The Pediatric Surgery staff understands that a child's impending surgery may be anxiety-provoking for patients and their parents. It is our goal to make your child's surgical experience as safe, stress-free, and comfortable as possible. Please take a minute to review the following information regarding your child's upcoming surgical experience.

Before Surgery

Once the pediatric surgeon has determined that your child needs surgery, the staff will arrange a date with the Ambulatory Surgery Facility (ASF). We will notify you as soon as we have a date; the ASF will call you the workday prior to your child's surgery to give you an arrival time as well as final instructions regarding what to wear, where to park, and when your child should stop eating and drinking. The Pediatric Surgery office will obtain the necessary pre-authorizations from your insurance company.

If at any time during the six weeks prior to surgery your child experiences any of the following illnesses or symptoms, please notify the Pediatric Surgery nurse at (734) 712-5523: croup, bronchitis, bronchiolitis, pneumonia, fever, wheezing, asthma flare, cold or flu symptoms, any condition requiring treatment with antibiotics (strep throat or a sinus infection, for example), or exposure to a contagious disease (such as chicken pox.)

Because certain medications increase the likelihood of bleeding, please do not give your child aspirin, aspirin-containing products (such as Pepto-Bismol), Ibuprofen (Advil, Motrin, Pediaprofen to name a few) or any other non-steroidal anti-inflammatory medications (such as Aleve) for two weeks prior to surgery. Tylenol will not affect a patient's chance of bleeding, and may be given at any time prior to surgery. If you have questions about your child's medications, please call the Pediatric Surgery nurse.

The Day of Surgery

The Ambulatory Surgery Facility (ASF) staff will call you the workday prior to scheduled surgery to give you your final instructions. You will be told to arrive one hour prior to your surgery. The ASF has its own parking lot behind the Reichert Health Building. Please watch the signs for the ASF as soon as you enter St. Joe's campus.

Your child should wear loose clothing that is easy to get in and out of. Many patients wear their pajamas to the ASF. An extra pair of underwear may come in handy, particularly for younger patients. Long hair should be braided or tied back in a comfortable style. If your child has a favorite blanket, stuffed animal, pacifier, or toy, please feel free to bring these "comfort items" with you to the ASF. These items may accompany your child into the Operating Room.

Your previous day's instructions will include when your child should stop eating and drinking. Remember that "nothing by mouth" means NOTHING, including lozenges, lifesavers, gum, or "sips". Failure to comply with these instructions can put your child at serious risk during anesthesia and may result in surgery being cancelled!! Out of courtesy to patients awaiting surgery, please refrain from eating and drinking in the ASF waiting room. Patients are offered a drink and a snack in the Recovery Room as soon as they are awake enough to cooperate. If your child prefers his or her own bottle or sippee cup, or needs a special formula, please bring these with you for the Recovery Room. Occasionally patients experience nausea from anesthesia; you may want to bring a bag or "bucket" for the car trip home.

The morning of surgery, your child will need your undivided attention. We strongly recommend that you make arrangements for siblings to stay with family or friends the day of surgery. Siblings are NOT allowed in the pre-op or post-op areas of the ASF.

The only time parents are separated from their child is during the surgery itself. Parents remain with their child in the pre-op area until it is time for surgery, and are invited to rejoin their child in the Recovery Room as soon as the child is awake.

You will have the opportunity to speak with the anesthesiologist (the doctor responsible for putting your child to sleep) while you are in the pre-op area. He or she can answer any questions you may have regarding your child's anesthesia. Initially, anesthesia is induced using a face mask. In children 10 years of age or younger, the IV will not be started until the child is asleep in the operating room.

Once your child is taken to the Operating Room, you will be asked to wait in the ASF waiting room. The Pediatric Surgery nurse will speak with you and review your child's post-operative instructions. An appointment for follow-up will be made at this time. At least one parent should remain in the waiting room for the duration of the surgery in case the surgeon has any questions or updates during the procedure.

Once in Recovery

As soon as surgery is over, the surgeon will come to the waiting room to tell you how things went. Your child will be in the Recovery Room by this time and will be starting to come out of anesthesia. Recovery times vary from patient to patient, but generally parents are called into Recovery within 15 minutes of speaking to the surgeon. Remember that there are a number of side effects of anesthesia that a patient can experience, including nausea, confusion, sore muscles, "funny" taste in the mouth, short term memory lapse, and (particularly in the toddler patient) irritability. These side effects are temporary, and usually subside within the first few hours after surgery.

As soon as your child has had enough to drink, the IV will be removed. Monitors are removed at the Recovery Room nurse's discretion. Generally, patients are in Recovery approximately one hour.

The Pediatric Surgeons will do everything they can to keep your child comfortable. You will in most cases be given a prescription for a narcotic painkiller. It is important to closely monitor your child for signs and symptoms of pain, particularly the evening following surgery, and medicate him or her appropriately. Remember that young children cannot always verbalize that they are feeling pain, and should be closely watched for subtle signs of discomfort.

Very occasionally a patient is admitted to the hospital following his surgery. The Pediatric Unit visiting hours are from 10 a.m. to 9 p.m. One parent is allowed to spend the night with the patient. All rooms are equipped with VCR's and video game systems.

This information is provided by the University of Michigan Department of Surgery, Section of Pediatric Surgery and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact your health care provider or our offices.