The Mom Crowd

Last week, Darah had her tonsils removed and her third set of tubes placed in her ears. Darah has had 12 surgeries in her 3 1/2 years of life and Connor’s had a same day procedure already as well (tubes placed in his ears). The picture to the left is of Darah before her open heart surgery at three months old. I am aware that not everyone is as “experienced” as we are when it comes to surgery for their child and want to share what surgery days are like for those of you who may be approaching your first surgery with your child. Every procedure, hospital, doctor, nurse, and child are so different. It’s hard to write up a one-size-fits-all post on what you can expect, but some things are pretty standard regardless of what your child is having done, and the emotional impact is pretty strong no matter how major or minor your child’s surgery is going to be!

Pre-Op (Before the surgery)

Before some procedures, doctors will want to get bloodwork done on your child. Ask for numbing cream if it’s available. This is a cream that acts as a local anesthetic and will help decrease some of the pain of the actual needle stick.

Tour the hospital with your child. Knowing where everything is prior to surgery day can help to alleviate some of the anxiety of the day. Most hospitals (if not all) are very prepared to show families where everything is prior to the surgery. It can also help with your child’s nerves if they see the hospital before the day of the surgery.

Visit the hospital’s website. If your child’s surgery is being performed in a children’s hospital, a lot of times their websites have great resources, virtual tours, and coloring sheets for your child. Take advantage of their website!

Surgery Day: Before the surgery

You will probably be asked to arrive 2-3 hours before the actual procedure. This is to register your child in the computer system, talk to the surgeon, nurse, and anesthesiologist about last minute questions. They will also check your child’s basic vitals during this time. Be prepared, surgeries often start later than usual.

Leave earrings, all jewelry, and valuables at home. If your child’s ears were recently pierced, discuss this with your doctor prior to surgery day.

If your child is anxious or irritable before the procedure, ask the anesthesiologist for a “cocktail.” Some doctors will call is “silly juice.” Basically, it’s a light sedative that will very much calm your child.

If your child needs an i.v. for the surgery, ask if that can be done after your child is already asleep. Sometimes the doctors will put the child to sleep in the operating room using a mask and then start the i.v.

While you’re waiting in the holding room before the surgery, ask your nurse if they have a playroom or any toys or books your child can play with while you are waiting. We ALWAYS bring our portable DVD player with us for Darah to watch movies on during the wait.

Do not be afraid to ask your doctors and nurses any questions you have. I also usually tell the staff something personal about Darah or our family so they go into the operating room remembering that this is somebody’s most treasured possession, and not “just another surgery.” This last surgery, I told the anesthesiologist a quick story about Darah’s beaten up Lovey she had with her. After the surgery, the recovery nurse said she heard the story about poor loved Lovey. This made me feel more comfortable in trusting them with my daughter.

When it is time to say goodbye, remain positive and reassuring. Remember, no matter how young or old your child is, they are sure to have some anxiety about being in a new place with new people and it is important to help them to feel ok with everything that is happening.

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On October 12th makers of cough and cold medicines pulled their drugs targeted for babies and toddlers from store shelves. Then the following Friday an advisory panel for the Food and Drug Administration voted to ban over-the-counter cold products targeted for children under six years old. The votes to ban the over-the-counter products for 2 years of age and younger was 21-1, while the vote to ban over-the-counter products for ages 2-5 years of age was 13-9. So we most likely won’t see a ban for drugs for children over the age of 2, because the agency is likely to ignore such a close vote according the New York Times.

The ban is suggested, because all 11 studies reviewed by the panel report that the medicines don’t work and in some rare cases cause serious harm. Also, the drugs were only tested on adults and assumed to be safe in children. Researchers have since found that some medicines react differently in children than adults.

A ban might not even take place at all. Dr. John Jenkins, director of the FDA’s office of new drugs, in an Associated Press article says, “If the agency chose to restrict use in children 6 and under, that won’t necessarily lead to a ban on the products. It might lead to labeling that says ‘do not use.’”

Also a ban may not happen for a while, because of the red tape of the FDA and the manufacturers will fight the ban according to the New York Times.

The panel’s patient and family representative, Amy Celento of Nutley, N.J. in an AP article said that she fears that parents will administer adult products to their children because they work for them or feel they work for them.

In the same AP article, “the panel also recommended drug makers provide standardized droppers with their liquid cough and cold medicines. Experts had told the panel the sometimes hard-to-use dosing devices contribute to parents unwittingly overdosing their children.” I agree! It takes me about five tries to get the medicine in the dropper right at .4 or .8. Better droppers would be nice!

There is a lot of talk in the media about these medicines and the FDA is taking no action right now. The advisory panel has only made suggestions to the FDA.

If the reports claim that the medicines don’t work, then a ban is not a loss to parents. Although, I know one parent who claims the medicines work for her four children. My daughter is only five months old, so I wouldn’t consider cough and cold medicine right now. She had her first cold last week and I have given her some children’s Tylenol when she had a fever and on the nights she was extremely uncomfortable. I have also made sure to feed her often, so she gets lots of liquids to break up the mucus. If needed, we also use a warm humidifier during the night.

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The New York Times recently published an article about a 356-page recommendation written by safety experts to the Food and Drug Administration to ban “over-the-counter, multisymptom cough and cold medicines for children under 6.” The article never specifies who the safety experts are, except that they are internal to the F.D.A. The next step in the review process is to get an outside expert recommendation.

The article speaks about the marketing strategies of drug companies. Apparently, there is a huge market to target children, because they get sick far more often than adults. It makes sense why they would offer more products for children.

The concern is that some of these medicines may be ineffective or even harmful. The article suggests that the research that has been done is outdated.

One specific narcotic to treat pain and suppress cough, Hydrocone, is said to be unsafe and ineffective. The drug has a shaky approval history with the F.D.A. The F.D.A. is currently allowing Hydrocone to be marketed for children.

I find this interesting, because I just went to the doctor yesterday for medicine to treat my cough and viral infection. I am breastfeeding, so that limited what my ENT could give me. He gave me medicine that they give children and babies. Then he informed me about the symptoms of pneumonia and to call if I got any of those. That didn’t sound encouraging.

I don’t believe that we should fear all cough and cold medicines. I would be absolutely sure that I consulted with my pediatrician or at least called the nurse before giving my child a “multi-system cough and cold” medicine. What would I do if my child was in significant pain with a cough and cold on a Saturday night and I couldn’t get a hold of my pediatrician’s office until Monday morning? It depends on the situation. I would definitely research more natural remedies until I could see the doctor or stick with the medicine I am sure is safe.

What steps would you take in this situation? What do you think about the article? Should all “multi-system cough and cold” medicines be banned by the F.D.A.?

Read the full article here.