WHAT YOU SHOULD
KNOW
In the first few weeks of life, some babies develop a
type of vomiting called gastroesophageal
(GAS-tro-ee-SOF-uh-JEE-ull) reflux, in which the contents of
the stomach back up into the esophagus (food canal). The
problem usually disappears on its own between the ages of 6 and
12 months. If it doesn't, the child may need to have an
operation called a Nissen fundoplication
(FUN-doe-pli-KAY-shun).
In this procedure, the surgeon wraps the top of the
stomach around the lower part of the esophagus, creating a more
effective valve to close off the stomach. Access to the area is
obtained through an incision under the child's left rib
cage.
Risks
There are always risks with surgery. The child might
develop internal bleeding or get an infection. Blood clots
could form and lodge in the lungs, making it difficult to
breath. However, medical personnel are always alert for such
complications, and know how to remedy them. And if the vomiting
is allowed to continue, it can interfere with the child's
growth.
IF YOU'RE HEADING FOR THE
HOSPITAL...
Before You Go
-
The child should not be given
any aspirin or ibuprofen in the days preceding the
operation.
-
Just before surgery, all food
and liquids should be withheld. The doctor will tell you
when to begin.
-
The child may need to have
blood drawn for tests.
What to Expect While You're
There
You may encounter the following procedures and equipment
during the child's stay.
-
Taking Vital Signs: These include temperature, blood
pressure, pulse, and respirations. A stethoscope is used to
listen to the heart and lungs. Blood pressure is taken with
a cuff around the arm.
-
Blood Tests: Blood samples can be taken from a vein
in the child's hand or the bend in his elbow. Several
samples may be needed.
-
Chest X-ray: The doctor will check this picture of
the child's lungs and heart to make sure there are no
problems that could interfere with the
surgery.
-
Heart Monitor: (Also called an electrocardiogram
[e-LEK-tro-KAR-di-o-gram] or EKG). Typically, three to five
sticky pads are placed on different parts of the child's
body. Each pad has a wire that is hooked to a TV-type
screen or to a small portable box (telemetry unit) that
shows a tracing of each heartbeat.
-
IV: A tube placed in the child's vein for giving
medicine or liquids. It will be capped or have tubing
connected to it.
-
Pulse Oximeter: With a little clip connected to the
child's ear, finger, or toe, this machine measures the
oxygen in his blood.
-
Emotional Reassurance: You'll be allowed to stay
with the child to give comfort and support. Children feel
safer in the hospital with their parents
nearby.
-
General Anesthesia: The child will be completely
asleep during the surgery. Anesthesia will be given either
as a liquid in an IV or as a gas through a face mask or
endotracheal (END-o-TRA-kee-ull) tube placed in the mouth
and throat.
After Surgery
Don't let the child out of bed until your doctor gives
the OK. If the child is in a crib, keep the side rails up to
prevent a fall. As the child recovers, you can expect the
following:
-
Nasogastric Tube: This type of tube, also called an
NG tube, is threaded through the child's nose and throat
and down into the stomach. It is attached to suction, which
will keep the stomach empty. It may also help to get the
child's bowels working. Food or medicine is sometimes given
through the tube.
-
Gastrostomy (gas-TRAH-stuh-mee) Tube: This soft tube
is often positioned in the stomach during the operation.
After surgery, it is used for feeding while the new stomach
valve heals. It will be left in place for only a short
time.
-
Postural Drainage: This treatment helps loosen the
sputum in the lungs to ease breathing. A nurse will lightly
tap the child's back and chest, either manually or with a
small machine, to break up the sputum and make it easier to
cough up.
-
Eating: When your doctor can hear bowel sounds
(stomach growling) through a stethoscope, the child will be
ready to eat. Start with ice chips first, then add liquids
(water, broth, apple juice, or soda). If the child has no
problems with the liquids, you can offer soft foods such as
ice cream, applesauce, or custard.
-
Medicines:
-
Antibiotics: These medicines help prevent bacterial
infection. They may be given by IV, as a shot, or by
mouth.
-
Pain Medicine: To ease pain after the operation,
your doctor will probably prescribe medication to be given
by IV, as a shot, or by mouth. Tell the doctor or the
child's nurses if the pain won't go away or keeps coming
back.
-
Anti-Nausea Medicine: This medicine calms the
stomach and controls vomiting. Your doctor may prescribe it
along with pain medicine, which sometimes upsets the
stomach.
After You
Leave
-
Always give medicine exactly
as directed. If it doesn't seem to help, let the doctor
know, but continue giving it until told otherwise. If the
doctor prescribe antibiotics, be sure to use them up, even
if the child seems better.
-
When you're allowed to bathe
the child, carefully wash the incision with soap and water.
Afterwards put on a clean, new bandage. Change the bandage
any time it gets wet or dirty.
-
Usually, children get better
quickly after surgery. Let your child rest as much as
needed. The youngster may return to normal activity as soon
as he seems ready.
Call Your Doctor
If...
-
The incision is swollen and
red, or you see any pus. These are signs of
infection.
-
The stitches or staples come
apart.
-
The bandage becomes soaked
with blood.
-
The child starts throwing up
again.
-
The child seems to be
suffering abdominal pain.
-
The child develops a high
temperature.
Seek Care Immediately
If...
-
The child suddenly has
trouble breathing.
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