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Idaho woman forced to fly to California for surgery with no room at local hospitals

Dr. William Dittrich M.D. and another medical worker are gowned and masked in PPE as they stand over a COVID-19 patient in St. Luke's Boise Medical Center's  ICU. The patient is laying on a hospital bed and their face is obscured.
Kyle Green
In this Aug. 31, 2021, file photo, Dr. William Dittrich M.D. looks over a COVID-19 patient in the Medical Intensive care unit at St. Luke's Boise Medical Center in Boise, Idaho.

Chelsea Titus lives in Boise with her husband, daughter and a labradoodle named Winston.

They moved here from California 10 years ago and she says their quality of life has gotten so much better.

“It’s such a beautiful place,” Titus said. “We can go do recreation and sports and we camped 20 times this summer.”

But earlier this month, Titus, who's 40, had a flare-up of endometriosis – and the pain is severe.

“Sometimes it feels like I am in active labor,” she said.

Endometriosis affects millions of women in the United States. It’s a condition where tissue that typically grows inside the uterus also grows outside of it. It can lead to ovarian cysts, internal scar tissue and sometimes cancer.

The initial medication Titus received didn't help and she reached out to her on-call doctor.

“He said, ‘If the hospitals weren’t in the situation they were in, I would have you in for surgery today.’”

Chelsea Titus
Chelsea Titus
Chelsea Titus experienced excruciating pain in mid-September, but couldn't get surgery to treat her endometriosis in Idaho.

State health officials recently authorized crisis standards of care for hospitals statewide to handle the crush of COVID-19 patients – nearly all of them unvaccinated.

Dr. Jim Souza, chief physician executive at St. Luke’s, was one of several hospital executives who spoke about the decision that day.

He described the hospital’s typical high standards of care as the net that allows doctors to perform high-wire medical acts every day.

But now, “The net is gone and the people will fall from the wire,” Souza said.

“We’ve now stopped surgical procedures that can be reasonably expected to be associated with a significant risk of permanent disability or pathology.”

That could be not operating on a broken bone or doing a routine knee surgery.

But it also includes more serious conditions.

“As cancer clinicians, we’re really frustrated,” said Dr. Dan Zuckerman, medical director for St. Luke’s Cancer Institute.

Zuckerman said they’ve delayed surgery for some breast cancers that can likely be kept at an early and treatable stage with hormones.

“There’s just no guarantees with that and there will still be some cancers that biologically may break through,” he said.

Zuckerman now spends half his day at the hospital to help his overloaded colleagues and said he can only see half as many patients at the clinic. He blames the situation on those who choose not to get vaccinated.

“People through no fault of their own may be suffering poorer cancer outcomes because of the choices of others. I’m just going to say that.”

Across town at Saint Alphonsus, another oncologist, Dr. Scott Pierson, said they haven’t had to postpone any surgeries – yet.

But standard cancer screenings, like colonoscopies, have been pushed back.

“We’re already a state that, if you look at the statistics, lags in screening testing,” Pierson said.

Federal data show Idaho women are the least likely to get a pap smear in the country. The state ranks 49th in women over 40 getting a mammogram, though Idahoans are more likely than the average American to get a colonoscopy.

Pierson said pulmonologists are the ones who usually perform lung biopsies at Saint Alphonsus, for example, but they’re swamped right now trying to treat severe cases of COVID-19.

“Because much more of their time is tied up taking care of the ICU patients, there’s less time for them to be available to do these biopsies,” he said.

While Treasure Valley hospitals are bursting with COVID-19 patients, they’ve also had a surge in demand from people who delayed care during the pandemic.

St Luke's Hospital Sign
Frankie Barnhill
Boise State Public Radio

Both Pierson and Zuckerman said they’ve seen more advanced cancers than usual that could’ve been caught earlier.

Zuckerman, who specializes in gastrointestinal oncology, said stage 1 colon cancer has a 95% survival rate. If a colonoscopy is skipped or delayed, and the cancer progresses to stage 3, he said it’s still survivable.

“But now the survival rate requires six months of chemotherapy, which can be highly toxic, can be dangerous in and of itself, and then the survival rate is down to 50 or 60%.”

Pierson said he's suggested patients might want to think about taking a less intensive form of chemotherapy so they're less likely to need a hospital bed if complications arise.

Meanwhile, the immense pain Chelsea Titus felt from her endometriosis was overwhelming and she said she couldn’t get surgery to remove her one remaining ovary anywhere in Boise.

Her brother took the extraordinary step of chartering a private plane to take her to the Bay Area in California for treatment.

“I guess I could’ve flown commercially, but it would’ve been really hard and embarrassing because I was, like, screaming in pain,” she said.

After landing, Titus went to an emergency room, an urgent care clinic and talked to multiple doctors before finding a surgeon in her insurance network with an open calendar. The procedure is scheduled for Sept. 29.

The flights, hotel rooms and a rental car for her stay in California add up to thousands of dollars out of pocket, all for a surgery she could’ve had at a hospital just a few minutes-drive from her home in normal times.

Those costs could increase if doctors discover the endometriosis has spread to her other organs. That would require a more invasive surgery, meaning a lengthier hospital stay and a longer recovery period with follow-up appointments.

It’s something she recognizes she’s privileged enough to afford.

“It breaks my heart that most in Idaho don’t have the ability to do that,” Titus said.

The situation has left her questioning just how much her friends and neighbors who have refused to wear masks or get the vaccine really care about the community – and whether she has any place here anymore.

“My husband and I used to say, ‘We’re never leaving Idaho.’ We love it here, it’s an amazing place to live and we’ve been looking at real estate in other states because this just isn’t ok.”

Follow James Dawson on Twitter @RadioDawson for more local news.

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I cover politics and a bit of everything else for Boise State Public Radio. Outside of public meetings, you can find me fly fishing, making cool things out of leather or watching the Seattle Mariners' latest rebuilding season.

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