Karen’s son was only 18 months old when he had to have surgery to repair blocked tear ducts. “I remember holding him in my arms while they gave him the nitrous, and he started crying,” she recalls. “The nurses told me that it was OK, that he was taking in the nitrous faster that way. Then his eyes rolled into the back of his head and he went limp, and they took him out of my arms.” Although it was a scary moment that she wasn’t entirely prepared for, Karen and her son both made it through the day just fine.
Surgery can certainly be scary for patients of ALL ages. When a child needs to have a surgical procedure, the fear is doubled. Both children and their caregivers experience anxiety, making advance preparation all the more important. Fortunately, the experts at Cincinnati Children’s Hospital Medical Center (CCHMC) have several tips to help children — and you — get through the day.
INFANTS
Routine and consistency are of the utmost importance with infants. When preparing an infant for a surgical procedure, the biggest obstacle will be taking them out of their routine. They might wake up earlier than usual, and they will most likely miss a feeding due to eating and drinking restrictions. Your child may be tired, hungry or generally cranky the day of surgery. This is absolutely normal.
You can try to soothe your child with comforting, familiar items. Bring a familiar lovey such as a pacifier, blanket or stuffed animal to the hospital.
It may be helpful to have teddy on hand, but Cindy Pettit, Pediatric Nurse Practitioner with the department of Anesthesia at CCHMC, says the most important asset your infant has prior to surgery will be you. Simply be there with your child. Be encouraging and calming towards your baby by dimming the lights, singing favorite songs, or even taking a stroll through the hall.
TODDLERS
Toddlers are well known for being opinionated and for saying “No!” They are more aware that they have some control over their world, and surgery may make them feel like they have none.
If your child enjoys making decisions, allow him to choose what he would like to wear the day of surgery, allow him to pick which stuffed animal he would like to bring with him, and include him in the process of choosing entertainment and snack options for afterwards.
Toddlers only need to know about their surgery a few days in advance. Pettit cautions that toddlers may act out once they know they’re going to have surgery, and this behavior is typical. Toddlers acting out are expressing their anxiety, and they should return to their normal behavior after surgery.
PRESCHOOLERS
By the time a child is 4 years old, he has most likely visited with his pediatrician a handful of times. He may express fear at doctor visits, or face them with a smile. But a new medical facility with unfamiliar faces may frighten your young child.
The experts recommend telling a toddler that he will be having a procedure only a few days beforehand, and to play to his strengths when explaining what’s going to happen. Preschoolers have a growing vocabularies and love pretend play! Play doctor with your child, and listen to a stuffed animal’s heartbeat with a stethoscope and take its temperature. Then allow your child to give you a checkup, and give him a little checkup, too.
Many children have favorite iconic characters that they love and trust. Television shows and book series often have episodes or books that focus on doctors, hospitals and health care. See what your local library has available. Kids trust their favorite characters, so hearing them discuss medical information will be reassuring.
SCHOOL-AGED CHILDREN
School-aged children may have misconceptions from the media or friends, so it’s best to approach the idea of surgery openly with them. Explain in simple terms what will happen the day of surgery and why. An open dialogue will hopefully clear up any misconceptions. Let kids this age know about their procedure two weeks prior. This will give your child several opportunities to ask questions and discuss concerns with you.
School-aged children (and all children ages 3 and older) may benefit from a tour of where their procedure will take place. Lauren Kathman, a certified child life specialist, is part of a team that gives tours to children who will have surgery at CCHMC. Tour administrators let children see basic medical equipment, put an ID bracelet on a stuffed animal and give it a quick checkup, view the surgery room, and also introduce kids to the many flavors of “sleepy air.” A same day surgery tour will familiarize your child with the hospital and may put his fears at ease.
TEENAGERS
Teenagers love a sense of independence, but a surgical procedure can make a teen feel dependent on their parents. After a procedure, he may need to take time off from school, work and other favorite activities. Being honest with your teen, and making him a part of the planning process may help ease pre-surgery tension.
Discuss with your teen’s employers, coaches and teachers how much time he may need to recuperate, and figure out what can realistically be done while he heals and what needs to be pushed back. Keeping other adults in your child’s life in the loop may reduce the pressure he feels regarding due dates and obligations.
Kathman recommends letting your teen know it’s OK to be nervous, scared and even to cry. Teens may feel the need to put on a tough face, but it’s important that they’re honest about their pain levels so they can receive proper pain management.
Both Pettit and Kathman agree that parents know their children’s personalities best. What works for one child may not work for another. Each child, condition and procedure is unique. In general, being there for him, giving him honest information regarding his procedure, and allowing him to make choices throughout the process can put him at ease.
Cincinnati Children’s Hospital Same Day Surgery Tours
Burnet Campus
513-636-8298
Tue/Thu 6 p.m., Sat 10 a.m.
Liberty Campus
513-803-9820
Mon/Wed 7 p.m., Sat 10 a.m.
For Parents and Caregivers
Regardless of your child’s age and what surgical procedure he’s having, it’s normal to be anxious. During the process of diagnosis and pre-surgery all the way through post-op, your child will look to you for answers and for strength. The experts at CCHMC recommend that you take care of yourself, and arm yourself with knowledge.
Prior to surgery, make sure you are hydrated, and getting good nutrition and proper sleep. Taking care of yourself will allow you to take better care of your child when he comes out of surgery.
Consider making arrangements for siblings on the day of surgery, so you can focus your energy on your patient.
If you would like to know more about your child’s condition or the procedure itself, ask his doctor about recommended resources. Doing “safe research” with recommended resources will allow you to learn about a condition or procedure, without getting misinformation from a regular internet search. If you and your child come up with questions prior to surgery, write them down in a journal, and ask the doctor.