Neuromuscular day of surgery
The day of surgery
The morning of surgery it is okay to brush your teeth and rinse out your mouth. Do not swallow the water. Do not chew gum.
When you get to the Stead Family Children’s Hospital, you'll need to check in at the Day of Surgery Admissions (DOSA), take the public elevators to Level 4. The nurse will take your vital signs (temperature, pulse, respiratory rate and blood pressure) and talk briefly with you. You'll get into a hospital gown and the nurses will help you onto a special bed. You will then go back to the EEG lab where they will put the special monitoring wires on your head. Sometimes they will put these wires on in the operating room.
Surgery
While you are in surgery, your family can wait for you in the Pediatric Surgery Family Lounge (take the public elevators to Level 4). The doctors will talk to them from time to time during your surgery to let them know how you're doing. They will also talk with them after surgery.
A nurse will greet you as you arrive in the operating room. The room is sometimes cool and noisy. Please let the nurses know if you are not comfortable. Warm blankets are available. You will be connected to many monitors in the operating room. This will not hurt. The monitors help the nurses and doctors keep track of how you are doing while you are asleep. An IV will be placed in a vein in your arm or hand. The anesthesiologist will give you medicine in your IV to put you to sleep. A mask may be placed over your nose and mouth to help you breathe.
A tube is placed in the back of your mouth and throat to get air to your lungs while you are asleep. They will put the tube in after you are asleep. Once you are asleep, the doctors will begin the surgery. You will lie on your stomach on the operating bed. Your arms and legs will be supported with pads. Your back will be washed before starting the surgery. The surgery usually takes about 4 hours, but you will be in the operating room a total of 4 to 5 hours.
A tube, called a Foley catheter, is placed in your bladder while you are asleep. The catheter drains urine from your bladder. The nurses will measure your urine and keep track of how well your body is getting rid of the urine. This tube will be removed on the first or second day after your surgery. You will be able to use the bathroom normally after the catheter is out.
A drain is placed in the incision during surgery. This is called a Hemovac. It is a small tube that drains extra fluid from your back into a small container. The doctors will remove the drain 2 days after surgery. There is a mild burning feeling when the drain is taken out.
Pediatric Intensive Care Unit (PICU) and pediatric unit after surgery
When you wake up you will be lying on your back in the Pediatric Intensive Care Unit (PICU). PICU is located on level 3 of the Children’s Hospital. You will stay in the PICU until the doctors decide you are ready to go to your room on the pediatric unit. The breathing tube will be left in your mouth and throat until your doctors feel you are ready to have it removed. This is typically the morning after surgery. Your parents can stay with you in the PICU as well as the pediatric unit.
The nurses will take your vital signs often. This is so important that they will even wake you up at night to do it.
Each morning we'll take a sample of blood from you to check your blood counts. If you're low on red blood cells, it may be necessary to give you a blood transfusion.
The medicine used during surgery may cause you to be sick to your stomach. You may even throw up after surgery. The nurses will listen to your stomach every few hours. Your stomach will make noise when it is working again. You may chew gum, which will help your stomach wake up.
You will have pain medicine to keep you comfortable. For the first few days, you'll get this medicine through your IV. This will continue until your stomach wakes up and you are able to drink and take pain medicine by mouth.
Antibiotics will be given through your IV until your Foley catheter is removed. The antibiotics will decrease the chance of infection.
In the operating room a bandage is applied to your back. This will be removed at home 2 weeks after surgery. The stitches used to close your wound are under your skin. They do not need to be taken out.
For the first 6 hours after surgery you will be flat in bed. After the first 6 hours, the nursing staff will help you move from side to side every 2 to 4 hours. When turning, your shoulders and hips must go all at the same time, like your back is one big log. The nurses will help you to move either onto your back or your side. They will use pillows to keep you comfortable.
Typically, the day after surgery you will sit up in bed 3 times. You may even get out of bed and sit in a chair. You will not be able to sit all the way. You need to go slow to get your body used to sitting up again. A Physical Therapist will help your parents learn how to transfer you.
While you are in the hospital your parents will be taught how to take care of you. We’ll encourage you to do as much as you are comfortable doing. Please ask the doctors or nurses any questions you have.
Child Life Specialists help find activities you can enjoy while you are in the hospital. They will come to your room and help you find things to do to pass the time you are in bed. When you can be up and out of your room, you will be invited to attend group activities.
The following is a list of things you might want to bring to the hospital with you. They will help make your stay as comfortable as possible.
- Clothes, pajamas, robe, and slippers
- Button down shirts or loose fitting shirts
- Shampoo/conditioner and a hair brush
- Toothbrush and toothpaste
- Pillows: body pillows work well for positioning. You will need extra pillows for the car ride home
- Special stuffed animal or blanket
- iPods or CD’s with your favorite music for relaxation
- DVD/VHS movies
- Chapstick