Taking your child for their Pre-admission check-up

The whole process of taking your child to Hospital for surgery is probably one of the worst things you'll have to go through as a parent. You are frightened but you have to put a brave face on for the little person who trusts you to make sure they are safe.

Before each procedure, your child will be invited for a pre-admission appointment. I thought I'd write a post sharing our experiences seeing as we've had a fair few of them by now. The pre-admission tests were the same for all of Martha's procedures, which has been helpful for us to be able to prepare her for what's coming next.

We live a 3hour 20minute train journey away from Great Ormond Street Hospital, so our pre-admission tests are carried out the day before surgery itself. Tests are usually valid for three months so if you live closer to your Hospital than we do, you may have your appointment within that timeframe before surgery. It should also be noted that Martha Grace has had surgery for resection of a fibrous ring around the Left Ventricular Outflow Tract and/or for a Pacemaker generator replacement. Other types of surgery will require different tests.

Height & Weight
When Martha was a baby she would lie down on a mat to have her height measured and then we'd have to remove all her clothes and her nappy, place her on a set of scales to be weighed. Now she's older, she only needs to remove her shoes and can stand for both.

Blood pressure and Oxygen Saturation levels
Straightforward really, they'd wrap a blood pressure cuff around either her arm or her leg to take her blood pressure and wrap the Pulse Oximeter around one of her fingers or her toes. Not a problem when she was a baby. These days we let her have a little bit of control and let her choose which arm and which finger we test. She's due for some pretty invasive tests through the day so we always try to keep her as involved/ in control as we can.

Nose and throat swabs
For obvious reasons, we need to make sure she's not carrying any infections before she's put under GA. A swab is taken from the back of her throat and from inside her nostril.

Bloods
There are a few reasons we draw blood, to check her blood for any infection markers for example. She will lose a lot of blood during the procedure and in the recovery period which will need to be replenished, so they'll need to check her blood type. She'll need aerated blood for the surgery itself.

ECHO
The whole reason Martha is even having surgery is the images they've seen from previous Echocardiograms (scan) and CT scans. But she'll always have another as part of the pre-admission tests to make sure nothing has changed in the meantime. They're usually quite detailed and can take a while (Martha has fallen asleep a couple of times) as they take measurements and photo's from every angle possible.

ECG & Pacemaker tests
Just a standard part of her pre-admission tests, to make sure there are no heart rhythm problems prior to them putting her under GA and stopping her heart for the procedure. Putting the stickers on and taking them off again will take a lot longer than the actual tests themselves.

Consent
This is when we meet with the Surgical registrar to discuss the operation. They always feel so surreal, we're chatting to the person who will be directly involved in keeping my child alive the next day. This is our chance to ask any questions (how long do you think this will take - I don't know why we ask this). Then we sign the paperwork, giving our consent and accepting the responsibility that should the worst happen - this was our choice. Mark has signed all but two of the consent forms, the only two I've signed were for her pacemaker and for her cardiac catheter which happened when he'd already returned home to work.

We've kept our copy of her first ever consent form...
The main benefit for this operation: To save life
The main risk associated with this operation: Death

Talk about being caught between a rock and a hard place.

Bath in non-perfumed soap
Before putting Martha Grace to bed that night we'll give her a bath and wash her hair. We don't know when we'll next be able to do that and it's always a bittersweet moment watching her splash about and play in the bath, thinking ahead at how different she'll look in 24hrs time and not knowing what kind of fresh hell we'll be living in by then. We use non-perfumed and alcohol-free bath products for this bath, I don't know the exact science behind it but I don't question it.

Fasting times
You'll be given your fasting times when they know if your 1st or the 2nd case of the day. Usually, you can eat up until 6hrs prior to the procedure and water only up until two hours before. Luckily for the past three operations, Martha has been the first case of the day which means she's sleeping for most of her fasting period. We'll wake her up at 5:45 and make her have a drink of water over 15minutes so that she's had a little drink after waking up. We then take her over to the ward for 7:30am and doesn't have long to wait without food before being taken to theatre.

It's a pretty full on day, which I think is good because it keeps you busy and you've not got too much time to think about what's coming next.

I hope this post has helped.

Heart Parents - did I forget something?

GM
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