Posts Tagged ‘informed consent’

When Your Child Needs Minor Surgery

Thursday, July 24th, 2014

In the summer of 2011, I had my second daughter. It was hot in Texas that summer—recording-breaking hot. We lived at the pool. It was one of our many afternoons at the pool that I noticed something odd. When my two-year-old looked into the sun or across the glare of the pool, one of her eyes turned outward. I kind of blew it off, not knowing what to make of it so the observation was stored in my little mom file in the back of my brain. But as the summer progressed, I noticed it happening more often, including indoors, out of bright-light situations, when she was tired.

When Your Child Needs Minor Surgery

One of the clues–closing one eye in bright light situations.

Finally, another child at the pool asked me what was wrong with my daughter’s eye, and I knew at that point it wasn’t just me obsessing. I called the pediatrician. We were referred to a pediatric eye specialist, who recommended eye patching for an hour a day for six months. When that didn’t help, he recommended surgery.

Outpatient surgery is now increasingly used for kids for minor procedures such as tonsillectomy, long dental procedures, and what we had done, which was double-strabismus eye surgery.

The risks for our surgery were minimal: at best, it would correct the lazy-eye problem, and at worst it would do nothing and we would have another go at it when she was older.

When Your Child Needs Minor Surgery

We already know our youngest will have to have the same procedure for her eyes.

The day we went in, we were instructed to bring her in her pajamas and she wasn’t allowed to have any food from midnight on. We were taken back to the waiting area, and they gave her “giggle juice,” which was a syrup that would help her relax and not remember anything while they put her under anesthesia. Our surgeon came over and talked to us about the surgery and what they were going to do. He happened to go to our church, so we prayed together and then they took her back.

The procedure only took about 20 minutes. We met her in the recovery room, where she woke up confused and crying inconsolably. Her eyes were bloodshot at the corners, but other than that you couldn’t tell anything had been done. She wept until a nurse arrived with a popsicle, which she greedily consumed and asked for another. After two popsicles, she was much better and ready to go home. The nurses let her pick out a stuffed animal, and my husband pulled the car around to pick her up. As soon as we buckled her in and began driving, she promptly threw up all over the backseat. After that, she was back to her old self.

For me, this sort of thing was hard because I was making decisions about another person without their input. My daughter didn’t have a say in what happened–she was a toddler and not able to have any part in the decision making. It wasn’t a life-threatening condition, and it didn’t affect her health.

I had an amazing doula through two of my births who gave me the BRAIN acronym to use in making medical decisions, and I love this approach for any medical situation.

B – Benefits. What are the benefits of this procedure?

R – Risks. What are the risks?

A – Alternatives. What are all my options?

I – Intuition. What is my gut feeling? What does my intuition say?

N – Nothing. What happens if we do nothing, either now or in the long term?

Although I was extremely nervous about having such a young child have a surgical procedure, I felt like we made an educated decision and in the end it was the right one for us. Since then, I have observed the same eye problems in my youngest daughter, so I anticipate having to go through the same process again.

The most important thing I learned was to pay attention to your children and observations. If something doesn’t look right to you, take a photo or video and ask your pediatrician, and then research all your options—including what happens if you do nothing—before making a decision. Only you can make the right choice for your family.

Erin Hayes Burt is a freelance writer and mother of three girls who lives and writes in Queensbury, New York.

Pregnancy Week 35: Writing My Birth Plan

Monday, July 21st, 2014

Pregnancy Week 35: Writing My Birth PlanFive weeks to go. Yesterday, I took a tour of my hospital and got to see the rooms where my son will be born. It’s getting real, ladies. With my daughter, I didn’t write a birth plan. I didn’t really have a lot of strong opinions and I was just eager to have her. This time around, I am trying to be more educated and prepared, just in case. A birth plan is basically a written document that guides you through making educated decisions about your labor and delivery, and also tells your medical team your preferences for labor.

Here are some things I am including in my birth plan.

Labor Preferences

Do you want to be able to walk around, move, and be in different positions while laboring? How much, if any, pain medication do you want? How often do you want to be checked during labor? One question I hadn’t even considered is, do I want to see baby as he greets the world for the first time. For me, I am planning on an epidural during my labor. I am definitely going to opt for minimal cervical checks this time, however. Who do you want in the room with you as you labor? We will not have any family or friends at the hospital with us. Many women find relaxing music, dim lights, and even few distractions optimal. Whatever you want your nurses or providers to know about your labor preferences should be included here.

Postpartum Preferences

Do you want to hold baby right away after he or she is born? I do! Do you prefer for baby’s bathing to be delayed? Don’t worry about cleaning him off–just give me my sweet son and let me put his skin against mine. That’s my plan. Many moms bank baby’s cord blood. While this isn’t in my plan, I do think it’s a great idea. It’s a good idea to include your preferences about breastfeeding or formula feeding. I do not want my son to be introduced to any artificial nipples while in the hospital. No pacifiers, no bottles. We are planning for my son to be circumcised in the hospital, so this should also be included in the birth plan. I would like my husband to cut baby’s umbilical cord.

Many websites and hospitals provide birth plan worksheets to make the process of writing the birth plan easier for you. While you are pregnant, there are so many things to do, so don’t stress over a birth plan. Just get your thoughts together, write them down, and discuss them at one of your doctor visits. I plan on doing this in the next few weeks. Five weeks will pass before I know it!

Karyn Meyerhoff is a mom of one and one on the way from Northeast Indiana. She is so excited to meet her little boy in 5 weeks!