Scheduling your child's surgery will be done after your initial appointment by the surgery scheduler in the Children's Neurosurgical Associates office. You will be contacted with possible dates so that you can actively participate in the decision about when your child will have surgery. You will also be scheduled for a pre-op appointment a few days before the surgery.
The neurosurgery program is very busy. Not infrequently, a child comes in to the hospital with a serious neurosurgical condition requiring urgent or emergency surgery to save their life or preserve their function. If this happens, it will be necessary to reschedule an elective surgery to do the urgent surgery. Please understand that we don’t cancel a scheduled surgery unnecessarily or lightly. We appreciate that your family has gone to a great deal of trouble to prepare for your child’s surgery. However, this does happen from time to time. We will make every effort to reschedule your child’s surgery as soon as possible. Also keep in mind that the scheduled time of surgery is an estimate, and the actual time may be very different.
The Pre-op Appointment
The pre-op appointment will be with a physician assistant. You will be given one of their numbers to call if you find that your child's needs are not being met by the normal channels of communication through the nursing staff. At times, an anesthesia nurse specialist will also see your child. At the appointment, your child will be evaluated to be sure that he or she is ready to undergo anesthesia and surgery. You will also be given instructions about what to do the night before and the day of surgery. We will also give you information about pain control after the surgery. You will be asked about medications which your child is taking at home on a regular basis. If you are unsure about the dosage and frequency, it is helpful if you bring the containers of the medications with you to the pre-op appointment. If the neurosurgeon has ordered blood work before the surgery, it will be drawn after this appointment. At the pre-op appointment you may also have the opportunity to meet with a child life specialist. This specialist helps prepare your younger child for the surgery experience. The pre-surgical preparation program is age-specific and helps deal with the fears most children have of the unknown. The visit is play oriented with hands-on time to see how our equipment “really works” and picture books about "operations" to look at. We will make sure that you have directions on how to get to the right location on the day of the surgery.
The Night Before Surgery
Before surgery, the patient must not eat or drink anything. Going for a number of hours without eating or drinking is often difficult, especially for children. Fortunately, some clear fluids can be safely given up to two hours before an operation. You will be given a list of the fluids that are acceptable to provide your child or infant before surgery.
The scheduled time of surgery can change, so please do not give your child anything without contacting one of us or the pre-op nurse.
If your child takes medicine on a regular basis, follow the instructions given to you at the pre-op appointment. A nice shower, bath and shampoo is a good idea the night before surgery.
What should you pack before coming to the hospital? Bring PJs and underpants, slippers, a hair brush, toothbrush and toothpaste. Also, bring a set of clothes or PJs to wear home from the hospital. Make sure to bring a list of all medications, their dosage and frequency.
During your child’s surgery you will be updated on a regular basis by our nurse practitioner, physician assistant or the nurse in the room about your child’s progress. Calling your cell phone is the easiest way to do this. Remember to charge your phone fully the night before surgery. If you do not have a cell phone or if you have poor coverage in the hospital, you will also be given a pager or telephone to use during the surgical procedure. We will ask you to call the four digits that appears on the pager from an in-house phone when you are paged.
Finally, remember that good surgery can take time, and long surgery does not mean that anything is wrong.
The Day of Surgery
On the day of surgery you will be asked to arrive at the hospital approximately one hour before the scheduled time of the operation. Please bring your child to the 3rd floor of the Outpatient Building at 744 52nd Street which is directly across the street from the hospital. The building is attached to the parking garage. This is the same building where you met with your neurosurgeon in our office before surgery.
Once in the hospital, you will be taken to the pre-op preparation area. Your child will change into a hospital gown. Weight and vital signs will be taken. When it is time for your child’s surgery, you will be taken to the Surgery Department with your child. Keep in mind the time of the surgery is an estimated time. If your child’s surgery is not the first case of the day, the time of their surgery is an estimated time. The surgery time before you child’s, or for your child, may take considerably longer or shorter. Be mindful that your surgeon devotes as much time as necessary for all children's surgeries.
You will stay with your child until he or she is actually taken into the operating room. During surgery, you may wait anywhere that you like. The best place is the cafeteria. You can be off campus or visit our office. The OR team can give you updates on your cell phone or beeper.
When surgery is nearly completed, someone from the OR will call you. They will tell you to come up to the Surgery Suite, ICU or that the surgeon will come to your location on the hospital's campus.
After leaving the Recovery Room, your child will be usually taken to the ICU or a room on the 5th floor of the hospital. On the 5th floor each room has two beds. Each child has their own TV next to their bed. One parent may stay overnight with their child at the bedside.
The ICU is a busy, open ward and most patients will not be in a private room, This set up, although a bit noisy, provides the best care since everyone is in sight of the doctors and nurses on duty.