Dr. Lewin’s office will contact you well before your surgical date to go over any questions you may have about surgery. A detailed email will be sent to you about surgery including all of the appointments, all pertinent addresses and phone numbers, as well as links to the surgery instructions.
You will receive a pre-operative call from a nurse the evening before your child’s surgery. During this call, you will be told when to arrive at the Surgery Center, and what items you should bring with you. The nurse will answer any questions you may have. The pre-operative fasting instructions for your child will also be explained. If your child is sick, please let the nurse know during the phone call.
Pre-operative eating instructions
Patients younger than 3 years of age may:
- eat solids up to 8 hours before surgery
- drink formula or regular milk up to 6 hours before surgery
- drink breast milk 4 hours before surgery
- drink clear liquids up to 2 hours before surgery
Patients older than 3 years of age may:
- eat solids up to 8 hours before surgery
- drink clear liquids up to 2 hours before arrival (apple juice or water only)
- Please notify Dr. Lewin’s office if there are any signs of illness up to 3 weeks before the date of surgery. This includes symptoms such as fever, sore throat, cough, runny nose, wheezing, rash or abrasion in the surgery site area.
- Do not take any Aspirin or Ibuprofen (Advil/Motrin) 2 weeks before or after surgery (ONLY Tylenol is okay to take before surgery)
- Patients should shower or bathe the night before surgery
- You may brush teeth on the morning of surgery, but do not swallow any water
- No candy or chewing gum on day of surgery
- Medication may be taken on the morning of surgery with a sip of water (please discuss specific medications with nurse prior to surgery)
- Wear loose fitting, comfortable clothes that can be easily removed at the Surgery Center
What to bring to the Surgery Center
- Your health insurance card and driver’s license or passport
- A favorite toy or two and/or a special blanket to comfort your child
- For infants: bring your child’s pacifier and bottle or sippy cup for after surgery
- For older children: A favorite item from home, small toy, iPad/tablet, personal CD or MP3 player with head phones
- If your child wears glasses or a hearing aid, bring a carrying case to store them during the surgery
- A laptop or reading material to pass the time during your child’s surgery (internet access is available in the waiting area)
If the patient is a minor, a legal guardian must stay at the Surgery Center throughout the surgery.
WHAT TO EXPECT ON THE DAY OF SURGERY?
In the Pre-operative Area
After completing some forms at the Reception desk, you will be taken to the Pre-operative Area. This is where patients will change into a gown, and the nurse will record the patient’s vital signs and weight. You and your child will meet with both Dr. Lewin and the anesthesiologist before surgery. This time will be used to talk about your child’s medical history and review your questions about the surgery. Your anesthesiologist will discuss with you the anesthesia plan and will talk to you about the risks of anesthesia.
Your anesthesiologist may prescribe an anesthetic “premedication” before surgery. This is a calming medicine given before surgery. In young children who are anxious, this is often given in the form of a flavored drink (“happy juice”) taken a few minutes before going into the operating room. Older children and adults may have an IV started in the Preoperative Area and receive an IV medication to help with anxiety. The goal is to make this experience as easy and comfortable as possible.
In the Operating Room
The anesthesiologist will use special equipment to monitor vital signs: heart rate, blood pressure, oxygen level and breathing.
Anesthesia may be given to your child using a plastic mask, which is gentle and painless, and does not involve getting a “shot”. Anesthesia from a mask is the most common way of “going to sleep” in children having elective surgery. After falling asleep, an IV is started. Your child’s surgery begins only after he/she is asleep. The anesthesiologist will make sure your child is comfortable during the entire operation. When the surgery or procedure is completed, your anesthesiologist will wake your child up.
In the Recovery Room
After surgery, patients will wake up in the Recovery Room. This process usually takes about an hour, but sometimes this may be much quicker or require more than an hour. During this time the vital signs are closely monitored and patients are kept as comfortable as possible. Some patients wake up from surgery very confused or nauseated. Special IV medications may be used to help with the recovery process.
WHAT TO EXPECT
- It takes some time for the anesthesia medications to wear off. If the surgery time was short (less than 4 hours) it may take about 1-2 days before feeling back to normal. If the surgery time was longer than 4 hours, then it may be 3 days before your child seems back to themselves.
- The area of the surgery may swell in the first 1 to 3 days after. This swelling should go away in less than a week. If the swelling is concerning to you, please call Dr. Lewin.
- Please call Dr. Lewin immediately if you notice any of the following after surgery:
Fever > 101°, rapid swelling, bleeding, bruising, increasing pain, redness or drainage around the surgical site.
- Your child should not be too active after surgery. This means quiet play, but no exercising or rough play until after Dr. Lewin has her first post-operative appointment with you. Dr. Lewin will give specific instructions to you after surgery about when your child can return to gym class and sports.
Prescription medications are usually called in to the pharmacy near the Surgery Center on the day of surgery. If you prefer the medications to be called into your local pharmacy, please contact Dr. Lewin’s nurse firstname.lastname@example.org with the name and phone number of the pharmacy you prefer.
-Acetaminophen with Codeine is used to treat pain.
- If your child has a lot of pain, give the Acetaminophen with Codeine as ordered for the first day or two after surgery.
- You may use plain Acetaminophen (Tylenol® ) if your child is not complaining of pain. Please dose as directed on the bottle.
-Keflex is an antibiotic.
- Please tell Dr. Lewin and the nurse if your child is allergic to Keflex so we can prescribe a different antibiotic.
- It is given 3 to 4 times per day, depending on the patient.
Additional medications may be prescribed depending on what type of surgery is performed.
- The anesthesia medicines may cause nausea. Start with drinks, bread and milder foods. If there is no nausea, your child may eat their usual diet after surgery.
- Anesthesia and pain medicines slow down the digestive tract. Your child may not have a bowel movement for several days after surgery.
- Some children get a sore throat and a hoarse voice after surgery. This is from a breathing tube placed during the surgery. This should go away in a few days.
THE SURGICAL DRESSING AND BATHING AFTER SURGERY
- In most cases, the surgical dressing should be kept dry, and the rest of the body can be sponge-bathed starting the day after surgery. Dr. Lewin will specifically discuss this with you if your child’s surgery needs a different course than this.
FEVER / COUGH / PAIN
- Your child may have a low temperature after surgery (<101 F). If your child has a fever that does not go away after surgery (>101.5), it may be from something else. Please call Dr. Lewin.
- If your child has ANY unusual symptoms after surgery that concern you, please don’t hesitate to call Dr. Lewin at any time on her cell phone (310.291.2078).
- Your child will be seen in Dr. Lewin’s office one to two weeks after surgery. IF THE DRESSING FALLS OFF BEFORE THAT APPOINTMENT, DO NOT REAPPLY ANYTHING WITHOUT FIRST TALKING TO DR. LEWIN.