A scheduled surgical procedure for a child is always frightening. Here’s how to prepare your child for an op.
An op to remove tonsils and adenoids is a fairly common surgical procedure for young children. While hospitals are geared up to make it as pleasant and unalarming, it is, understandably, a daunting experience. So, preparing your child beforehand will reduce the anxiety.
My son’s snoring, periodic yet alarming sleep apnoea and associated speech delay finally sent me to an ear, nose and throat specialist. Within 10 days, my son, who was almost four, was booked into a local hospital for a tonsillectomy and the removal of his adenoids.
We entered the children’s day ward armed with distractions – books, puzzles, stickers, crayons, playdough and headphones for the TV. Three other children were already there and I handed out fistfuls of playdough, despite the arched eyebrows of a few nurses. Playdough, I soon discovered, has a particular way of getting all over starched pre-op hospital gowns. We waited and played, watched TV and waited, and then they brought the pre-meds. This concoction, I later learnt, helps eradicate any memory of the procedure.
Provide information about the op and the chain of events that your child can understand. If your child is a bit older, you can refer to a book or show pictures. Bear in mind to not give information that will be more alarming than helpful. Explain the problem and why surgery is needed. Don’t rely on the hospital staff to do this. Be honest about pain, but reassure your child that you will be there the whole time. Try doing a hospital tour before the day of the operation, to familiarise your child with the environment and meet some of the nursing staff.
After the operation
Santi Steinmann, who is based at Netcare St Augustine’s Hospital in Durban, warns that children can become disorientated after anaesthetic, and will often cry and fight with their parents and the nursing staff. “The best thing you can do is to reassure them. Make them feel safe and loved and then they will calm down and go to sleep.” A very useful point to bear in mind here is that they do not cry because they are in pain. “They are given adequate pain control in theatre,” says Steinmann.
On the morning of my son’s op, the children who were first in line began to return to our day ward from theatre. Although somewhat dazed and confused, they fell asleep peacefully, so I was not unduly phased as I left my child on the operating table to run downstairs for a cup of coffee.
When he did wake, he was as they had warned – distressed. I was prepared for this, but things swiftly escalated and I was told to get on to the bed with him quickly and hold him. Then all I heard was nurses giving each other quick instructions. “He is losing colour, bring me oxygen, and check his pulse, quick, we need the oxygen now!” And then the words I was really hoping not to hear, “we need to get him back into recovery.” Recovery is a sterile area where I would not be able to be with him.
Knowing this, I started to sing softly – the lullabies I had sung to him as a baby. I hummed and sang and held him close, hoping he would know he was safe. His pulse rate normalised, his rapid breathing subsided, his colour returned and the team of super-competent nursing staff dissolved into the background.
Staying the night
Samantha Shepherd, who is based at Mediclinic Constantiaberg hospital in Cape Town, says that for a parent staying overnight, reclining chairs with pillows and blankets are available. “I suggest parents bring a comfy tracksuit and night socks. A small book light is very convenient if they wish to read after 8pm because the TV and lights go out automatically to ensure the young patients get their rest.” Most private hospitals seem to provide a similar service, with St Augustine’s giving the parent a sleeper couch with pillows and blankets. Nursing staff are, of course, more than happy to accommodate parents overnight as no one comforts a child in pain or distress quite like a parent can.
Most hospitals accommodate parents overnighting, but check with your chosen hospital first before going ahead with surgery. Also, due to COVID-19, overnighting with your child may not be permitted depending on the current lockdown level.
what your little patient will need
- Special blanket or toy.
- Set of headphones for the TV if there is one.
- Familiar drinking cups or bottles for babies.
- Change of pyjamas and a few spare nappies (even for the toilet trained).
- Slippers and a dressing gown if it is cold.
- Puzzles, crayons, playdough, books to distract while waiting for surgery. These are also great for reading afterwards when confined to bed.
- A damp face cloth in a plastic bag that can seal for cleaning faces afterwards.
- A small gift to distract them when they wake up so that the procedure feels like a special event.
and for you
- If you are staying overnight, get someone to bring you proper food from home. Alternatively, buy vouchers for canteen food if this is an option.
- If there is no hospital snack bar, take some fruit and sandwiches to keep yourself going.
- Have a change of clothes in case your child spills anything on you, some bed socks and tracksuit pants.
- Bring your own blanket, sleeping bag or duvet and a pillow.
- Stock the home fridge and freezer and precook meals for yourself and the family.
- Organise playdates for younger siblings who may feel excluded and not understand why your attention is focused on the recovering child and pick up some special treats for them.
- Find someone who will release you for a walk, a yoga class or some sort of exercise to keep you strong during your child’s recovery.