Wednesday, October 16, 2013

Taking Your Child to Surgery - Some Useful Tips

My 4 year old had to have his tonsils and adenoid out about a month ago.  I accompanied him into the theatre and stayed until he was anaesthetised.  He settled onto the bed easily, accepted the mask on his face without a twitch, closed his eyes and immediately went to sleep.  The nurse was astonished.  She asked “is he always this compliant?”  While he is a good kid, he’s a pretty typical 4 year old.  When I told her we’d practiced for the operation the night before she said “bless you – it makes it so much easier on everyone when they (and you) are calm and well prepared”.  I wondered why they don’t suggest it when you book in for surgery.
Here’s what we did – in case it can help someone else:
·         We only told him about the surgery the day before.  No point letting him build it up in his head.  He’s ok with change and isn’t wedded to routines, so we didn’t want to give him too much thinking time. If he struggled with change we may have told him earlier.
·         The evening before we told him we were going to play “going to hospital”.
·         I am fortunate enough to have a theatre gown, hat, mask and booties.  I work in a hospital (in an administrative role) and somehow ended up with them after a work fancy-dress event.  So I put them all on. You could make do with a scarf, apron etc.  I put on the washing up gloves too! I then called for my patient.
·         My husband carried my son in and laid him on the couch.  He looked nervous and also ready to do something fun.
·         We had my husband’s dust mask from the shed and I, the doctor, explained that it was going over his mouth and nose, and that it had special air in it.  The special air had medicine in it that would help him fall asleep and then we’d do his operation. He’d stay asleep and wouldn’t feel anything. He knew his tonsils were coming out but we never specified cutting or anything remotely threatening/scary.
·         We got the toy doctor kit and I then tried to be as funny as possible – tickling him with my instruments and generally hamming it up.
·         We then had him “wake up” and told him his throat was a bit sore and that we’d give him medicine and ice cream.
·         Of course then his big brother had to have a go at being the patient and my younger son got to be the nurse.  He loved it.
The whole thing was a big game.  The next day was so much easier than it may have been as a result. 
A couple of other things I wish I’d known about tonsillectomy/adenoidectomy in kids before we went ahead:
·         They arch/stiffen their body just before they completely lose consciousness.  It is perfectly normal and happens to almost everyone. I wish I’d known that – it scared me at the time.  The anaesthetist reassured me it was normal, but only when I asked.
·         My son recovered physically quite quickly.  He was eating toasted sandwiches by day 3 post-op.  What wasn’t so smooth, but is apparently very common, was the 10 nights of night terrors all night long.  He’d sleep for 45 minutes to an hour, wake up in the grip of a night terror, and take about 30 minutes to settle down from it.  He’d then sleep for another 45-60 minutes and it would start all over again. During the night terror his body was stiff and unyielding.  He didn’t want to be held or comforted. He couldn’t answer questions or respond to commands.  His night terrors lasted 10 days, but apparently they can go for as long as 2 weeks.  His disturbed sleep was also exacerbated by night time episodes of copious floods of sticky, mucous-y saliva.  He found this extremely upsetting, which of course didn’t help him sleep.
All in all it wasn’t an experience I’d care to repeat, but could have been a lot worse.  The sleep deprivation for those first 10 days was horrible.  We only found out how common the night terrors were and how long they last on day 10 and I wish we’d been expecting it from the start!

This is Michelle's son a month after the operation:

Michelle Austin

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