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Off to the Hospital

Surgery Day is closing in.

Later this month, 4-year-old will undergo a surgical procedure that four doctors agree he needs. This isn't the first time he's gone into the operating room, but it is the first since a study on animals raised questions about the potential risks of anesthesia on children. And it's the first procedure that I've questioned ad nauseum and harried over in detail. The doctors have heard -- and answered -- the questions: Are there other ways to get the information you need? Why this and not that? What's wrong with simply giving him the medicines we've been using? What happens if you find X? And what about Y? What if we just wait and see for awhile?

His first surgery was pretty straightforward and quick by all standards: A basic set of ear tubes that allowed him to hear properly for the first time in five months. He was six months old and recovery was quick. We were home just a few hours after the surgery and other than his initial surprise at how loud everything sounded, he was in a happy, playful mood. Unfortunately, the tubes fell out in eight months, leading to a return of thick gunk in his ears.

So, next came surgery No. 2: Replace the ear tubes with a type that would stay in longer. And while we're at it, remove the adnoids that could be causing some issues. Again, a quick recovery.

Procedure No. 3, though, has been more difficult to decide upon. About an hour under general and the procedure will probably have some short-term residual effects. Still, if all goes well, he'll be home the same day, so no long hospital stay -- nothing like what children with serious illnesses and their families go through.

Now that he's older, the preparation questions become tougher. The hospital has children's tours, but will that scare him or help him get comfortable? How much do I tell him? The American Academy of Pediatrics advises that parents talk to children about anesthesia 2-3 days ahead for toddlers and 5-6 days ahead for older children. Be honest and use words they know to describe what they'll feel, the AAP says.

How have you dealt with hospital visits and surgeries with your children -- both those getting procedures and siblings? And what do you do to make sure you're comfortable with a doctor's advice to have surgery in the first place?

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By Stacey Garfinkle |  January 11, 2008; 7:00 AM ET  | Category:  Health
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I had my tonsils yanked when I was 4. Back then, it was an overnight hospital procedure. They didn't let me eat and when I complained that I was hungry, they asked me to be patient and promised me as much ice cream and popsickles I wanted after the procedure.

After the surgery, I asked for my ice cream that was promised to me for being so brave. then they told me that they didn't have any left. The freezer was empty. Sorry!

Liars! Flat out, stinking, unadulterated effing liars!

That was almost 40 years ago, and to this very day, I still have a healthy mistrust for the medical profession. (Maybe it's a good thing though)

Posted by: DandyLion | January 11, 2008 3:47 AM | Report abuse

Dandy Lion - that is just WRONG! How could they not have it for you? I'd still be bitter too.

Posted by: moxiemom | January 11, 2008 7:31 AM | Report abuse

Sound was the first sense I got back after waking up from getting my gall bladder out (2 years ago - as an adult) and the best thing in the world was that I heard my mom talking next to me. Then I could feel her hand and a few minutes later I could open my eyes.

If I were in your place, i'd sit there and sing their favorite songs from the time they wheeled my child out until they squeezed my hand.

Surgery was freaky at 29 and I'm glad my mommy was there!

Posted by: Anonymous | January 11, 2008 7:44 AM | Report abuse

-I- still hate anesthesia! Um, just from personal experience, if he's still having his ear tubes replaced, he might be allergic to feathers in his room. If he has a down comforter or pillows or...really anything in his room, it could be that. I had a cousin who had his ear tubes replaced abour 8 times as a child, until his family moved to a different (smaller) city, and the doctor just looked at him and went "I'm not operating until you've taken all the feathers out of his room." Bam. Cleared him right up. For some reason, doctors in large cities don't seem to always take that kind of stuff under consideration.

Posted by: Kat | January 11, 2008 7:45 AM | Report abuse

My son has had 14 surgeries-some a bigger than others. He is now in college aand not especially traumatized. We got through them by acting like it was no big deal. As a 2 year old I simply said, "Tomorrow we are going to the operation room so the doctors can fix your leg." I always fed him something special at the latest time he was allowed to eat even if that meant waking at 3 AM and going out for breakfast. I usually gave him a small present to open and enjoy while they got him ready. Sure, he cried, threw up etc but I worked hard to build his trust in the medical folks even. Even though I advocated and complained-I didn't let him see that I remained composed and positive and he trusted that things would get better. Surgery is a good time to show what difference a grown up parent can make.
Good luck!

Posted by: BAB | January 11, 2008 8:08 AM | Report abuse

Be honest with your child, good bad or ugly, but MOST of all let them know you will be there!!!

Posted by: cindalu | January 11, 2008 8:09 AM | Report abuse

My daughter had tubes in her ears as well. I was a nervous wreck, but she was fine. We took we out to breakfast afterwards and never had a problem with them.

The one thing that really bothered me though was her doctor's comment about it not being real surgery when he referred her. He said his daughter had had real surgery and this wasn't it. Well, it was real surgery to me; she was knocked out after all.

The ear doctor was wonderful. I think his name was doctor Bahadori.

Posted by: Irish girl | January 11, 2008 8:15 AM | Report abuse

I have been in the unfortunate position of having my youngest child undergo more than 40 surgeries and medical procedures that required anesthesia. I have always gone into the operating room with him while he goes to sleep. It is always difficult but he has never, ever, had an issue or any kind of problem with anesthesia. I think you can feel pretty confident that all will go well.

Posted by: older mom | January 11, 2008 8:17 AM | Report abuse

My 4-yo (3 at the time) had her tonsils and adenoids out last summer, plus new ear tubes put in - 2nd pair. We got a book about tonsillectomy from the library and read it to her a few times in the week or so before the surgery. She would talk about having her tonsils out, but I'm sure didn't really know what it meant.

We didn't have any reservations about the anesthesia (I haven't been reading anything that alarmed me - should I be?). DD was very upset when she woke up and DH had to calm her down - he is her go-to person when she's distressed. Recovery was a nightmare, but I think that had more to do with her personality than things truly being bad.

She really needed the tonsils out for speech reasons. She vocalized through her nose and was very hard to understand. The surgery was transformative in that area, and in her enjoyment of food. She eats like a horse now. We think she just couldn't smell very well before. Totally worth the agony post-surgery.

Posted by: ViennaMom | January 11, 2008 9:03 AM | Report abuse

I, too, remember going to the hospital to have my tonsils taken out. I was 3 years old (yes, I do remember it). They never told me a thing about going in for surgery. Never mentioned what was going to happen. We went into a big old brick building with lots of people in white clothes. My mother plopped me down into a crib (not my own bed), waited until I went to sleep and then left. I woke up, she was nowhere around; I felt completely abandoned. Then a nurse came by and said "are you ready to go?" I thought she meant go home, and answered 'yes' so I was put on a gurney, rolled down the hall and a mask with ether was put on my face.

I remember I didn't cry at all -- was apparently to frightened to cry. In a day or two my parents came to pick me up to go home. Nothing was ever said to me beforehand about the procedure or what was going to happen. My mother's theory is "Don't mention it, maybe they won't notice." The same theory applied to puberty and adolescence -- don't mention the fact she has a body below her neck.

Posted by: TGIF | January 11, 2008 9:15 AM | Report abuse

Similar trauma with tonsil removal in the 1960s. DO NOT read "Curious George goes to the Hospital" to your toddler. It is cute and all goes well but the scene with the shot stayed with me for years. The hospital shooed my parents away as soon as I was in bed, I woke during surgery (I KID YOU NOT!) and hemorraging after the surgery. I woke drowning in my own blood with no mother nearby. I still suffer weekly night terrors 40 years later waking in a sweat believing I am choking on metal instruments.

Flash forward 35 years and my son has an appendectomy. I am there when he falls asleep and there when he wakes. I am a wreck inside but as other reader points out it is the adult's role to be positive about the procedure and the doctors. It was an uncomfortable recovery but I am so proud that my traumas are not revisited on my son. Thanks to more humane hospitals, good anesthesia techniques and a calm mother.

Posted by: samclare | January 11, 2008 9:29 AM | Report abuse

My son had three surguries to clear a clogged tear duct with each being progessively more invasive. During the last one, he was three and the doctor gave him something to put him into a light sleep before the anesthesia. So he saw all of us, including his six y.o. sister, while he went to sleep and heard us telling him how strong and brave he was.

My daughter was a god-send. She talked him through everything before the surgery, promised to be there for him, and was so incredibly attentive that she practically smothered him! But he really responded to it because he trusted her completely.

Seeing him come out of the anethesia that third time (which was more than he'd ever had) was brutual for me but I agree with BAB - never let your child see how nervous you are. My son was comforted by all of us telling him how he was going to be fine going in and again while he was coming out of the anesthesia. What he never saw was me sobbing in the bathroom in fear. Neither did my daughter. To them, I was calm, cool and collected and definitely not worried. (HA!)

So be honest but very positive, have the things that comfort them the best nearby (be it toys or sisters), and never let them see you sweat! Good luck.

Posted by: Alexandria Mom | January 11, 2008 9:36 AM | Report abuse

I go with the "no big deal" approach. Try to get an early morning surgery time to avoid a starving child. Promise a Slurpee on the way home - worked for us!

All the hospitals we went to always let Mom/Dad stay with the child until they were asleep. With a young child I wouldn't consider any other way. They should also come get you BEFORE your child wakes up so you can be right there. Since this makes the nursing staffs job easier they usually don't have a problem with it.

I had a bad ear tube experience where the tubes fell out and the ear didn't heal up. I don't think it's a bad idea to hesitate about elective surgeries for things kids will outgrow. The complication rate may be low, but you can't be sure it won't happen.

Posted by: RoseG | January 11, 2008 10:06 AM | Report abuse

My little brother had hernia surgery when he was 4. Back then, my parents took him into NYC where they were experimenting doing this as outpatient surgery at NYU. Scariest part for his big sisters left home was that parents and brother didn't come home when expected. They were supposed to be home by dinner, but my brother was apparently still throwing up from the anesthesia. So we were home alone, getting scared, and finally went to the next door neighbor. (We were 8 & 10 - old enough to be home alone for a few hours in those days, but not till dinner.)

But my brother milked the surgery for all he could get. Smart kid, even then. Since he was given special treatment before and after surgery - meals, sleeping with mom, etc. - for about a year, when the folks said no, he responded "but I'm the one who had the operation" in the expected sing-song voice of a kid.

My point - he didn't really remember the bad parts. He remembered that it was something that got him special treatment from mom and dad, and might get him more special treatment since they seemed to think it was a big deal.

Posted by: jb | January 11, 2008 10:07 AM | Report abuse

I don't remember my last surgery for ear tubes because I was only 2. However, my mother has always told me that it was different than the first when I was a baby because I was aware somewhat of what was happening. Afterwards I was very cautious about anyone touching me and also easily upset by certain sounds, such as flies buzzing and leaves crunching.
To people questioning whether tubes are necessary, I know that without mine I would have lost my hearing. I had severe ear infections (not allergies) and also have mis-shaped ear canals. Even after having tubes, my ear drums have burst a handful of times, including once as an adult.

Posted by: Anonymous | January 11, 2008 10:54 AM | Report abuse

I work in the dept of anesthesia of a children's hospital. The biggest factor that will affect how your child does is YOU. Be calm, be direct when you help him cope, be loving. If you over-react, he will. If you cry, he will. When children wake up crying it is often something called emergence delirium. This is because of the medications and is usually short lived. Having parents in the recovery room can be a good thing, but only if you are there to comfort your child but you get out of the way when you need to. Studies have shown that apologizing to your child for the procedure, sympathizing and reinforcing how hard this is increases pain scores. Talk ahead of time about how to cope (deep breathing, counting to 5 etc.) and then you direct your child to begin using the coping skill (think laboring woman and a Lamaze partner). This reduces pain scores. Yesterday I was preparing a young teenager for a below the kneee amputation for cancer and the mother of the child in the next room was crying and carrying on about ear tubes. I mean GET A GRIP and count your blessings.

Posted by: anesthesia NP | January 11, 2008 10:59 AM | Report abuse

The pre-surgery hospital tour helped immensely in our case. It calmed both my son and me, and we knew exactly what to expect the morning of the surgery. It was especially helpful to know that some children become combative when they come out of anesthesia. My son didn't, but other children in the recovery area did and I imagine knowing about the possibility is better than not.

Posted by: Capitol Hill Mom | January 11, 2008 11:01 AM | Report abuse

"Yesterday I was preparing a young teenager for a below the kneee amputation for cancer and the mother of the child in the next room was crying and carrying on about ear tubes."

Well, the kid having his knee amputated is not her child. Her child is being knocked out for ear tubes. While it is sad that the teenager has cancer, it doesn't take away how she feels for her child. Just saying.

Posted by: Anonymous | January 11, 2008 12:10 PM | Report abuse

My kid has had 3 open heart surgeries. In our hospitalization experiences we've found that most often - but not always - the basket case kids are the ones with the basket case parents. So - like the others - your child will read your signals so be calm, tell him the truth but keep your nerves to yourself. good luck!

Posted by: maria | January 11, 2008 12:43 PM | Report abuse

"Yesterday I was preparing a young teenager for a below the kneee amputation for cancer"

Boo freaking hoo. Someone should tell this kid that a few years ago he or she would have been DEAD! So live with one leg and enjoy it!

Posted by: antipATRICK | January 11, 2008 12:58 PM | Report abuse

Well, 12:10 we all know how crazy people are about their own kids. See story in the Washington Compost about the mother who killed --oops, sorry ALLEGEDLY killed -- her four daughters several months ago and lived with their bodies in the house. Then there's the Vietnamese father who threw his four off a bridge this week. Way to go, parents. Only strong and stable people have children, right?

Posted by: Anonymous | January 11, 2008 1:33 PM | Report abuse

Yes, 1:33 because those things are the same??????????

Posted by: Anonymous | January 11, 2008 2:03 PM | Report abuse

Also one who did the tonsils/adenoids/tubes in one shot and then was in and out of surgeries regularly through my young life for tube issues.

I was bought a special animal to have with me in and out of surgery. And having my mom there for all of it was the most help of all.

I'd say be calm and sincerely encourage the kid to ask questions- their fear and desire to just go with things might mask some real concerns they have.

Posted by: Liz D | January 11, 2008 2:10 PM | Report abuse

"encourage the kid to ask questions"

Liz, my wife has made a living out of giving shots to kids for a good portion of her adulthood, and I can sincerely tell you that the above advice is one of the worse things a parent can do to mentally prepare a child that is about to experience pain. (as in a shot) Typically the worse tantrums are thrown by the child that brought "The Berinstien Bears go to the Doctor" book to the office, and the mother is trying to talk it out with their child and trying to convince him or her that it isn't going to hurt that bad, it only lasts for a second, blah, blah, blah..., and keeps on asking her child what he or she is afraid of.

I'll tell you exactly what the child is thinking: IT'S GONNA HURT!!! REAL BAD!!!

Taking your child to the doctor to get a shot is one of those cases where "talking it out" only makes it worse.

Posted by: DandyLion | January 11, 2008 2:39 PM | Report abuse

Ahhhh, DandyLion, you just reminded me of my son's last visit to the pediatrician (the 18-month one). My daughter was desperate to go with, in that sympathetic/sadistic "is he going to get a shot?" way of young siblings. But because she was due for her annual checkup anyway, I scheduled them both together.

BIG mistake -- by far one of my worst. I didn't realize that the boy was getting FOUR shots. And in the interim, they had changed the recommendations for the chicken pox vaccine, so my daughter, who thought she was getting no shots, ended up having to get a booster for that.

The toddler was a champ -- 30 seconds after the last one, he was completely over it and on to the next thing. The 6-yr-old, however, was borderline hysterical before they'd even touched her! We got her shot done as quickly and painlessly as possible, but she was so worked up that she was still sniffling 20 minutes later when we got home. Never, NEVER again!

Posted by: Laura | January 11, 2008 2:50 PM | Report abuse

antiPatrick wrote:

Boo freaking hoo. Someone should tell this kid that a few years ago he or she would have been DEAD! So live with one leg and enjoy it!

Excuse me, chances are he or she will die anyway, you idiot! Y'all are hyperventaliting about a kid going under for an hour to get ear tubes. Ever seen a kid come out of surgery for metastatic osteosarcoma and wake up to learn that one of the best docs in the world took one look and closed him back up???

Do you have any idea what the relapse rate is for osteosarcoma? How about the rate of secondary cancers for kids and teens that survive childhood cancer???

My child has gone under anesthesia probably 20 times--all but one of them in my arms. Be there when he wakes up. If you can't go to the OR, have them give him some versed b/f they take him in. HAVE FAITH, in your doctors, your child and yourself. If you don't have all three, get another opinion.

Posted by: Anonymous | January 11, 2008 4:29 PM | Report abuse

I think prepping a kid for a quick shot is not the same as prepping a kid for a surgical procedure requiring anaesthesia.

Posted by: Liz D | January 11, 2008 5:57 PM | Report abuse

I think preparing a child for surgery, whether it is tubes or osteosarcoma, has much the same anxieties and concerns for parents. I think to downplay a parent's concern for his/her child on the basis that you know someone who has it worse is not particularly helpful - though of course, you didn't intend to be helpful. It is most certainly rude. And really, what's the point? Just because you can get away with it, in the anonymity of the internet, is no reason to do it.

Posted by: vklip | January 14, 2008 11:47 AM | Report abuse

Vklip, the intention is not to be rude. My point is that in the grand scheme of things, not every issue deserves a 10/10 response. How can a child know what to react to post surgery or pre surgery for that matter if the parent does not recognize when something is non-emergent, is not life threatening and is routine for 99.9% of the population. I know what it's like to have things happen to my own children. I know the panic. But it is not OK to overreact. Cry when you are out of earshot of your child. Your response to my post was really unkind. The anonimity of the internet certainly allowed you to sling a little mud. Try living in my world for a day and then pass judgement.

Posted by: anesthesia NP | January 14, 2008 2:32 PM | Report abuse

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