and only about half of those patients need home care assistance.

“We can have physical therapy, do telemedicine appointments with you as part of your home care,” he said, adding that visiting nurse services take all appropriate precautions. So, there are many ways to recuperate at home.

If a patient needs to go to a subacute nursing facility, Atlantic Health System has a list of facilities that we work with, he said, including which facilities are taking just patients who have not been diagnosed with COVID-19. “We can also keep you separated in that realm.”

Patients should speak with their physician about what approach is right for them.

What was it like on the first day?

Dr. Wittig described resuming scheduled surgeries and procedures as a seamless sort of return to normal. Many of the operating room nurses and techs were back from redeployment where they cared for sick patients in other areas.

“It was very exciting to get back to … doing what we were meant to do,” he said, “making people better and using our surgical skills to get them back up on their feet or using their arms and legs appropriately.”

Dr. Wittig noted one difference however — the waiting room areas were virtually empty. Social distancing policies are just a few of the enhanced safety measures in place.

What surgeries were not postponed?

Time-sensitive surgery continued throughout Atlantic Health System during the last few months, Dr. Wittig said, meaning surgical procedures for patients who were either in extreme pain, had a cancer diagnosis where intervention could not be delayed or where any delay in their care would compromise the person’s health in some way.

What message do you want people to take away from this?

“Now is the time to really seek your care and follow your doctor’s advice,” Dr. Wittig said. “If your surgery was postponed,” he advised patients to speak to their surgeons about “getting on the schedule to get it taken care of and recuperate over the summer.”