Many parents have to make decisions about surgery for their child. As parents of deaf children, the surgery will usually be elective and you have time to consider your options. All surgeries carry benefits and risks and you need to know about these before deciding if the surgery (and the surgeon) are right for you and your child.
It can be difficult asking tough questions of the surgeon looking after your child. Dr Thomas Russell, a surgeon and executive director of the American College of Surgeons says, "Patients should feel free to ask their surgeon anything they want answered about the operation or the surgeon's competency to perform it. There are no questions that should be off the table."
Surgeons usually prefer their patients to ask questions. It is better for them if you understand the procedure and its benefits and risks. Some people find it very difficult to question the surgeon about his or her record. Be friendly and nonconfrontational when asking questions. Dr Russell suggests you avoid surgeons who are unresponsive, distracted or rushed. If you are not happy with the surgeon's recommendations, seek a second opinion.
There are many articles on the Internet discussing the questions to ask your surgeon. We have reviewed a number and compiled a list that may assist parents of children with hearing loss.
Questions about the surgery
- What is the operation being recommended?
Your surgeon should clearly explain the surgical procedure, explain the steps involved and provide you with drawings or models of the procedure. You should ask if there are different methods for performing this operation and why the surgeon favours one way over the other.
- Why is the procedure necessary?
While the reason for cochlear implant surgery may seem self-evident, there are other procedures, such as grommets or atresia repair, where you should ask your surgeon to specifically explain why this procedure is being recommended for your child. Make sure you understand how the procedure can improve your child's condition.
- What are my alternatives to this procedure? Are there other treatment options available?
In some cases, medication (antibiotics vs grommets) or non-surgical treatments (hearing aid vs cochlear implant) may be helpful in improving your child's condition. Your surgeon should clearly explain the benefits and risks of each option so that you can make an informed decision. Sometimes a "wait and see" approach is taken to monitor your child's condition over time. Surgery may still be the best option in the long-term.
- What are the benefits of the surgery? How long will they last?
The benefits of some surgery may only last a short time and further surgery may be needed. It is better to know if additional surgery may be required.
For children undergoing cochlear implant surgery, discuss the reliability and upgradeability of the internal component of the implant being recommended. The electronics of the implant will have to stay relevant and functional for decades. External processors can be replaced but replacing the implant itself will require further surgery.
- What are the risks and how do they relate to my child?
What are the risks for this type of surgery, in general, and the risks for your child, in particular?
- What happens if I choose for my child not to have the operation?
If you decide, after weighing the benefits and risks of the surgery, not to have the operation, could there be adverse consequences for you child in the future?
- How long have I got to make this decision?
When the surgery is not an emergency procedure, you may have time to consider your options more thoroughly.
Questions about the surgeon
- What is your experience in performing this procedure?
You can minimise the risks of surgery by choosing a surgeon who is thoroughly trained and experienced in performing the procedure. You may ask the surgeon about his or her experience with the procedure being performed, including the number of times he or she has performed it on a baby or child. Ask the surgeon about their complication rate with the surgical procedure.
- Will you perform the whole procedure?
If you wish to have the surgeon perform the whole procedure, you may need to have the surgery performed in a private hospital.
- Who will be doing the anaethesia?
The anaesthetist is a critical member of your child's surgical team and can make all the difference to how your child feels before, during and after surgery. Ask to meet the anaesthetist before the surgery. Ask if you can stay with your child until the anaesthesia takes effect.
Questions after surgery
- Did everything go as expected?
- If I have any questions, who can I contact?
- Should I expect any problems or side effects from the surgery or medication?
- What symptoms would warrant a call to your office?
- What symptoms would warrant immediate medical attention?
- When should my child next see you?
Making decisions about a surgical procedure for your child can be difficult and stressful. To make an informed decision, you need to ask questions of the surgeon. It is crucial that you have trust and confidence in your child's surgeon. You are your child's best advocate and communicating effectively with your child's specialists will achieve the best outcomes for you and your child.