These tips will help you (and your child) be your best on the big day.
Dr. Nina Shapiro: Millions of children each year have elective surgery. But what matters to you is that one child -- yours -- who is scheduled for a procedure. Once you've made that decision to schedule surgery, take a few steps back and make some plans. Just as doctors have to take care of themselves in order to take care of others, you need to take care of yourself in order to take care of your child. Here are some tips:
1. Try to relax. As anxious as you may be, any anxiety you have will be picked up like a magnet by your child. A positive attitude on your part goes a long way.
2. Talk it over -- with your spouse, your own parents, siblings, and friends. Try to find someone you know with a child who's had a similar procedure. Hearing about their experience can help you prepare yourself and your child for what's ahead.
3. Ease your guilt. Many people feel guilty about scheduling elective surgery for their kids -- feeling that they are unnecessarily putting them in harm's way, or causing them undue pain. Even though it is not "life or death" surgery, elective surgery is still necessary surgery, and you are doing it to help your child.
4. Ask questions. Ask your surgeon, your anesthesiologist, and nurses. No question is a "dumb" question. Health care professionals often make assumptions about your medical knowledge if you nod and agree to everything. The more you know, the more confident you'll be about the plan.
5. Get some rest. Eat right, get some sleep, etc. You need to be healthy during your child's recovery.
OK, now the important part. What about your child?
I can tell you that the worst mistake parents make is NOT telling their child that he or she is having surgery. Telling a child having surgery that they are just coming for a routine doctor's appointment is cruel, and an enormous breach of trust. That said, you need to prepare your child in an age-appropriate way, to help them understand what is happening, and allay their fears as best you can:
1. First, explain the "problem" to your child in words they can understand ("you are getting so many ouchies in your ears these days"). Next, explain that "the doctor you met will help fix your ouchies." In general, steer clear of phrases like "the doctor will cut you open to cure you," "you will have stitches with a needle," "you'll be put to sleep with gas," etc.
2. Kids (especially young kids) don't like having things taken from them, especially when it's their own body part. So, for example, if they are having their tonsils out, you can say "the doctor will fix your tonsils."
3. Both kids and adults are fearful of anesthesia, oftentimes more so than the surgery itself. Younger children fear separation, abandonment, and pain, while older kids fear needles, knives, damage to their bodies, being out of control, waking up during surgery, or not waking up at all. While there are risks to anesthesia, it is much safer than it was years ago. You can tell your child that they will have a special nap with a deep sleep, and will not feel anything that is being done. Many operating rooms allow a parent to be present while the child is going off to sleep, and to be there as soon as the child is waking up in the recovery room. From the child's perspective, the parent is present the whole time.
4. Explain what will happen. Find books about having surgery ("Goodbye, Tonsils," written by 7-year-old Julianna Hatkoff is a favorite of mine), practice with toy doctor kits on dolls or teddy bears, and encourage your child to ask questions.
5. Many hospitals and surgery centers provide tours and orientations for families scheduled for surgery. Decide with your child if this would be right for them. If so, find out if your facility has child-life specialists (people trained to talk to kids about medical procedures, provide comfort, toys, and "doctor-free" play areas in the hospital).
6. Make a scrapbook. Many children like to document their experiences. Ask your doctor and facility if you can take pictures of your child before and after surgery. Or, your child can draw pictures or write a journal about their experience.
7. The big day. Expect to arrive at the hospital or surgery center one to two hours before your scheduled time. Your child will not be able to eat or drink, so come prepared for some crankiness. Some parents like to "sympathy fast," and not eat or drink along with their child. I don't recommend that. While you may not want to slather your pancakes with syrup and chow down in front of them, you should discretely eat and drink something. You are not the patient, but the caregiver, and need not be hungry, decaffeinated, and cranky yourself. Pack as you would for a very long plane flight that has no limits on carry-ons. Toys, books, games, favorite blankets, etc., all work. This is the time to break out that portable DVD player and favorite DVDs. Your surgeon may be running late -- make sure that battery is fully charged, or bring an extra one! A very simple "after-surgery" toy is fine, but save any elaborate treats for the recovery days. Right after surgery, your child will not be up for designing a Lego village or coloring by numbers.
8. After. Depending on the type of surgery, you may or may not go home that day. More and more elective surgeries are performed as "outpatient surgery," where your child goes home that night. Either way, you will be able to be with your child 24 hours per day if needed, even in the hospital. When you do go home, you'll get instructions on recovery issues, and what to expect during those days.
Nobody wants surgery, especially for their child. But if it has to be done, a little prep goes a long way.
|Dr. Nina Shapiro is a graduate of Harvard Medical School, and she completed her residency in ear, nose, and throat surgery at Harvard. She is an Associate Professor and Director of Pediatric Ear, Nose, and Throat at the Mattel Children's Hospital at UCLA. She has treated tens of thousands of children with ear problems, sleep problems, and breathing problems. She lives with her husband and two young children in Los Angeles.|