ABOUT YOUR VISIT

Pre-Consultation

Prior to your visit with us, your doctor will communicate with us regarding your suspected diagnosis and possible treatment options. If it is agreed that you may be a candidate for fetal therapy, then we will work with you to set up an ultrasound and consultation with Dr. Chmait.

Consultation and Ultrasound Assessment

When you arrive at CHA Hollywood Presbyterian Hospital, please drive up to the front of the hospital and see the attendant for Valet Parking. Your car will be parked for you compliments of the hospital. Introduce yourself to the doorman, who will assist you to the Suite 706, on the 7th floor, in the Doctor’s Tower. You will meet with Terry Maitino, RN, Fetal Therapy Coordinator. She will answer any immediate questions that you may have regarding your suspected diagnosis.

You will then be taken to our 7rd floor office where you will meet Dr. Ramen Chmait, the Director of Fetal Therapy who will perform your ultrasound evaluation. This exam may take up to two hours. Following the ultrasound, Dr. Chmait will discuss all findings and will review the treatment plan (which may or may not involve surgery), prognosis, and recommended follow-up care. He will be able to answer your questions and concerns at this time.

You with then discuss any further questions with Terry. She too will reiterate the treatment plan and answer any questions you may have. If surgical therapy is recommended, you will receive a folder than contains information you need for surgery and additional information you will find helpful. The surgery consent form will be given to you for review. It explains the surgery in detail in terms that are easy to understand. This is in addition to the hospital consent form. Both consent forms will need to be signed prior to surgery. Dr. Chmait will answer all questions regarding the consent forms that you may have.

Pre-Admission Testing

If you desire to proceed with fetal surgery, you will be given a time to arrive at Out-patient Surgery on the 2nd Floor of the Doctor’s Tower. When you arrive, you will register as a patient. The Fetal Therapy Coordinator will help you to complete a medical history form. This form will ask you about your general physical status and any specific health problems you may have. The lab tech will draw blood for various tests that are necessary prior to surgery. One of the anesthesiologists will see you and evaluate your physical condition and determine any specific needs you may have concerning your anesthesia. You will be given a time to report to Labor and Delivery on 3rd Floor at the main hospital. This completes your visit to pre-admission testing. You will not have to go to Labor and Delivery until 90 minutes prior to your scheduled surgery time.

Preparing for Surgery

Before surgery, you will not be allowed to eat or drink for a defined amount of time (usually 6-8 hours). This is to prevent the risk of vomiting during surgery. In medical terms, this is known as “NPO”(nothing by mouth).

You may have a regular diet at dinner the night before surgery. You may drink water and clear liquids only after that time. Clear liquids mean tea, black coffee, (sugar or sweetener is permitted), apple juice and jello. SIX HOURS BEFORE YOUR SCHEDULED SURGERY YOU WILL BE NPO.

Before Surgery

When you arrive on the 3rd Floor of Hollywood Presbyterian Medical Center, Labor and Delivery, you should report to the nurse’s station. You will be accompanied to your private room. An intravenous line (IV) will be inserted by needle stick to give fluids and medications during surgery. In most cases, this will be the only needle stick that is needed.

An ultrasound will be done prior to going to the operating room to confirm the babies’ heartbeats. One of the specially trained nurses that will be assisting in surgery will accompany you to surgery.

During Surgery

When you arrive in the operating room you will be moved to the operating table. You will be covered with a warm blanket and a pillow will be placed under your knees to keep you comfortable during surgery. Medication will be given through your IV tubing to relax you. Surgery is performed under local anesthesia, meaning you are awake but relaxed and your abdomen is numbed where the instrument is inserted. An anesthetist stays with you throughout the procedure. You will be given additional medication as needed. Rarely, general anesthesia, meaning you are put to sleep, may be used.

A catheter will be put in your bladder to drain urine and will remain in place until later that evening.

During surgery, one or two small incisions, approximately 1/10 inch long, are made on the abdomen. The incision(s) are small, and will only require a band aid dressing.

In most cases, surgery lasts one to two hours, but this can vary depending on a number of factors.

After Surgery

Following surgery, you will be taken back to your room on Labor and Delivery where you will be monitored for at least one hour. Medication may be given after surgery to relax the uterus and stop any contractions. Pain or discomfort after surgery is usually minimal. If needed, pain relief medicine is available.

The catheter will be removed from your bladder about four hours after you arrive in your room on the 3rd Floor. Your husband or other support person may remain with you in your room. There is a bed available for his/her comfort.

Following surgery, you may have food as tolerated. That night, activity is restricted to bathroom privileges only, but this depends upon your specific condition.

The day after surgery, a follow-up ultrasound will be done in the morning. Most patients are discharged following their ultrasound.

You may plan on being here approximately 2-3 days: one day for ultrasound and consultation and one day for surgery. You will spend the night of surgery in the hospital. Most of our patients are discharged the following morning. We recommend that you consider spending one day at the hotel before traveling long distances.

RETURN TO PREVIOUS »