My daughter was 13 months old when she needed her first surgery. I was a basketcase, but luckily, she had no idea what was happening. Still, it was hard. When she got a little older and had to have other surgeries, things were a little more challenging. She asked questions and sometimes, I didn’t know how to answer her. I wanted to give her the information she needed to process what would be happening to her, but I didn’t want what I said to make her feel more concerned or stressed. 

Three Most Common Fears
According to Dana Achary, a Child Life Specialist at Our Lady of the Lake Children’s Hospital, most children have one of these three common fears:

1. Separation from their parents
2. Waking up during the procedure
3. Not waking up ever again

What Parents Can Do to Help
The most important job adults have when giving children potentially upsetting information is to first be honest. Achary shares, “Honesty is key. Don’t bring your child to the hospital with her not knowing what is happening. Your child may lose trust in you and it makes the experience much more difficult.” She also says that children are resilient and can often understand and accept things that sometimes parents didn’t know they could handle.

Secondly, provide them with step-by-step information. Let them know what will happen when they arrive at the hospital, when they go to pre-surgery, when they are taken for the procedure, and when they wake up. Will they be going home on the same day as the procedure or stay for a night or two? Like adults, kids want to know what will happen.

Next, don’t cause unnecessary anxiety. The amount of information, and when the information is delivered, typically depends on the age of the child. Older children may be told about a procedure a week in advance, where a younger child needs a shorter time. Older children can understand information with more scientific terms, younger children need less detail and more developmentally-appropriate language. For example, instead of “an induction mask with anesthesia,” a younger child may need to hear that “a special mask with sleepy air” will be used to help them fall asleep. Local mental health counselor Tara Dixon suggests, “Because children have an underdeveloped emotional vocabulary, it’s important to pay attention to their body language. Be careful to notice the small signs, such as moments of silence or less eye contact. These are indicators that your child may need more information or another explanation to fully process what you are saying. After giving them the time to process the information, use open-ended statements such as ‘You got quiet after my statement. Tell me about that.’ Using open-ended vocabulary helps your child explore his/her individual concerns or anxieties.”

Finally, be available to your child with an open line of communication. “Ask your children what they know about what will happen to them and let them lead the conversation,” suggests Achary. A child may take time to think about the situation and it is important to be available to him or her now and later. 

Special Surgery Strategies
Our Lady of the Lake Child Life Specialists, or “hospital teachers,” allow children to experience some of the surgical experience pre-surgery. Having knowledge and familiarity with the various rooms, equipment, and people can help to ease stress and anxiety. Achary will often let children hold and explore things like the blood pressure cuff, the pulse sox sticker that the child will wear, and the EKG leads. She lets them see the pre-op area and points out how many people are bustling around to help. Achary shares that even though parents aren’t allowed in the operating room, special comfort items, such as stuffed animals, are welcome to help soothe the child.

A Little Extra
For children with special needs or high anxiety, parents can speak up for their children to receive a more individualized experience. At Our Lake of the Lake Children’s Hospital, parents can register for additional support. There are a variety of things that can be done to reduce anxiety for the child. ■