Prior to the day of surgery you will meet with Dr. Osterdock to review all of the plans for surgery as well as the CT scan. You will have the opportunity to ask any questions that you have. Sometimes it is helpful to come with a list of questions that you have had regarding surgery so that the important ones are not forgotten.
Typically, after this appointment you will be sent over to the lab to have blood work done which is essential for surgery. Most children will only need a CBC (complete blood count) as well as a blood type check in the event that a blood transfusion is required. If one of the parent is interested in donating blood this needs to be done 7 days prior to surgery and we will direct you in how to do that.
The Night Before Surgery
You will likely be called by the anesthesiologist prior to surgery to discuss any concerns and so they can familiarize themselves with your child’s history. All of the anesthesiologists are Pediatric trained anesthesiologists and there are no other individuals involved in your child’s anesthesia.
Continue your child’s normal routine as much as possible prior to surgery. It is important that you follow the following guidelines for feeding your child prior to surgery:
The Morning of Surgery
You will check in at the main admissions desk at the Rocky Mountain Hospital for Children. They will then direct you to the Pre-op area on the second floor.
Once you have checked in you will meet the nurses who will get your child ready for surgery and the nurses who will take care of your child in the operating room. You will also meet the anesthesiologist who will take care of your child in surgery. Dr. Osterdock will also meet with you again to answer any additional questions.
Once your child is taken back to the operating room you will be taken to the waiting room where the nurses will be able to updat you throughout the procedure. The anesthesiologist and nurses will be working on starting iv’s and monitors that are necessary for keeping your child safe during the surgery. This can often take an hour just to get everything set up properly for surgery.
The nurse will call out to the waiting room to let you know when the surgery actually begins. The typical operating time is less than an hour. The surgery will be performed by Dr. Osterrdock herself, there are no residents or students involved in the surgery. Occasionally a plastic surgeon will be involved if felt to be necessary. Dr. Osterdock will then come out to the waiting room to talk with you as soon as the surgery is complete.
After the surgery your child will either go to the recovery room or directly to the ICU. There is no difference between the two and this decision is based on nursing and anesthesia. As soon as your child is awake and stable you will be allowed to be with your child. One your child is awake he/she can be held, talked to, breast or bottle fed, or whatever is soothing. There will be a small drain exiting the skin on the back of the head which will connect to a test tube that will be changed as needed by the nurses.
Typically there will be a special iv in the wrist that will allow blood to be drawn after surgery. We will be checking the blood count and sodium periodically over the next day to make sure everything remains stable. Swelling is variable after surgery but most children do not have significant swelling after this surgery. If swelling does occur a mild diuretic may be given to help remove some of the fluid. Your child’s pain is carefully monitored and treated by the nurses taking care of your child.
The usual hospital stay is two days and most children are back to fairly normal behavior after 36 hours. Once the baby is eating well and the blood work is stable your chld will be discharged home. Most infants only require tylenol at the time of discharge. You will be able to wash your child’s hair on the second day after surgery. There is no special incision care once you go home but please do not put any ointments or lotions on the incision. The sutures are absorbable and will not need to be removed.
Once You Go Home
Once you go home there are no special precautions. A helmet is not required. Your child may resume his/her normal activities and diet.
You should call the doctor if any of the following occur:
- Fever greater than 101.5
- Your child will not eat or is vomiting excessively
- Your child does not have an appropriate number of wet diapers for their age
- There is significant redness or drainage from the incision
- You have any concerns that your child is not acting right
You will have a follow-up appointment with Dr. Osterdock 2-3 weeks after surgery. Further follow-up will then be 3 months later and then after that depending on the situation.