The pre-op exam is a manditory part of the surgical process. The first thing to make sure to have is a correct medical history on your child. The doctor will need this to make sure that everything that could cause a problem due to a preexisting problem is avoided. This is usually done before the accual exam starts or while you are waiting in the waiting room. When your child goes back, several things will be checked. The exam is most like a "mini-physical". Your child will have his/her blood pressure, pulse, breathing rate, and pulse ox (a clip is put on your child's finger to take a percentage of oxygen in his/her blood) taken. Next, general things will be checked such as temperature, listening to the heart/lungs, and reflexes. Finally, lab work will be done. A blood test is taken to check to see if your child's blood is ok to be ready for the surgery.
If everything looks ok, sometimes a reperesntitve of the hospital will come to talk about what will happen during the surgery and the pre-operative as well as the post-operative problems. This is mainly to inform you as a parent, as well as calm your child's fears of the surgery. If you have any questions about your hospital procedures, ask them now.
The Day of Surgery
The day of surgery will be, obviously, a stressful day. I know I cannot cover everything about this first day, but I will state some key points. If you have any other questions, please feel free to ask me via e-mail. Also, check the Frequently Asked Questions page to see if your question in answered there.
When you get to the hospital, you will have to check in. This might be done at the front desk, or on the surgery floor. The doctor or hospital will give you information about that prior to the surgery date. Make sure to be early. It is always a good thing to be early rather than late. Next comes the waiting. I know from experence that this is a very difficult and emotional time. After a while, they will call you and your child back to go to pre-op. Pre-op holding is where your child will change into a hospital gown, be preped for surgery, and, most commonly, say goodbye to you. The gown opens in the back, and, if your child feels more comfortable, most hospitals will give your child another gown to put on opening in the front. The nurses will give your child a bracelet with his/her name on it. The nurses will also check all of your child's vital signs, much like they did at the pre-op exam. A blood test might be done. Other tests might be done, but, once again, this depends on the hospital and the doctors/nurses.
One thing that, once again, depends on the hospital and anesthesiologests, is any pre-op medication. Some will have your child take a seditive to help relax them prior to surgery. Others will not do anything. Still, others will start an IV in your child before he/she goes back to the operating room. This should be discussed with the anesthesia team and your child to get the best for the need. If your child is very anxious and/or scared about the surgery, the seditive or IV would be the best option to calm them down. If your child has a fear of needles, then the IV would not work for the pre-op, and the seditive can be used.
When it is time for your child to go back to surgery, you will need to say goodbye. This is obviously going to be dificult for most parents. Just take it as best as you can. When your child gets back to the operating room, he/she will be moved onto the operating table. Here, the doctors and nurses will put monitors on your child. These usually include several chest electrodes to monitor heart and breathing activity, a pulse ox (the clip or tape on electrode which they used at the pre-op exam), and a blood pressure cuff around one arm. Once all this is done, the anesthesia induction process will take place. This process is diffrent at every hospital, so for the details, ask the anesthesiologest. Your child, if he/she had an IV, might be induced by an IV injection. Otherwise, the child will get a gas through a mask, which goes over the nose and mouth. Several places might start an IV after your child has gone back to the OR, so your child might still get the IV injection even if your child did not have one before entering the operating room. A combination of the two might be used as well. Once again, if you have any questions, ask the anesthesia staff. Once inducted, your child will drift off to sleep.
Once asleep, if an IV was not started while your child was awake, one or more will be started now. A breathing tube will also be inserted into your child's throat to be sure that his/her breathing will be controled and stable throughout the procedure. Your child will also get a folly catheter, which is a tube that goes into your child's bladder to extract urine. Now is when the surgery will be done.
When your child comes out of surgery and you first visit them, be aware that they will look very puffy and covered in wires and tubes. This is VERY normal. The best thing to do for your child is comfort them and let them know what is going on. He/she might get a little fussy, but its normal, and just try to do you your part. Also be aware that your child will be very drowsy as well. This will last for as long as it takes for the anesthesia to wear off. Throwing up also happends. Just be aware that this does happen. It is often just a reaction to the anesthesia and/or the pain medicine
The Hospital Stay
Various things will happen durring your child's hospital stay. Most will vary based on hospital and physicians. There are, however, some key points. The nurses will come in at all hours of the day and night to check your child's vital signs and equipment. This is totally normal and their jobs. Your child will probably have his/her IV(s) removed after about 3-5 days. After this occurs, he/she will be placed on oral medication. Make sure that the dosage that the nurses provide is adiquate for your child's comfort. The catheter will come out around this time as well. This usually means that your child will need to walk to the bathroom when nature calls. Remember that your child will most likely not be discharged until their digestive system works again. If your child had a chest tube, this will be removed around this same time as well. This is just a deep breath and a tug. Your child, if he/she had a chest tube, might have some breathing treatments to recover some after the chest tube. Physical Therapy will come see your child to help them get back on their feet again. These sessions depend on the doctors wishes. Remember that activities such as walking should be taken at your child's pace. From my personal experence, rushing things never pays off in the long run. If your child has the surgery durring the school year, he/she might have a teacher come in to work with them. This is really depending on your wishes, as well as your local school system.
