Advocating for surgery

 My baby (13 y.o) is in surgery right now. He's has autism among other challenges. It’s just dental so nothing like most situations we’ve experienced. But, I thought I’d share how it went down in the OR prep/recovery room for those who deal with procedures with sedation. 

I’ve lost count of how many times my sweet boy has been sedated. But I do know that every time I learn a little more about how to communicate his needs better. It’s just like any relationship, communication is key to success and I like to share this in case you might have to deal with it.

As soon as the team comes over to check in, and we go over everything to be done, I ask the docs if they are residents. Being that our two main hospitals, UCLA and CHLA, are both teaching hospitals, you’ll find it’s routine for residents to work on your child. Of course the attending is there with them. But I believe we’ve had too many negative situations with residents’ work that I’m not open to them being the one with the scalpel or needle. If you know me, you might feel I’m not the confrontational type and you’d be correct. When I ask this, I always feel a pit in my stomach but I push through it. Diplomatically explaining that I’m all for learning but I no longer want it done on my child. Feel free to be in the room and over seeing, I just request that the work be done by the attending.

Where anesthesia is concerned, I’m also very straight forward with them. I explain the trauma he has been through and that we need to work as a team to figure out the least traumatic way for him to go under. I also explain how many botched IV he’s had in his life. And ask the doc to please share with me who will be placing it and if they are honestly at an expert level. I ask for what the options are for presedation. I explain that he once went in for a PICC Line placement (a procedure that should take 1 hour max) and came back 3 hours later with no PICC Line, 4 IVs and none of them worked.

This time, they decided on an intramuscular sedation before heading off to the OR which worked. But, again, the doc spent too long cleaning the spot and I asked him to please go ahead with the shot as Ian reacts to the cleaning knowing what is coming after.

Whenever we have to deal with someone placing an IV, I always ask questions. If they are hesitant in their reactions, I ask if they could get someone from the PICU (or NICU when he was smaller) as they are used to having to get them quickly and under duress. Also, no matter who does it, I make sure they have their supplies at the ready. Their tape pulled and torn, their needle and Tagaderm (or whatever they are using) prepped and an assistant at the ready to help if needed. Here at CHLA they also have a vein finder which is super helpful, as well as a Buzzy Bee, which they can put on top of the spot to confuse the nerves before placing. But they have to be quick with those as well for kids with experience.

Also, if you have a very little one that you can hold just keep in mind if they get the IV going to put them out while you’re holding them it’s quite traumatic. This happened to me way too many times and the last time it did I had asked them to not start it until I set them down on the bed and they did it anyways, which was really frustrating. 

And for our kids have a short video at the ready,  to show what they are like when they’re not affected by sickness or anesthesia. Because looking at a chart the team might assume that your child is not that much different than how they’re acting at the moment. 

We also talk about what is going to happen for the week before. I tell him every step before it happens and explain why. And give him lots of choices to give him as much power in the situation as possible.

All of these things I do with kindness and a smile. Making my requests as light as possible and showing genuinely appreciation for their understanding. I know their job is not easy, especially when you’re trying to get things done and have a mom like me holding things up. But I fully believe it’s worth every bit of time and energy expended by all parties.