ROCHESTER, N.Y. — Hurricane Helene shut down much of North Carolina, including the Baxter Drug Manufacturing facility. The plant supplies 60% of the country’s IV sterile fluids. Hospitals in New York started postponing elective and semi-elective surgeries on Wednesday. Jordan Fogg got the call on Tuesday morning that her 6-year-old daughter Sydney’s tonsillectomy procedure would be pushed back from Wednesday to the end of February.

“It was originally scheduled for August of this year. They pushed it back to September. Then in September, she's got another case of strep throat. So they pushed it back to October. And now in October, it's entirely pushed back until February,” her mom explained.

Her daughter’s already missed about a week of school so far this year, or gone home early not feeling well.

“Right now, her tonsils are very large. They classified it as a plus three size, which in my understanding, means that her tonsils are touching the part of the uvula where it drains down her throat, which causes a complication of her own. She was actually also diagnosed with sleep apnea,” Fogg explained.

“It feels like my tonsils are so big,” the first-grader explained. “It hurts and it hurts when I cough.”

The 6-year-old has already had a few surgeries in her lifetime. This procedure was planned to remove her tonsils, her adenoids for the second time and fit a hole in her ear. It’s already been pushed twice and each time it’s scheduled means planned time away from school and work to prepare, and recover, plus more sick time waiting for the big day.

“We've actually gone shopping on a couple of different times to make sure she's had all of the food that she needs and making sure she's set up for recovery in a safe, comfortable spot. Having the Tylenol, Motrin, all of the medications she's going to need to help her recovery, plus taking time off from work and dad also has to put in time for her to in order to be home for the surgery," said Jordan Fogg.

Both mom and daughter have already missed hours of school to accommodate the little girl's health needs.

“I'm supposed to start my student teaching in January of 2025, and I'm not supposed to miss any time while doing student teaching or her having a surgery in February really causes a big problem, because now, who's going to stay home with her for the two weeks of recovery?” Fogg explained. “When she's uncomfortable, she misses school. Plus, we've had multiple appointments to go and take her to surgery prep or to make sure that she's all set up to go so she misses time from school then.”

“Unfortunately, the shortage of IV fluids has made us make difficult decisions to make sure that we could take care of all emergent, urgent and critically ill patients. But the group meets daily. It includes surgeons, anesthesiologists and other health care providers to look at the case and make decisions with our surgeons as to how urgent or emergent, whether it's elective or semi-elective, and whether it can safely wait three months, to allow us, time to, reschedule,“ said Dr. Michael Apostolakos, the University of Rochester Medical Center’s chief medical officer.

He says elective, or semi-elective cases can be delayed three months or longer without risk of harm to the patient. URMC has had to postpone 50% of their procedures, approximately 100 per day, in order to preserve the IV sterile fluids.

“That to me is absurd, like how is a surgery that's causing her sleep apnea breathing problems, choking in her sleep? How is that an elective? How is that not a necessary thing?” Fogg asked.

“With this pause, we aim to extend our system wide reserves of IV fluids by at least 30%, which, combined with conservation efforts are already underway, should preserve our supply for priority, urgent and emergent cases. IV solutions will be given to patients when medically necessary. We believe this step is necessary in the near term to maintain essential care as we work to stabilize inventories,” he said.

The Department of Health says some of the state’s hospital's conservation strategies include immediately beginning inventorying, monitoring and tracking usage, limiting routine use in pre-hospital settings, prioritizing critical cases, administering alternative routes for medication when possible, and limiting surgeries that use IV fluids to those that are necessary for the preservation of patient safety.

“We've looked at innovative ways and new strategies to save IV fluids. And, we're saving approximately 20% with those efforts. But, we believe we need to, preserve even more fluids,” Dr. Apostolakos added.

URMC says they’re also looking into ways to create their own IV fluids, however, those supplies are also in high demand.

“We are limited in several ways in order to make the IV fluids, you need some base fluid, and that's in short supply. You also need, bottles or bags in order to make it, which is also in short supply. And then there's also limited area to which we can make it and limited staff to work on it,” Apostolakos explained. “However, we are doing what we can to make some of our own fluids. But we don't believe that's going to be a long-term solution for us in that the amount we can manufacture is minimal to the amount that we use on a daily basis.”

Fogg says they’ve offered other alternatives to try to ease her daughters pain while awaiting surgery, but already having waited a year, she doesn’t feel like other solutions will suffice.

“She can use Flonase nose spray to help her. She can use air, breathing treatments to help open her airways. They've talked about giving her allergy medicines that will help her. And it's all kind of just to fix the symptoms rather than the actual problem, which is the very large tonsils,” Fogg explained. “It's heartbreaking. Like, I honestly spent hours on the phone after I got the phone call about them canceling the surgery, calling the doctors, calling the practice managers, talking to the surgeon himself like it's my child is suffering. And we've gotten messages back saying, 'oh, tonsils don't cause pain.' But if you look at her, she's in pain. She's uncomfortable. Her quality of life is lower while she's waiting for this surgery."

Her daughter's surgery was rescheduled for Feb. 26. Little Sydney is just ready to get back to school.

“My favorite part is going outside for recess,” she said. “I feel sad because I want to see my friends.”

“She's in pain because of them. She can't sleep. She's missing school. She's missing time with her friends," her mom said. "We struggle taking her out in large crowds like holidays, things like that. Because we worry, is she going to end up getting sick and not be able to get the surgery? Or be in even worse pain because of whatever thing? Her immune system is struggling. So she is at risk for catching colds or like the flu, or even COVID because her body is constantly dealing with these swollen tonsils."

“I understand the frustration. I am frustrated. Our leadership's frustrated. Our surgeons are frustrated. Our staff is frustrated," Dr. Apostolakos said. "We do not want to pause any surgeries. People rely on us for their care. Unfortunately, we have to assure our patients and community that we can provide emergent, critical and lifesaving care at all times."

“She's a 6-year-old who's just trying to enjoy first grade and have fun, go trick or treating. And instead she's home sick,” Fogg explained. “I understand a fluid shortage. I understand a nationwide problem, but four months just feels like an unacceptable time frame when your child's in pain.”