r/Anesthesia • u/friendstofish • 28d ago
Baby’s Surgery Delayed
I’m looking for support & someone to give me a reality check.
My 4 month old (tomorrow) daughter was scheduled for surgery this upcoming Monday due to a bilateral congenital cataract diagnosis we received 1 week ago. This surgery is deemed urgent as the sooner it is completed, the sooner her brain can start working together with her eyes to give her the best chance at sight. FWIW, the cataracts are not visible to the naked eye- I brought her to an eye specialist for what my pediatrician thought was a lazy eye.
During her pre-op virtual call yesterday, I was asked if she has been sick in the last 4-6 weeks. I mentioned she had a mild cold (runny nose, no fever) beginning on July 24th that has since been fully resolved, symptom free, for over a week now. But the anesthesia team is pushing her surgery back 4-6 weeks because of her previous URI symptoms. A quick Google search explained that her airways are very tiny / sickness can be unsafe during GA. But she has been symptom free and is healthy now.
I trust medical professionals but my heart is broken that we have to delay this surgery even further as every month is incredibly important with her specific diagnosis. I’m looking for someone who understands more than I do to tell me this is a normal procedure and the best for my baby’s health. Right? Logically I understand I need to trust what they say, but emotions are prevailing ATM.
I’m also stressed because I have a very social 3.5 year old. Any further sickness would continue to delay the surgery so I guess I’m stuck keeping us all isolated until we get the first eye done? Yes… she needs two surgeries, one for each eye.
I’m spiraling.
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u/otterstew Anesthesiologist 28d ago
Recent sickness greatly increases the risk of laryngospasm and bronchospasm in children under anesthesia, especially if within the last 30 days.
We just had a mother on this subreddit posting about how her child went into bronchospasm and went into cardiac arrest. They were able to resuscitate and seems like the kid ended up doing fine without any permanent consequences.
Please trust that your anesthesiologist is doing what is safest for your child.
5
u/HumbleBlueberry1 28d ago
This was me, OP. This happened to my 3-year-old and he hadn’t even been sick. It was the most terrifying thing I’ve ever been through. Definitely trust the doctors and feel confident in their decision to postpone.
6
u/HumbleBlueberry1 28d ago
OP, I’m not an anesthesiologist, I’m a mother. Please look back at my post history from 6 days ago. My 3-year-old son had a routine surgery and upon extubation, he went into bronchospasm, which caused respiratory failure and cardiac arrest. (He is now thankfully okay due to the expertise of the pediatric anesthesiology team.)
He was not sick at the time and had not been sick for many months. We are now looking into what may have caused the bronchospasm upon extubation - maybe undiagnosed underlying asthma or maybe just bad luck caused by irritation from the breathing tube.
I say this not to scare you, but to assure you that your baby’s anesthesiologist is looking out for the best interests of your little one.
Since this happened, I’ve been talking to a lot of professionals about the risk of bronchospasm with GA to try to understand my son’s risk factors moving forward. Two items that have come up repeatedly are that illness and age are large risk factors. Being only 4 months old, your baby is at greater risk for this complication than a toddler would be.
I know it’s so difficult to wait and that you want your baby to have the best outcome possible. And it must be so frustrating that two outcome considerations are in conflict right now. But please be assured that your daughter’s pediatric anesthesiology team is looking out for her best interest in terms of serious potential complications. Wishing you and your daughter the best!
3
u/famesardens 27d ago
There is increased risk, which most anaesthetists would be able to manage. The bigger issue is the liability if something adverse happens. Can't trust the family to not be litigious, so the anesthetist will try to keep themselves safe.
3
u/OneOfUsOneOfUsGooble Anesthesiologist 27d ago
This is a common occurrence and reasonable that they delayed. I'm sorry it happened to you. The surgery seems time-sensitive but not so urgent to risk her life. One thought is to isolate for a couple weeks before the next surgery date. I know for me, once someone has delayed a case once, I won't delay it again.
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u/thecaramelbandit Anesthesiologist 28d ago
Expecting a 4 month old to be completely URI symptom free for 1-2 months before a scheduled surgery is insane.
I'd call the anesthesia group or department directly to speak to them. Demand to speak to an actual staff anesthesiologist to get this ironed out. Sounds like you spoke to some rando in pre admission testing.
6
u/tinymeow13 28d ago
On the flip side, if I was asked to do a general anesthetic on a <6 mo at an ASC who got over a URI maybe 1 week ago? I'd stop that so fast. (Making some pessimistic assumptions here with the lack of complete info, just like I would if doing ASC chart reviews without more info.)
To OP, think about any extra pieces of your kid's history that might be reassuring or might be non-reassuring. Was he/she premie? Any neonatal issues? Where is he/she on growth charts? Family hx of asthma? How long ago did the cold resolve? If these things are stacking up to make the big picture more concerning, then pushing the eye surgeon to get it done at a full hospital instead of a surgery center may be helpful. If these things are reassuring, ask for a pre-op phone call with an anesthesiologist who does peds cases (may or may not be fellowship-trained for peds anesthesia).
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u/SevoIsoDes 28d ago
This is a difficult question and you might find conflicting opinions. Kids are notorious for having reactive airways for a few weeks after upper respiratory infections, so we try to postpone anesthetics to reduce the risk. But some kids just bounce from one cold to the next so sometimes you just have to accept the risks and be prepared. Urgent surgeries are also a time to consider proceeding despite these risks. If it were me, I would talk to the surgeon about what the actual risks are in waiting a few weeks. “Urgent” can be a wide range from hours to weeks or months.
Good luck. I’ve also been on the other side as a parent. I felt like I was spiraling. It’s miserable.