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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 aren't 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. 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 wasn't always this way. After a 1998 vehicle rollover, Mr Cook 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. 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're considered an elective surgery — but plastic surgeon James Savundra says this doesn't 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." Not enough specialists Australian Medical Association public hospital doctors' group chair Tony Ryan said the delays in the spinal ward are 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 didn't 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. Uncertainty ahead After the long wait and 45 days in hospital, Mr Cook went home to his family. 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," Mr Cook 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."
