Calming a young child before surgery -- and her mom, too
You may have missed Kayris' good question, buried as it was under the Baked Ziti recipe. She asked:
I found out today that my 2-year-old will most likely need eye surgery and an MRI before that. Any suggestions for making it easier for a child so young, and any suggestions to get ME through having to see my child under general anesthesia?
Our hearts go out to her and the family, obviously; this is going to be hard to endure no matter what advice we can give. I sent her question to Dr. Michael Crocetti, director of pediatrics at Johns Hopkins Bayview Medical Center. Here are his thoughts:
"Having surgery or a medical procedure that requires sedation can be scary and very anxiety provoking for the child and parents. Fortunately, doctors, nurses, and other hospital staff that specialize in pediatric sedation and anesthesia are experts at easing anxiety and going through each step of the process until you feel as comfortable as possible.
"Also, most pediatric centers decorate their rooms and procedure suites in a warm, family-friendly way."
Hospital staff, he says, usually take the age of the child as a cue for how they should work with the family. "Most 2-year-olds have anxiety around strangers and new environments, so for them it's all about surrounding them with familiar things - a special blanket, toy, book, etc.," Crocetti writes.
And even though mom and dad may be extremely nervous about watching their child go through surgery (I would be!), Crocetti writes that it's all the more important to stay calm at a time like this. "Parents should try and appear calm and collected with their children, which I know can be tough, but children can sense your anxiety," he writes.
"Parents are usually allowed to go into the procedure area or operating room with the child. How far the parent goes is dependent on their comfort level and how calm and matter of fact they can keep themselves. Usually children are sedated in a gradual fashion with medications that first make them sleepy followed by stronger medications that put them fully asleep. The parents usually are asked to leave the room once the child is asleep."
The good thing, Crocetti writes, is that kids really won't remember anything from the time they fall asleep until they wake back up after surgery.
Do any of you who've gone through this have advice to share?
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Comments
We've had tubes. When one of our boys was three he got tubes. When he came out of anesthesia, he was beside himself and tried to pull out his IV. You should be prepared for this. Anesthesia can be very disorienting.
Another one of our children had some facial surgery when she was about a year and a half. The doctors staff was very solicitous. There were bubbles and balloons in the office (IIRC). This was a pediatric dermatologist. You're probably better off having surgery done by a doctor who specializes in treating children.
Posted by: soccer dad | December 8, 2008 10:41 AM
Thanks for answering my question! The surgery probably won't be until March, so I have some time to get used to the idea.
Posted by: Kayris | December 8, 2008 9:06 PM
As a practicing CRNA or nurse anesthetist with small children, I understand firsthand the anxiety that both parents and child go through when faced with the prospect of surgery and anesthesia.
There is a fantastic book entitled "Sweet Dreams at the Hospital" by CRNA author Marjorie Bregemann, illistrated by Karen Monckton and published by the American Association of Nurse Anesthetists (AANA). This is a coloring and activity book for parents and children to work on together that describes what the child can expect during a hospital stay for surgery. All the characters in the book are friendly animals, and the child can color the book to make it more personal.
The book is available from the AANA website at this link.
http://www.aana.com/Resources.aspx?ucNavMenu_TSMenuTargetID=159&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=206
As soccor dad mentioned above, anesthesia can be disorienting. Most children wake up kicking, crying and pulling at their IVs and monitoring lines. This is normal. Children also regress during this period of stress, so you can expect to have to 'baby' your two year old a bit more.
Some hospitals let the parents remain with the child until anesthesia is induced (the child is asleep), and some do not. This is facility specific.
At many hospitals, you may have both an anesthesiologist and a CRNA or nurse anesthetist taking care of your child. In most hospitals, the CRNA will remain with the child during the entire surgical procedure and anesthetic. Johns Hopkins has some spectacular Nurse Anesthetists who specialize in providing anesthesia to the pediatric population.
Hope these comments help. All the best for a smooth procedure and speedy recovery.
Posted by: Numb CRNA | December 9, 2008 5:24 AM
My 3 year old had surgery on March 13, 2009. Tonsillectomy and adenoidectomy. She was great until she woke up from the anesthesia. She bit us, punched us, head butted, ripped her IV out, and screamed for over an hour. It was horrifying. When she screamed to be put down, she proceeded to slam her head into the wall and bite herself.
Now, 2 weeks later she is suffering from night terrors. Let me tell you that before the surgery she would get up 1-2 times a night just calling for me, but now she wakes screaming and thrashing around. Lastnight, she coughed so hard it scared me. I asked if she was okay, she said she was but that her throat her just like when the doctor put the big tweezers in her mouth. NEVER, has the doctor put big tweezers in her mouth, but during surgery. I think she woke up, and this traumatized her, which has led to her night terrors.
Any suggestions? We are visiting a therapists office this week, so if all else fails, lets hope she can help her with the night terrors.
Posted by: Monica Wilson | March 30, 2009 7:27 AM