When a Child Needs Surgery
A Pediatric Anesthesiologist explains what you should know
Stanley Dee, MD, loves kids. He has four of his own (Robert, Martha, and twins Victoria and Tommy), and he has helped hundreds of children “go to sleep” as one of the area's few board-certified Pediatric Anesthesiologists.
For more than 20 years, he has worked at Northwestern Lake Forest Hospital and was recently named Medical Director of the Northwestern Grayslake Surgery Center. Here he explains what parents should know about pediatric surgery.
Q: What is the biggest risk for a child having surgery?
A: Most complications have to do with respiratory and breathing issues, which is why the anesthesiologist’s skill is so important. The particular surgery might be general or common, but pediatric anesthesiology is always a complex process. The challenge for us is to maintain the airways and make sure kids emerge from the anesthesia breathing well.
Q: Having worked with many surgeons and parents, what is your best advice?
A: Always let the surgeon or your primary care physician know if your child is not feeling well. A cold during surgery, when breathing is critical, increases the risks. Parents are reluctant to reschedule the surgery or change a planned day off from work, but safety is the priority. Also, take seriously any orders to withhold food. Many parents cheat a little, but gastric contents can enter the lungs during surgery and that’s dangerous.
Finally, stay calm and be honest with your child. We had a wonderful dad here recently who was relaxed and treated it as no big deal—his son wasn’t afraid and went to sleep beautifully.
Q: How does a specialization in pediatrics make a difference—e.g. how do you help children?
A: Kids are not small adults; their systems are entirely different. It is about knowing these physiological differences but also being gentle, calm and quickly establishing trust. We talk, and I use toys and flavored masks to establish a playful mood. I also maintain physical contact with the child throughout the surgery—I’m not just monitoring equipment.
A common complaint from parents during children’s surgery is that the anesthesiologist talked to the parents, but never even looked at the child—it shouldn’t be that way. The anesthesiologist’s personality and orientation to children is very important. I love kids, and I think being a father has made me a better pediatric anesthesiologist.
Parents should also know that pediatric specialty training is important for the surgeon to have as well. At Northwestern Lake Forest, we have a full staff of pediatric specialists who perform surgery, as well as pediatric general surgeons.
Q: What are the rules regarding parents in the operating suite before and after surgery?
A: For children over one year old, parents are allowed to come in during the beginning of the anesthesia process, and we try to explain what they will see and hear. It doesn’t interfere, and it makes the parents feel better. Bringing a parent in toward the end of surgery is prohibited because of the careful process we undergo to make sure the child emerges from the anesthesia safely. We can’t promise, but often by the time the child is fully awake the parent is already there.
Q: What should parents look for in an Outpatient Surgery Center?
A: Proximity, facilities and technology are important. But it comes down to the experience of the surgical team—the surgeon, the anesthesiologist, the nurses. The clinical staff at our new Northwestern Grayslake Surgery Center is made up of veteran nurses and anesthesiologists whose average years of experience is high, some of them more than 20 years. I often hear from surgeons that our anesthesiologists are highly regarded in the county—and our external patient satisfaction scores [PressGaney™] back that up.