As far as childhood surgeries go, a myringotomy (ear tube placement) is about as no-big-deal as you can get. It’s low risk, doesn’t require an IV, and is so fast that the allotted time from check-in to checkout is a swift three hours (at American Family Children’s Hospital). The surgeon my husband and I spoke with told us that if he were to do the surgery on an adult, we probably wouldn’t require anesthesia.
No big deal, right?
Not for me! It was a huge deal.
My daughter (I’ll call her N) had five ear infections between November and March. She was almost constantly on antibiotics. As soon as one course was completely out of her system, the next infection would pop up.
Our pediatrician referred us to an ENT after the third one, and our consult happened to be during the only good stretch of ear health N had all winter. So, when her hearing tested normal despite the infections, and the surgeon casually said “I’d be happy to put tubes in for you”—as though that was my goal and therefore why he’d do it—I started to feel very uneasy about the whole thing.
I worried about the required fasting, I worried about how scared she’d be, how long she’d be awake without me and wondering why I’d left her. I worried about the general anesthesia. I thought if we could just get to spring N would outgrow her ear trouble. I decided to cancel the surgery.
But then, the next cold struck—and with it a double ear infection. The worst she’d had in a while. Maybe ever. She was in a lot of pain. When the pediatrician peered in N’s ears, she described her eardrums as bulging and mentioned puss. She urged us to get the tubes.
So we went through with it, and I was scared, but everything went fine. It would have been so very helpful if more time were spent explaining things during the ENT consult. Sure, they explain the procedure, but they don’t say much about how parents are involved. The general vibe seems to be that this is a fast easy surgery, absolutely no big deal for them, and so it should be no big deal for you.
For someone with my personality, this breeds anxiety. So I asked a lot of questions. I asked them at the consult, I asked them when staff called to schedule the surgery, I made my husband call and ask some questions, I asked our pediatrician questions, and then I asked a few more when a nurse called the day before the surgery.
Here’s what I learned from the extensive questioning and from our experience.
Fasting: I was really concerned about this. N was still nursing once overnight and I assumed I’d have to deny her that. But she was allowed to have breast milk up until four hours before her surgery. (This may vary depending on the anesthesiologist.) She could also have water, apple juice and Pedialyte up until two hours beforehand. No food or cow’s milk after midnight the night before.
Scheduling: I wanted to be scheduled as early in the day as possible to make the fasting less awful for N. At first you’re only given the date—you don’t learn the time until the day before. I talked with the scheduler and made sure to get a day when our surgeon only operates in the mornings. This at least made an afternoon surgery an impossibility!
Medications: Whether or not your child should take medication before the surgery is dependent upon the type of medication. The one I asked about was ibuprofen because N was frequently taking it for ear pain. I’m glad we asked, because the answer was to stop three days before the surgery. No one offered that information.
Going back to the OR: I was relieved to learn I could accompany my daughter to the OR and stay with her until she fell asleep. Then, during pre-op procedures, the anesthesiologist asked how she was with strangers; he held his hands out to see if she’d go to him. She did.
Shortly after, I heard a nurse ask him if anyone was going back to the OR, and he said no—she would be fine being carried back by them. (He didn’t even ask us what we wanted to do.) I intercepted the nurse and put a fast stop to that. N would have been terrified being carried away from me by strangers; I can’t believe the doctor thought that would fly. Moral of the story: don’t let anyone railroad you for their convenience!
Recovery: For some unknown reason (I wish I’d asked), parents aren’t shown to the recovery room until the child is awake. By the time I got to N, she was screaming bloody murder while a nurse she didn’t know tried to give her a bottle of Pedialyte. It would have been better if I were present when she opened her eyes. In retrospect, I wish I’d pushed back about this so she didn’t have to wake up so scared.
Even a small surgery is still surgery, and it’s a parent’s job to be informed and to advocate for our kids. Here’s hoping these details help some of you out!
