Skye Enjakovic just knew there was something wrong with her son’s throat.
Key points:
Marley Enjakovic was diagnosed with a tracheoesophageal fistula after years of ongoing health issues
Doctors found a plastic flower found lodged in his airway
His mother believes the flower was there for five years
As a toddler, Marley had begun to choke and vomit when eating food.
“We always assumed that he was eating too fast because it would self [resolve] and there’d be no other issues,” she told ABC Radio Adelaide.
“As time went on, that’s when his wheezing started to happen and he just was in and out of hospital and doctors’ surgeries.”
The Adelaide boy was diagnosed with asthma, and initially Ms Enjakovic believed her son did have the respiratory disease.
But eventually the use of a puffer no longer helped with the wheezing or coughing.
In December 2021, Marley had a coughing fit so severe he was rushed to hospital.
His oxygen levels were low and a chest x-ray showed something was missing with his trachea and oesophagus.
A bronchoscopy revealed Marley had a tracheoesophageal fistula, which is a connection from his oesophagus to his trachea.
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Marley had the flower removed from his throat earlier this year.
“Meaning that food, drink and salvia had basically been entering his trachea (airways) and going on to his lungs,” Ms Enjakovic wrote online.
A week later he was flown to Melbourne for surgery as the connection was sitting close to the main artery to his heart.
Just prior to the surgery, doctors used cameras to take another look down Marley’s airway and that was when they discovered a plastic arts and craft flower lodged in his throat.
Up until this point, inflammation had prevented doctors from finding the foreign object in his throat.
Ms Enjakovic believes the plastic flower could have been there for up to five years, as that was when Marley had begun to show symptoms.
“I just knew there was something wrong with his throat and I couldn’t figure out what it was,” Ms Enjakovic said.
“I never thought it would be a foreign body, but it’s just not normal for a child with asthma to choke and vomit over food and drink and literally cough for hours straight.”
The flower was removed in January, but Marley, now 8, will undergo more surgery in Melbourne on Tuesday to remove the connection between his oesophagus and trachea.
“They will do a cut along his chest, compress his right lung and then peel the oesophagus off the trachea and then cut out that connection that’s caused from the foreign body,” Ms Enjakovic said.
Marley Enjakovic had ongoing health issues for years.(Supplied: Skye Enjakovic)
“Then [they will] take a little bit of muscle from his chest and put it between the oesophagus and trachea so it doesn’t create another fistula.
“The surgical team in Adelaide did a really good job trying to get his body to heal [the fistula] and it has done an amazing job, but it’s just not healing any further and now we have to go to, unfortunately, having another operation.”
As well as preparing for the upcoming surgery, the family is raising funds for the Women’s and Children’s Hospital Foundation.
“We spent a lot of time at the Women’s and Children’s Hospital and honestly we had the best care by the surgical team there,” Ms Enjakovic said.
“Nothing was left unturned, even his surgeon from Adelaide is coming to his operation in Melbourne, that’s how much they’ve cared for and looked after him.”
Troy Patten’s life for the last two years has been more isolated than most.
Key points:
Elective surgeries were postponed during the COVID pandemic to relieve pressure on hospitals
Waiting lists have increased by the thousands across the country, with as many as 100,000 people waiting for surgery in New South Wales
Health experts say delaying elective surgeries will eventually put pressure on other parts of the healthcare system
The 58-year-old has been waiting for a hip replacement, and the risk of catching COVID-19 just when he might finally have his surgery scheduled is not one he’s willing to take.
“All I do is sit by the phone and wait for someone to let me know I can have my life back and give me a hip replacement,” he told 7.30 at his home in regional Victoria.
Like thousands of Australians, Mr Patten’s operation has been delayed due to repeated shutdowns of elective surgery to take pressure off the strained healthcare system.
He currently relies on a walking stick and said he struggles with day-to-day tasks. He’s also had to stop working, and can’t pursue hobbies, like doing up cars, which he’s passionate about.
Despite this, his surgery is considered non-urgent. He was told in July 2020 that it should happen within 365 days – two years later, he’s still waiting.
Troy Patten can’t pursue his hobbies, like fixing up cars, because he’s in too much pain while waiting on a hip replacement.(ABC News: Daniel Fermer)
“It’s got to the point where it’s not ‘am I in pain?’, it’s ‘how much?'” he said.
“Everything in my whole life is in a state of flux.
“Everything’s half-finished and everything’s in the process of getting done because I just do bits and pieces here and there and try to get the best out of what I have for the day.”
But it’s the toll on his family life he has struggled with the most.
“It’s just surviving now and it’s missing out [on the] grandkids, being able to hold my grandkids,” Mr Patten said.
“I had one of my grandkids on the weekend want to sit on my knee and I couldn’t.
“It’s things like that people just take for granted.”
Waiting lists blowing out across the nation
In Victoria, there were 87,000 people on the waitlist for elective surgery at the end of June – that’s an increase of 21,000 in a year.
In a statement, a spokesperson for the Victorian Department of Health said $1.5 billion was being spent to get on top of the backlog and improve capacity in the future.
“Health services work closely with all patients to reschedule any postponed procedures as soon as possible and provide them with alternative supports while waiting for treatment,” they said.
But the problem is far from limited to that state.
Continuing pressure on hospitals and staff shortages have seen elective surgery waitlists blow out across the country. (ABC News: Chris Gillette)
There were more than 100,000 people on the list in New South Wales at the end of March, nearly 19,000 of whom were overdue.
The West Australian list has grown by 10 per cent in the last year to 33,000.
Tasmania’s waitlist has improved by about 2,000 in the last year, down to 9,400 in June.
In Queensland, there are almost 58,000 on the list, 7,500 of which are overdue.
The federal Department of Health told 7.30 in a statement: “The Commonwealth provides a significant proportion of spending on the Australian health system to states and territories … and is committed on working with states and territories on longer-term health reforms of the health system to reduce pressure on hospitals.”
“All health ministers realize there are challenges and pressures facing the state and territory health and hospital systems and are working in partnership to consider a number of long- and short-term measures to ease pressure on hospitals.”
The president of the Australian Medical Association Queensland, Maria Boulton, said just because someone’s surgery is considered “non-urgent” (recommended to be completed within a year) does not mean their injury or illness has no profound impact on their quality of life.
Maria Boulton says elective surgeries shouldn’t be considered optional for those on the waiting list.(ABC News: Michael Lloyd)
“It’s important to understand that surgery is not optional,” she said.
“These are people that are in pain, these are people that are having effects into their activities of daily living… it’s also causing a lot of stress to them.
“You don’t know what’s going to happen if they have to wait on a waitlist for that long — are they ending up in an emergency? Will that surgery then become an emergency surgery?
“It’s not fair that they’re waiting for so long for a procedure in such a state.”
‘My fear is that my life will change dramatically’
Dianne Hill, from Brisbane, has been waiting 13 months now for cataract surgery, which she was recommended to have within a year.
While she is managing, she said she was worried about what would happen if her condition deteriorated.
Dianne Hill has been waiting over a year for cataract surgery in Queensland.(ABC News: Michael Lloyd)
“I can drive still, but I’m on the cusp, so I’m very concerned… I’m on my own, single, no-one to look after me,” she said.
“I am having issues. I can’t read instructions … I’ve got a magnifying glass I have to use.
“I’m still lucky I can get out and about and keep up with some of my hobbies and activities … my fear is that my life will change dramatically.”
A spokesperson for Queensland Health said in a statement $15 million was being spent to tackle waitlists.
“All hospital and health services (HHS) continue to prioritize clinically safe care for patients who require emergency surgery, the sickest patients will always be seen first,” they said.
System in need of reform
Jeffrey Braithwaite from the Australian Institute of Health Innovation was part of a team of researchers who looked into how to improve elective surgery waitlists in the first year of the pandemic.
He said there were a number of things that needed to be considered.
“Prioritising people on the list and really looking at where it is that we would provide the best value care for conditions,” he said.
“We could optimize the public and private hospital nexus … the public hospitals are often jam-packed, and under huge pressure — sometimes the private system has some capacity.”
He and Dr Boulton agree that delaying elective surgeries would also eventually put pressure on other parts of the health care system.
Jeffrey Braithwaite says it will take a variety of measures to get on top of waitlists. (ABC News: Kathleen Calderwood)
“You can say a simple hip replacement is not as urgent as some cardiac surgery — that may well be true,” Professor Braithwaite said.
“However, to what extent is the hip not being replaced going to create huge effects for that person not being able to work, to be deteriorating over time, to not be mobile at all?
“[And then there will] be a much bigger set of problems [and] comorbidities coming into the health system six months later because we didn’t tackle them to start with.”
For Troy Patten, he’s just desperate to get his life back.
Troy Patten has had to remain isolated at his home in regional Victoria while he waits for a hip replacement.(ABC News: Daniel Fermer)
“It’s hard on the mental state,” he said.
“Am I not worthy? Am I worthy? All these things go through your head.
“Then you start thinking they’re just going to throw me away and they’re finished with me — where I have a lot more to give.”
Since Alex Stosic’s heart failed in 2021, everyday tasks like waking up and getting dressed take hours and require a herculean effort.
Key points:
Mr Stosic is one of more than 87,000 people waiting for elective surgeries in Victoria
Quarterly government statistics show the wait has stabilized despite a rise in emergency department presentations
Ambulance Victoria faced its busiest quarter on record, for the third time in a row
For more than a year, the normally energetic 71-year-old Frankston man, who runs his own business with his wife, has been living with his heart only operating at a fifth of its usual capacity.
Earlier this year his surgery for a new valve was deemed semi-urgent, also known as category 2, which meant treatment was recommended within 90 days.
But he has been waiting more than 150 days.
Since his body shut down, Alex has lost more than 30 kilograms, is struggling to keep his small business running and has barely been able to see his grandkids, who live in regional Victoria.
“I can only take about 20 or 40 steps and I have to have a significant rest,” he said.
“Even working on the computer, I can really only do a few hours and then I have to have a rest.”
While waiting for surgery, Alex Stosic is only able to work on his computer in short bursts.(ABC News: Danielle Bonica)
Normally Alex is on the tools in his small business, which specializes in removing scratches from surfaces like glass, but since he fell ill he has only been able to do accounts.
“It certainly limits my lifestyle and limits what I can do,” he said.
Alex Stosic’s dog Suzie Q barely leaves his side since he got sick.(ABC News: Danielle Bonica)
The poor state of Alex’s physical health has left him and his wife Maureen basically housebound, which has taken a heavy toll on his mental health and prevented him from seeing his three children and five grandkids as much as he used to.
In Victoria, elective surgery is defined as any necessary surgery that can be delayed for at least 24 hours.
During the COVID-19 pandemic, elective surgery has repeatedly been put on hold to help the state’s health system cope with an influx of cases, which has led to a backlog.
At the beginning of April, the Victorian government announced a $1.5 billion investment package to address that backlog, but as the most recent wave of Omicron ramped up, individual hospitals began deferring all but category 1 cases again.
The latest quarterly data, released today, shows that at the end of June 87,275 people were on the waiting list, slightly down from the three months earlier.
That is due in part to the more than 41,000 elective surgeries conducted during the quarter, almost 50 per cent more than the previous three months.
But the waitlist is dramatically higher — about 21,000 people more — than the same time a year earlier.
And while the hospital waitlist showed small signs of stabilization, other areas of the health system were put under increasing pressure.
Busiest quarter in Ambulance Victoria during ‘unprecedented’ demand
The three-monthly data, released by the government a week later than expected, showed hospital emergency department presentations had risen by 5.1 per cent in the three months to June 30.
That took the number to 486,701 emergency presentations, an increase of more than 23,000 on the last quarter.
The surge is being attributed to a number of factors, including deferred care from lockdowns and a more severe influenza season than previous years.
“What we are seeing in Victoria at the moment is unprecedented demand,” Health Minister Mary-Anne Thomas said.
The average stay in hospital also rose, with sicker patients staying in beds for longer.
The number of code-1 callouts for paramedics has continued to rise.(AAP: Diego Fedele)
For the third quarter in a row, Ambulance Victoria experienced its busiest three months on record.
Urgent code 1 call-outs rose to 97,982, up by nearly 5,000 on the previous quarter. That’s 16 per cent more than the same period a year earlier.
Only about 64 per cent of those urgent code-1 cases were responded to within the benchmark 15 minutes, a drop on last quarter.
The pressure has led to at least seven code red escalations being called in as many months, in comparison to the nine called between 2017 and 2021.
Authorities have continued to urge Victorians to save triple-0 for emergencies only, with Ambulance Victoria saying about 500 callers each day did not need paramedics.
The Health Minister thanked paramedics, healthcare workers and those in the hospital system for their work during a time when up to 2,000 hospital staff are furloughed each day.
“This is our third COVID winter,” Ms Thomas said.
“All winters are hard in our hospital system, but indeed this winter has proven particularly challenging.”
A study published in June showed deadly ambulance ramping was already on the rise before the pandemic hit.
The Opposition has criticized the government for the delay in releasing the statistics and called for more to be done to address problems within the system.
“This isn’t just because of COVID,” Shadow Health Minister Georgie Crozier said.
“It’s years of under-investment and mismanagement by the Andrews Labor government.”
The government has announced a suite of measures as part of its $12 billion pandemic repair plan, including the expansion of virtual EDs, new paramedics and the overhaul of the crisis-riddled triple-0 system.
Alfred among hospitals restricting operations due to Omicron wave
The Alfred Hospital, where Alex Stosic is due to be treated, put out a statement in mid-July saying that because of the winter wave of Omicron, it was making operational changes such as deferring some elective surgeries and procedures.
It was one of a number of health services across the state to implement similar measures.
“It should never have got to this,” the opposition’s Ms Crozier said.
“These are huge numbers of Victorians who are waiting for this vital surgery, and while they’re waiting, they’re waiting in pain.”
Despite the way the wait has been affecting his life, Alex described his attitude as “stoic.”
Frankston man Alex Stosic was in good health in the years before he fell ill.(Supplied: Alex Stosic)
“Provided I readjust my whole lifestyle, I can cope,” he said.
“I feel there’s people there who are probably worse off than me who have contracted COVID and need ventilators — I don’t need a ventilator.”
The keyhole surgery he requires is relatively new, meaning only a handful of surgeons are able to perform it.
In the meantime, Alex said he was not able to do much except wait for the phone call about the surgery likely to put his life back on track.
He said he was extremely grateful to the paramedics, doctors and other healthcare workers who saved his life and stabilized his organs after his body first shut down last year, and was trying to remain patient.
Alex Stosic’s life revolves around waiting for news he can have surgery.(ABC News: Danielle Bonica)
“I’ve always had an attitude that you can play the cards that you’re dealt with and they’re the only cards you can play,” he said.
“I’ve been dealt these cards so I just have to play them.
“The only thing I can do is live a fairly sedentary, restricted life and hope that somehow we get the hospital system and COVID under control so I can get in there and get my operation.”
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