Preparing your child for surgery

By Lisa A. Smith, MD

It’s been said that “minor” surgery is surgery on someone other than yourself. One exception to this old adage is when your child needs surgery.
All children can benefit from psychological preparation for planned surgical experiences. Adequate preparation can help children feel less anxious about the surgical process and have a smoother recovery.
Studies show significant differences in post-surgery anxiety between children who were prepared for surgery and those who were not. The differences are consistent across age groups and between genders, and regardless of the pain level involved.

Preparing yourself
To prepare your child for surgery, you must first prepare yourself as a parent. Become as knowledgeable as possible about the planned surgery. At the preoperative office visit, ask your child’s surgeon about the length of the procedure, expected time in the operating room, pain control, wound care and recovery time.
Most surgeries are now “same-day” procedures requiring no overnight or prolonged stays. At least one parent may stay with the child at all times except while the surgeon is operating. After surgery, you may stay with your child in the recovery room. If hospitalization is required, many hospitals, like T.C. Thompson Children’s Hospital at Erlanger, allow parents to stay overnight, minimizing separation anxiety for both parents and children.
As a parent, you can help your child by remaining calm. Simplify your life during this time, and don’t be afraid to ask for help from family and friends. Children, including infants, will sense if you’re feeling frightened or stressed. Even nonverbal communication—relaxed facial expressions, gestures and body language—can give positive assurance to your child before surgery.

Preparing your child
Once you’re prepared for your child’s upcoming surgery, you’re ready to prepare your child.
How you do so will depend on your child’s age, maturity and level of development. Children cope much better with medical procedures if they have some idea of what will happen and why it is necessary. Try to explain in terms appropriate for your child’s level of understanding, correcting misconceptions and dispelling fears and feelings of guilt.

Infants
Although infants are too young to understand verbal explanations, they can benefit from your efforts to minimize stress in the hospital environment. Stressful situations for infants may include separation from parents, strange sights, sounds and smells, changes in routines or sleep patterns, and different caregivers.
Before the day of surgery, maintain your baby’s routine. Inform the nursing staff of your baby’s schedule, including sleep patterns and feeding habits. Plan to distract, rock, walk and comfort your baby during the brief period before surgery when eating and drinking are not allowed.
Bring your baby’s favorite blanket or toy or other security item to the hospital to make the environment seem more familiar. Give lots of love, and let your baby know that you will be nearby.

Toddlers
Common hospital fears for toddlers may include being left alone, staying in a strange bed or room, losing the comforts of home, family and possessions, being in contact with unfamiliar people, painful procedures, medical equipment that looks and sounds scary, and feeling helpless.
Before surgery, help your toddler by reading books about going to the hospital. Use dolls or stuffed animals to play out hospital scenarios. Use clear, simple language about hospitals and medical procedures.

Preschool and school-age children
Interactive play and books also help preschoolers and school-age children. Touring the hospital before surgery allows them to see and hear events that they will experience on surgery day.
Make sure preschoolers and young children know why they will be having surgery and clear up any misconceptions. Often, children think they have done something wrong, or they think needles are used on kids who are “bad.”

Teens
Common fears and concerns of teens who are facing surgery include

∑ loss of control
∑ being away from school and friends
∑ having a body part damaged or changed in appearance
∑ fear of surgery and its risks
∑ pain
∑ dying during surgery
∑ fear of what others will think about their sickness or hospitalization.

Books and Internet articles can help your teen learn more about the upcoming surgery. Let your teen know that it is acceptable to be afraid and to cry. Recording thoughts and feelings in a journal may be helpful to your teen. Encourage friends and family to call, visit or send cards after surgery, so your child will be assured of a strong support system.

Surgical care
Pediatric surgeons specialize in the surgical care of children. They are surgeons who, by training, are oriented toward working with children and understanding their special needs. By discussing a proposed surgery ahead of time with the pediatric surgeon, parents can help their children cope effectively with the experience.
Parents are the most important resource for answering children’s questions. So it is vital that parents understand what will happen during their child’s experience with the hospital/surgery.

Dr. Lisa A. Smith is a pediatric surgeon with University Surgical Associates and an assistant professor of pediatric surgery at the UT College of Medicine Chattanooga. For more information, call Erlanger’s physician referral line at 423-778-LINK (5465).