Preparing Yourself
Your child needs elective surgery and a date has been scheduled.
Unlike emergency surgery, an elective procedure isn't done as
an immediate matter of life and death. Having an elective
procedure gives you the time to prepare your child psychologically
for the hospital and the surgery.
Good preparation can help kids feel less anxious about the
anesthesia and surgery and get through the recovery period faster.
But, like parents everywhere, you're probably uncertain about
the best way to prepare your child.
The key is to provide information at your child's level
of understanding, correct misunderstandings, and get rid
of fears and feelings of guilt. Help your child understand why
the surgery is needed and become familiar with the hospital and
some of the procedures he or she will undergo.
Kids of all ages cope much better if they have an idea of
what's going to happen and why it's necessary. To do that,
prepare yourself first and correct any misconceptions of your
own.
Ask Questions
The horror stories you heard from grandparents and parents about
traumatic parent/child separations and very limited hospital
visiting hours belong to days gone by. Hospitals have changed
enormously. For example, many surgeries are now
"same-day" procedures requiring no overnight or prolonged
stays; most kids are back home, in their own beds, the same
night.
Furthermore, most U.S. hospitals permit at least one parent to
stay with the child at all times except during the operation.
After the surgery, you may return to your child in the recovery
room. As your child awakens, he or she will not even realize
you left.
Ask the doctors, nurses, or staff for the information you need
about what will take place so that you can prepare your child and
deal with your own fears or concerns. To parents, one of the most
fearful aspects of surgery is
anesthesia
. Anesthesia is much safer today than in the past, but still
carries some risk. You should discuss any concerns you have in
advance with the anesthesiologist.
When hospitalization is required overnight or longer, most
hospitals avoid separation anxiety by permitting at least one
parent to stay with the child day and night. Check with the
hospital about its rules regarding parents staying over and
when other close family members can visit.
As soon as your child is able, he or she may be playing with
other children, toys, and games in a children's recreation room
- even if that involves taking along an IV bag on a rolling
support.
Explain the Problem
Now that you're more at ease, start preparing your child.
Begin by explaining the reason for the surgery in simple,
nonthreatening words. Explain - at your child's level of
understanding - about the medical problem and why surgery is
necessary. Don't use alarming language like "the doctor
will cut you," "open you up," or "sew you with
a needle." Say that the doctor will fix the problem, and
explain that many kids have this problem and must get it fixed
at the hospital.
Although they seldom express it, kids may fear that their
parents aren't telling them everything - that their health
problem is worse than they've been led to believe. To build
trust, don't mislead your child - tell as much of the truth as
your child can understand.
Dispel Fears
Many kids fear that an operation will be painful. It can
help to explain that a special doctor, called an anesthesiologist,
gives medicine to make patients sleep very deeply so they won't
feel anything during the operation and once it's finished,
they'll wake up. (Older kids, in particular, need special
assurances that they
will
wake up.)
Again, avoid frightening language - don't say,
"You'll be given gas" or "You'll be put to
sleep." Young kids may confuse "gas" with the
fuel that can poison or kill and "put to sleep" with what
can happen to sick pets.
Explain that you'll be there when your child wakes up - and
a favorite toy can come along, too. Tell your child that if
anything feels sore right after the operation, a doctor or
nurse can give medication that will make it feel better.
Common surgery-related fears of young children are the
possibility of separation from (or abandonment by) parents and the
possibility of pain. School-age kids also fear needles, knives, and
damage to their bodies. Give a child this age clear, rational
information as well as assurances that the surgery is to fix
an existing problem, not create a new one.
The fears of adolescents go well beyond those of younger kids.
Besides pain, change of appearance, and disfigurement, your teen is
probably afraid of losing control, missing out on events, being
embarrassed or humiliated in public, and sounding childish by
expressing fear, anxiety, or pain. A teen may also be afraid
of waking up during the operation - or not waking up afterward.
Anticipate these fears, then emphasize that expressing fear,
anxiety, and response to pain is quite normal (and OK) at any age,
even adulthood. Correct any misconceptions about disfigurement or
injury. And explain that anesthesia is very safe today and
that patients do
not
wake up during operations but will certainly wake up afterward.
Encourage your teen to read up on the medical
condition and share the information with the family. Reading
and sharing information is an excellent coping mechanism.
One further fear that affects kids of all ages is being seen
naked and having their "private parts" touched. If the
operation involves the genital or anal area, your child will cope
better if you explain in advance that although it might be
embarrassing, doctors and nurses will need to examine these private
areas, especially to check if they're healing after the
operation. Explain that doctors, nurses, and parents are the only
exceptions to the rules about privacy.
Encourage your child's questions about the health problem
and hospital experience, so that other fears and anxieties can be
expressed. Take all questions seriously and answer them to the best
of your ability. If you don't know an answer, tell your child
that you'll find it out, and explain that the doctors and
nurses are happy to answer questions, too.
Relieve Guilt
Children often believe that their medical problem and operation
are really punishments for "being bad." They may not say
so, but they may feel guilty and believe that they've brought
events on themselves.
Explain that the medical problem is
not
the result of anything your child may have done or failed to
do, and that the operation is
not
a punishment, but simply the way to "fix" the
problem.
On the other hand, if the medical problem was caused by an
accident that could have been avoided by obeying safety rules, make
sure your child understands the reason for the rules and will
follow them in the future.
Explaining What Will Happen
Find books, appropriate to your child's level of
understanding, about what to expect at the hospital. Reading
together and discussing the surgery will make the hospital seem
less threatening. Discuss each idea and encourage your child's
questions.
Young kids also will benefit from practicing on a doll or
stuffed teddy bear with toy doctor-kit "instruments."
Your child can take the toy's "temperature" and
"pulse" and listen to its "heartbeat" and
"breathing."
Remember, as you discuss the hospital and surgery, that in
addition to your words, your nonverbal cues convey assurance: your
tone of voice, facial expressions, gestures, and body language send
powerful messages. If you appear fearful, your child is likely to
feel fearful regardless of the words you use.
Pre-Operative Orientation and Tour
Many hospitals offer special pre-operative children's
programs, family orientations, and hospital tours, conducted by
specially trained nurses or licensed child-life specialists
(professionals trained to talk to kids and teens about medical
procedures, comfort them if they're upset or need extra
support, and organize "play time" for hospitalized kids
and teens to get together and hang out).
Call the hospital to schedule a pre-operative tour,
program, or orientation as soon as possible, even from the
doctor's office when the appointment for the surgery is made.
It's best to schedule the appointment for a few days before the
surgery.
An orientation program can remove the mystery of the surgery for
kids and their families by making the hospital familiar and
friendly and the experience predictable.
On the Day of Surgery
When you arrive on the day of surgery, your young child can play
with toys and books you bring from home or sit on your lap and be
cuddled during the waiting time.
You won't be allowed to stay in the operating room during
the surgery, but afterwards, you'll be escorted to the recovery
room to be with your child as he or she awakens. Upon discharge,
you'll receive instructions for further recuperation at home
and for a follow-up visit to the surgeon.
During recovery, there may be times of discomfort for your
child. It can help to explain that your child may be sore or
uncomfortable, but will get better.
Distracting your child, whether with a new book or a visit from
a relative or friend, also can make recovery more pleasant. Just
make sure your child gets plenty of time to rest and
recuperate.
Reviewed by:
Larissa Hirsch, MD
Date reviewed: September 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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