How do I prepare myself and my child for her general anesthesia?
May 9, 2010 5:49 PM Subscribe
How did you prepare your young child for general anesthesia? How did you prepare yourself?
Our daughter, about age 3, is going to have a molar crowned. That tooth was never quite right since it erupted, and now it has been badly decayed by dental caries. It's going to be a tough job, and her pediatric dentist is going to do it at an outpatient surgery center. They will put her under general anesthesia, administered by an anesthesiologist.
I am freaking out. I've been very fortunate in my life, not to have much experience with anesthesia. (Just my epidural.) I can't get over the idea that our daughter is completely helpless, and we are going to hand her over to have this done. It's part of being a parent, I guess.
Now as to her - I don't want to show her my distress. I want us to tell her what will happen without complicating it. She is very much able to think about things, wonder where we are going, why we are there, etc. She remembers a recent painful hospital experience where we were in the ER for her, and so she is already saying she doesn't want the dentist to fix her tooth because "it will hurt." I think she's equating it with her ER experience, and I'm afraid of how she will react when we get to the surgery center.
Please tell me how you prepared yourself and your young child for your child having general anesthesia. How did you feel while walking away from your child, and while waiting? How did your child react? And can you reassure me about the procedure?
Thanks!
Our daughter, about age 3, is going to have a molar crowned. That tooth was never quite right since it erupted, and now it has been badly decayed by dental caries. It's going to be a tough job, and her pediatric dentist is going to do it at an outpatient surgery center. They will put her under general anesthesia, administered by an anesthesiologist.
I am freaking out. I've been very fortunate in my life, not to have much experience with anesthesia. (Just my epidural.) I can't get over the idea that our daughter is completely helpless, and we are going to hand her over to have this done. It's part of being a parent, I guess.
Now as to her - I don't want to show her my distress. I want us to tell her what will happen without complicating it. She is very much able to think about things, wonder where we are going, why we are there, etc. She remembers a recent painful hospital experience where we were in the ER for her, and so she is already saying she doesn't want the dentist to fix her tooth because "it will hurt." I think she's equating it with her ER experience, and I'm afraid of how she will react when we get to the surgery center.
Please tell me how you prepared yourself and your young child for your child having general anesthesia. How did you feel while walking away from your child, and while waiting? How did your child react? And can you reassure me about the procedure?
Thanks!
My son had anesthesia when he was about 4 for an inguinal hernia. The anesthesia itself was not a big problem for him, he was more scared by the IV that preceded it. I just told him they would give him some medicine that would help him sleep, and that when he woke up he would be all fixed up and we'd take care of his belly-button stitches over the next few days. He was fine with it. He did get nauseous/sick from the anesthesia (I tend to as well, it's pretty common) but that didn't last too long.
When he was about 12 he had anesthesia again to have some molars removed for braces; then my younger son had a similar procedure.
In all three cases I was the one with anxiety about it --- they didn't know there was anything to worry about --- odds are so so slim that anything can go wrong with anesthesia, especially the minute amounts they use for kids with minor/short procedures, so I know my own anxiety was irrational --- that helped me present a calm face to them about it.
She will be fine. How she handles this is in your hands --- kids follow their parents' lead in how to handle things. I was able to hold my pumpkin's hand while the anesthesia took hold, and I was there when he woke up. He was fine though, I am sure that the policy of letting parents be there has more to do with reassuring parents than with reassuring the kids!
Best wishes to you and your daughter!
posted by headnsouth at 6:11 PM on May 9, 2010
When he was about 12 he had anesthesia again to have some molars removed for braces; then my younger son had a similar procedure.
In all three cases I was the one with anxiety about it --- they didn't know there was anything to worry about --- odds are so so slim that anything can go wrong with anesthesia, especially the minute amounts they use for kids with minor/short procedures, so I know my own anxiety was irrational --- that helped me present a calm face to them about it.
She will be fine. How she handles this is in your hands --- kids follow their parents' lead in how to handle things. I was able to hold my pumpkin's hand while the anesthesia took hold, and I was there when he woke up. He was fine though, I am sure that the policy of letting parents be there has more to do with reassuring parents than with reassuring the kids!
Best wishes to you and your daughter!
posted by headnsouth at 6:11 PM on May 9, 2010
Our son had GA at 3 years because of a shitload of cavities. It was scary (for Mom and Dad) but he was finen - he was groggy for a few hours afterward, but could eat dinner.
Your child is in more danger driving in a car on the way to and from the surgery than she is from the procedure itself.
posted by KokuRyu at 6:15 PM on May 9, 2010
Your child is in more danger driving in a car on the way to and from the surgery than she is from the procedure itself.
posted by KokuRyu at 6:15 PM on May 9, 2010
I don't have experience with general with my child. I have had some luck with playing doctor/dentist, etc.
I would ask THAT anesthesiologist how is will go and play similar games with her. The mask would rob be a little scary so get her used to that.
Also laying down on a bed like that is pretty weird for a kid.
Me and my almost-2-year-old (at the time) traced his body on big paper several times. When he later had to lay down in the ER he lay down VERY still as I "traced" him and the doctor worked on his head wound.
Tracing might be fun and you can tell her to lay down just like when you traced her. And maybe even pretend to trace her. It was somehow really calming for my son.
posted by beccaj at 6:17 PM on May 9, 2010 [2 favorites]
I would ask THAT anesthesiologist how is will go and play similar games with her. The mask would rob be a little scary so get her used to that.
Also laying down on a bed like that is pretty weird for a kid.
Me and my almost-2-year-old (at the time) traced his body on big paper several times. When he later had to lay down in the ER he lay down VERY still as I "traced" him and the doctor worked on his head wound.
Tracing might be fun and you can tell her to lay down just like when you traced her. And maybe even pretend to trace her. It was somehow really calming for my son.
posted by beccaj at 6:17 PM on May 9, 2010 [2 favorites]
I just had my first general anesthesia experience a few months ago at age 32. Even as an adult, hearing everyone's stories about general anesthesia, what it felt like, and so on, I was still a bit nervous about it. For a young child, I think the best approach is something along the lines of, "The doctor is going to give you some medicine to make you fall asleep so he can fix your tooth, and when you wake up, I'll be right there to bring you home" might be the best you can do. Possibly, mentioning watching a favorite cartoon/movie once you get home would be a nice way to give her something to look forward to and distract her from the medicine part.
It really is like going to sleep. You truly don't remember the moments before and immediately afterward. One minute you're feeling groggy (I remember them putting those little EKG discs on me), and the next you are waking up and talking to a nurse. One of the best pieces of advice I was given was to "not fight" the anesthesia. I think that would be more of an adult's response than a child's one, but if you make the whole thing sound as super normal as going to sleep or taking a nap, that's something she can relate to and there would be no reason for her to fear it. I'd also suggest talking to the anesthesiologist about nausea, because as I understand it, that's usually the worst part. I had no nausea at all, and I am prone to a nervous tummy, but they gave me a motion sickness patch to put on the night before the procedure, and made sure something was in the actual anesthesia to help with that as well. If you avoid that, it will make things that much easier for both of you.
In some ways being an adult might be a bit tougher in this situation because as much as you can rationalize, you also know that adults aren't infallible. That said, anesthesiologists are very precise and good at what they do, your daughter will be fine, and you will be, too. Good luck and may she have a speedy & fairly painless recovery!
posted by katemcd at 6:26 PM on May 9, 2010 [1 favorite]
It really is like going to sleep. You truly don't remember the moments before and immediately afterward. One minute you're feeling groggy (I remember them putting those little EKG discs on me), and the next you are waking up and talking to a nurse. One of the best pieces of advice I was given was to "not fight" the anesthesia. I think that would be more of an adult's response than a child's one, but if you make the whole thing sound as super normal as going to sleep or taking a nap, that's something she can relate to and there would be no reason for her to fear it. I'd also suggest talking to the anesthesiologist about nausea, because as I understand it, that's usually the worst part. I had no nausea at all, and I am prone to a nervous tummy, but they gave me a motion sickness patch to put on the night before the procedure, and made sure something was in the actual anesthesia to help with that as well. If you avoid that, it will make things that much easier for both of you.
In some ways being an adult might be a bit tougher in this situation because as much as you can rationalize, you also know that adults aren't infallible. That said, anesthesiologists are very precise and good at what they do, your daughter will be fine, and you will be, too. Good luck and may she have a speedy & fairly painless recovery!
posted by katemcd at 6:26 PM on May 9, 2010 [1 favorite]
Hi!
My three-year-old hasn't been under anesthesia (though he has undergone another intense hospital procedure), but on pediatric clinical rotation I have assisted families and children through this process, and I think, as a mom, I have a unique sort of empathy with my patients and families.
First, general anesthesia dental procedures, including those more involved and complex than the one your daughter will be undergoing, are tolerated incredibly well by pediatric clients. Obviously, there is no pain during the procedure, and typically, the post-procedure pain is significantly less than the pain caused by the original problem. Generally, with a precocious three, I would tell her that her tooth is sick and hurting and that while she is asleep a doctor will give the tooth medicine and a special, hard bandage for chewing. She will wake up, and feel funny, but then the funny feeling will go away and her tooth will be better. Her face may feel "stretched out" and tired for a little while, but she will rest with her mama and eat her favorite (insert favorite soft food here), and then her face and tooth will be rested and better.
Second, pediatric surgery providers treat patients with an incredible amount of dignity and care. I have been in quite a few procedures, and the child is lifted, positioned, and touched gently, the operating room talk is focused on the work at hand, and every care is maintained to keep everything as safe and respectful as possible. I know, as a mom, that the fear "handing off" your kid is that they will encounter adults who can't or won't care for her how you do and can, but there is an incredible awareness in those rooms about the responsibility everyone has to "be mom." For your daughter, tell her that you will be in a room nearby the doctor's room because the doctor's room doesn't have very much space and has be kept very, very clean. When she goes into the room with the nurse, there will be a lot of people she doesn't know, wearing silly hospital clothes (and if you could get a OR cap, mask, and gown to put on for her to show her, that would help), but that they are nice and there to fix her tooth. It might be cold, but they will cover her up while she sleeps. It will be easy to fall asleep because she will get to breathe special air through a mask (ask if they can issue you her mask right before the procedure and ask for a scented one. This way she can go in with the mask she is going to use and smell the fun fruity smell and play with it as she's going in).
Finally, recovery and waking up are the most difficult part for children, but it's also not memorable for them. You may or may not be with her in recovery. It's mainly difficult because the kid's are confused, and if they were intubated to protect their airway (some procedures require this, some not), it's uncomfortable to wake up. But again, they will have one on one attention and care, and the goal is to get her to you as soon as possible. Tell your daughter that someone (find out who) will be with her as she's waking up and the next person she will be with is you.
Walking away from her will be difficult; I hope I have demystified a bit of that feeling of helplessness. Procedures like this are very safe and have low complication rates, and pediatric health care providers are overwhelmingly meticulous and gentle. Develop the script to use with your daughter and go through it again and again--"this is why, this is what, and then I'll be there"--your calm repetition of the steps she'll go through will reassure her that you're OK with it (and so it's OK), and help you meditate to a place where you're OK. The vast majority of families, in the moment, typically find themselves being very brave and cheerful with their young ones, and then finding themselves a bit weepy in the waiting room--so that's normal. Think about skilled hands working on your daughter gently and efficiently; think about snuggling her at home when she's done.
Plan on your schedules being a bit wacky for awhile after, and a period where she'll need a little extra TLC. I hope this helps--I know it's not easy, but know that your daughter's providers understand that it's not easy for you, and that they are highly motivated to have an excellent outcome. Too, think about her healthy, pain-free tooth at the end of the journey, and how she's better protected against abcess and other complications. The surgery center should be more than willing to provide any props and info you need for your "script" (surgery outfit, info on what the room looks like, steps she'll experience), so you can get started going through it--by the day of the procedure, with your brave face, she will sail through.
Good, good luck, and take care of yourself, mama!
posted by rumposinc at 6:28 PM on May 9, 2010 [13 favorites]
My three-year-old hasn't been under anesthesia (though he has undergone another intense hospital procedure), but on pediatric clinical rotation I have assisted families and children through this process, and I think, as a mom, I have a unique sort of empathy with my patients and families.
First, general anesthesia dental procedures, including those more involved and complex than the one your daughter will be undergoing, are tolerated incredibly well by pediatric clients. Obviously, there is no pain during the procedure, and typically, the post-procedure pain is significantly less than the pain caused by the original problem. Generally, with a precocious three, I would tell her that her tooth is sick and hurting and that while she is asleep a doctor will give the tooth medicine and a special, hard bandage for chewing. She will wake up, and feel funny, but then the funny feeling will go away and her tooth will be better. Her face may feel "stretched out" and tired for a little while, but she will rest with her mama and eat her favorite (insert favorite soft food here), and then her face and tooth will be rested and better.
Second, pediatric surgery providers treat patients with an incredible amount of dignity and care. I have been in quite a few procedures, and the child is lifted, positioned, and touched gently, the operating room talk is focused on the work at hand, and every care is maintained to keep everything as safe and respectful as possible. I know, as a mom, that the fear "handing off" your kid is that they will encounter adults who can't or won't care for her how you do and can, but there is an incredible awareness in those rooms about the responsibility everyone has to "be mom." For your daughter, tell her that you will be in a room nearby the doctor's room because the doctor's room doesn't have very much space and has be kept very, very clean. When she goes into the room with the nurse, there will be a lot of people she doesn't know, wearing silly hospital clothes (and if you could get a OR cap, mask, and gown to put on for her to show her, that would help), but that they are nice and there to fix her tooth. It might be cold, but they will cover her up while she sleeps. It will be easy to fall asleep because she will get to breathe special air through a mask (ask if they can issue you her mask right before the procedure and ask for a scented one. This way she can go in with the mask she is going to use and smell the fun fruity smell and play with it as she's going in).
Finally, recovery and waking up are the most difficult part for children, but it's also not memorable for them. You may or may not be with her in recovery. It's mainly difficult because the kid's are confused, and if they were intubated to protect their airway (some procedures require this, some not), it's uncomfortable to wake up. But again, they will have one on one attention and care, and the goal is to get her to you as soon as possible. Tell your daughter that someone (find out who) will be with her as she's waking up and the next person she will be with is you.
Walking away from her will be difficult; I hope I have demystified a bit of that feeling of helplessness. Procedures like this are very safe and have low complication rates, and pediatric health care providers are overwhelmingly meticulous and gentle. Develop the script to use with your daughter and go through it again and again--"this is why, this is what, and then I'll be there"--your calm repetition of the steps she'll go through will reassure her that you're OK with it (and so it's OK), and help you meditate to a place where you're OK. The vast majority of families, in the moment, typically find themselves being very brave and cheerful with their young ones, and then finding themselves a bit weepy in the waiting room--so that's normal. Think about skilled hands working on your daughter gently and efficiently; think about snuggling her at home when she's done.
Plan on your schedules being a bit wacky for awhile after, and a period where she'll need a little extra TLC. I hope this helps--I know it's not easy, but know that your daughter's providers understand that it's not easy for you, and that they are highly motivated to have an excellent outcome. Too, think about her healthy, pain-free tooth at the end of the journey, and how she's better protected against abcess and other complications. The surgery center should be more than willing to provide any props and info you need for your "script" (surgery outfit, info on what the room looks like, steps she'll experience), so you can get started going through it--by the day of the procedure, with your brave face, she will sail through.
Good, good luck, and take care of yourself, mama!
posted by rumposinc at 6:28 PM on May 9, 2010 [13 favorites]
You're not the only person to feel like this, believe me. Surgery is scary, especially since you rarely get to be in the OR with your kid. It's one of those times that you have to trust someone else entirely.
I am freaking out...I can't get over the idea that our daughter is completely helpless, and we are going to hand her over to have this done. It's part of being a parent, I guess.
You can hide being freaked out from your kid - this is one of those times where you have to lead by example. Your kid is going to take your cue as to how to behave. They don't know what anesthesia is personally, since they've never experienced it. So if you don't want your kid freaked out, you're going to have to either not freak out, or put on show of calm.
Now as to her - I don't want to show her my distress. I want us to tell her what will happen without complicating it.
"You're going to fall asleep, and you'll wake up in a bed with us by your side."
posted by zippy at 6:32 PM on May 9, 2010
I am freaking out...I can't get over the idea that our daughter is completely helpless, and we are going to hand her over to have this done. It's part of being a parent, I guess.
You can hide being freaked out from your kid - this is one of those times where you have to lead by example. Your kid is going to take your cue as to how to behave. They don't know what anesthesia is personally, since they've never experienced it. So if you don't want your kid freaked out, you're going to have to either not freak out, or put on show of calm.
Now as to her - I don't want to show her my distress. I want us to tell her what will happen without complicating it.
"You're going to fall asleep, and you'll wake up in a bed with us by your side."
posted by zippy at 6:32 PM on May 9, 2010
I had GA multiple times as a child (from ages 3 to 12), and it gets scarier the older you are. I once had a bad reaction where I become really combatant and aggressive with the nurse when I came out. Strange things can happen, so be aware. GA is really common, and complications are very, very rare.
posted by BusyBusyBusy at 6:36 PM on May 9, 2010
posted by BusyBusyBusy at 6:36 PM on May 9, 2010
I had surgery at 3 and 5 years old, under general.. I don't remember anything of the first one, but remember most things about the 2nd. There was nothing at the start of it that needed any prep what so ever. I wasn't nervous or scared or anything. You just go to sleep, done.
Waking up sucks though, its like trying to wake from an interrupted afternoon nap, times 3. Incredibly tough, and you are in pain. But the first thing I saw when I opened my eyed was an awesome toy-truck by my bed. I couldn't play with it yet (tired) but just holding it was awesome.
I also had General surgery at 21, and 27. It was the healing time after that is more hassle. Not quite well enough to do anything but sit around and do nothing. Going under she said "Your arm will go cold" and I went "oh hey neat, it really is goi...." and asleep. Being a nerd I was wondering if I could stay conscious, but man, no chance - just gone.. quite fascinating!
My boy had eye surgery at 9 months, which was real hard for us parents, but didn't phase him at all, playing (with red eyes) the next day he woke up. I wrote what I remembered of that on my wiki if you want to read it.
posted by lundman at 6:36 PM on May 9, 2010
Waking up sucks though, its like trying to wake from an interrupted afternoon nap, times 3. Incredibly tough, and you are in pain. But the first thing I saw when I opened my eyed was an awesome toy-truck by my bed. I couldn't play with it yet (tired) but just holding it was awesome.
I also had General surgery at 21, and 27. It was the healing time after that is more hassle. Not quite well enough to do anything but sit around and do nothing. Going under she said "Your arm will go cold" and I went "oh hey neat, it really is goi...." and asleep. Being a nerd I was wondering if I could stay conscious, but man, no chance - just gone.. quite fascinating!
My boy had eye surgery at 9 months, which was real hard for us parents, but didn't phase him at all, playing (with red eyes) the next day he woke up. I wrote what I remembered of that on my wiki if you want to read it.
posted by lundman at 6:36 PM on May 9, 2010
My daughter had general anesthesia to remove a dermoid cyst from her eyebrow when she was about 14 months old. We were lucky that we had a surgeon who was good at explaining things to us in a way that we understood but without talking to us like we were stupid. Another thing that helped was the pre-surgery appointment. We started in the pediatric waiting room and the older kids stayed with the nurses/hospital staff who explained the surgical stuff to the old er kids (our kid stayed with us since she wouldn't take in any of that), and the parents were in a meeting room with a nurse who explained general preparation (don't eat/drink depending on your surgery) and the paperwork. They then took us on a tour around the various places we would go (pediatric waiting room, surgical waiting room, post-op, that kind of thing) Being able to ask questions beforehand really reassured us.
When the surgery happened, they took her completely awake and they put her under without us there, which was fine with us (I thought it would be hardest to see that part since she was so small). Once she was done and in post-op, they brought me in to be with her while she woke up. (One parent only was the rule, so my poor husband was waiting even longer to see her.) The wakeup part was the scariest part for me. She looked so small in the bed and had an IV attached to her. Once she started to wake up she was gasping for air (perfectly normal, but sounded horrid). Once the nurse gave me the okay, she let me hold her and she just snuggled into me and slept. Once they wheeled her back into the pediatric wing, she was more awake and grumpy. I think the grumpiness was more about being hungry and feeling weird than anything else. With the nurse's okay, I nursed her and she was given popsicles to eat. By the time we left (an hour or so later), she was mostly herself. We spent the rest of the day relaxing at home (a Friday), and she was back in daycare by Monday. (She was pretty much okay by Saturday, but since your daughter is having dental surgery, I would imagine YMMV with regard to pain and stuff.)
Since your child is older, your experience will be a bit different than mine - her being able to talk will help guide your reactions. I wish your daughter a speedy recovery and you calm nerves.
posted by melissa at 6:44 PM on May 9, 2010
When the surgery happened, they took her completely awake and they put her under without us there, which was fine with us (I thought it would be hardest to see that part since she was so small). Once she was done and in post-op, they brought me in to be with her while she woke up. (One parent only was the rule, so my poor husband was waiting even longer to see her.) The wakeup part was the scariest part for me. She looked so small in the bed and had an IV attached to her. Once she started to wake up she was gasping for air (perfectly normal, but sounded horrid). Once the nurse gave me the okay, she let me hold her and she just snuggled into me and slept. Once they wheeled her back into the pediatric wing, she was more awake and grumpy. I think the grumpiness was more about being hungry and feeling weird than anything else. With the nurse's okay, I nursed her and she was given popsicles to eat. By the time we left (an hour or so later), she was mostly herself. We spent the rest of the day relaxing at home (a Friday), and she was back in daycare by Monday. (She was pretty much okay by Saturday, but since your daughter is having dental surgery, I would imagine YMMV with regard to pain and stuff.)
Since your child is older, your experience will be a bit different than mine - her being able to talk will help guide your reactions. I wish your daughter a speedy recovery and you calm nerves.
posted by melissa at 6:44 PM on May 9, 2010
My son (now age 3 1/2) had general anesthesia twice: once at about eleven months and again this past October. At eleven months I have no idea how they did it because I was not in the operating room with him, but I was with him every step of the way this past fall and I can tell you what worked really well for us.
1) He knew in advance that we were going to the doctor to have his hand "fixed" and that he'd be asleep while they did it and that he'd wake up with a big bandage on his hand, but we didn't talk much about it with him, and didn't really start talking about it until about a week before the surgery.
1a) My son loves Curious George, and we had read Curious George goes to the Hospital many times before we even knew he was going to have the surgery, and I think that helped a lot. He understood about an operating room, etc. before any of this ever came up.
2) The day surgery center instructed us to have him wear "soft" clothes - sweats and a tee shirt - and didn't change him into any different clothes for the surgery; they just did it in what he was wearing. That was a big help. We were also allowed to bring his bear and a blanket from home.
3) When we were taken into pre-op, they gave him a facemask (like the one the anesthesia comes out of) to play with and we all played with it for about a half hour - Daddy wore it, I wore it, he wore, the nurse wore it, his bear wore it, it just became some familiar non scary object.
4) I went with him into the OR and we sang songs the whole time while they put the mask on his face. They actually encouraged me to sing a song with him that he would sing along with because it would help him breathe in the gas. I was pretty freaked out myself (I have really bad memories of having surgery myself as a child; in particular of being on a gurney in a cold hallway alone for a long time and not knowing what was going on) but worked hard not to let him see that. So we sang, and they put the (now familiar) mask-thing on his face and it took less than a minute to put him under. I did have to hold his hands to keep him from moving the mask, but I don't think he wanted to move it because he was scared, just because he was trying to sing better.
5) At no time did either his father or I make a big deal out of it. I think that was key. It was just a thing that was going to happen and that was that.
Walking away from him wasn't that hard, mainly because in the short time we were there we really came to very much like the nurse who was "in charge" of our son. She was great with him, very caring and loving and gentle with him, and that made a big difference.
I know how terrifying it is to have your child go through this. It is MUCH more scary for you than it is for your child. The real key is to not make a big deal about it.
Also, talk in depth with the doctors (without your child present) before the appointment, and make sure you understand what their procedure is and how involved you can be. For my son's first surgery the promised me that I could go in to the OR with him but then the anesthesiologist decided at the last minute that my (eleven month old) son was "confident and happy enough" to go in the OR without me and just whisked him away. THAT tore me up. Our second experience was much, much better, in large part because we worked with a practice and a facility that has a ton of experience with small children, and a great reputation.
Be strong and good luck. I'm sure everything will be fine.
posted by anastasiav at 6:50 PM on May 9, 2010
1) He knew in advance that we were going to the doctor to have his hand "fixed" and that he'd be asleep while they did it and that he'd wake up with a big bandage on his hand, but we didn't talk much about it with him, and didn't really start talking about it until about a week before the surgery.
1a) My son loves Curious George, and we had read Curious George goes to the Hospital many times before we even knew he was going to have the surgery, and I think that helped a lot. He understood about an operating room, etc. before any of this ever came up.
2) The day surgery center instructed us to have him wear "soft" clothes - sweats and a tee shirt - and didn't change him into any different clothes for the surgery; they just did it in what he was wearing. That was a big help. We were also allowed to bring his bear and a blanket from home.
3) When we were taken into pre-op, they gave him a facemask (like the one the anesthesia comes out of) to play with and we all played with it for about a half hour - Daddy wore it, I wore it, he wore, the nurse wore it, his bear wore it, it just became some familiar non scary object.
4) I went with him into the OR and we sang songs the whole time while they put the mask on his face. They actually encouraged me to sing a song with him that he would sing along with because it would help him breathe in the gas. I was pretty freaked out myself (I have really bad memories of having surgery myself as a child; in particular of being on a gurney in a cold hallway alone for a long time and not knowing what was going on) but worked hard not to let him see that. So we sang, and they put the (now familiar) mask-thing on his face and it took less than a minute to put him under. I did have to hold his hands to keep him from moving the mask, but I don't think he wanted to move it because he was scared, just because he was trying to sing better.
5) At no time did either his father or I make a big deal out of it. I think that was key. It was just a thing that was going to happen and that was that.
Walking away from him wasn't that hard, mainly because in the short time we were there we really came to very much like the nurse who was "in charge" of our son. She was great with him, very caring and loving and gentle with him, and that made a big difference.
I know how terrifying it is to have your child go through this. It is MUCH more scary for you than it is for your child. The real key is to not make a big deal about it.
Also, talk in depth with the doctors (without your child present) before the appointment, and make sure you understand what their procedure is and how involved you can be. For my son's first surgery the promised me that I could go in to the OR with him but then the anesthesiologist decided at the last minute that my (eleven month old) son was "confident and happy enough" to go in the OR without me and just whisked him away. THAT tore me up. Our second experience was much, much better, in large part because we worked with a practice and a facility that has a ton of experience with small children, and a great reputation.
Be strong and good luck. I'm sure everything will be fine.
posted by anastasiav at 6:50 PM on May 9, 2010
My kiddo had general at age 9 to have her adenoids removed. In addition to all the good information already here, you might keep in mind that kids react differently to coming out of anesthesia.
Ours woke up crying and very distraught for a few minutes, and the nurses said it was a completely normal reaction, a result of being confused and not understanding the loss of time but feeling generally weird. One of our nurses said she's regularly had pediatric patients wake up laughing.
So, just be ready to be there, as a reassuring smiling face!
posted by pineapple at 7:19 PM on May 9, 2010
Ours woke up crying and very distraught for a few minutes, and the nurses said it was a completely normal reaction, a result of being confused and not understanding the loss of time but feeling generally weird. One of our nurses said she's regularly had pediatric patients wake up laughing.
So, just be ready to be there, as a reassuring smiling face!
posted by pineapple at 7:19 PM on May 9, 2010
Awesome advice in here! One thing I wanted to add is to avoid the phrasing "the doctor will put you to sleep." Even kids who haven't lost a pet or don't really understand the concept of death might still associate this phrase with something bad and scary. Stick with "the doctor will give you some medicine to help you sleep" or "to help you take a nap" or something like that.
posted by vytae at 7:55 PM on May 9, 2010 [1 favorite]
posted by vytae at 7:55 PM on May 9, 2010 [1 favorite]
Like you say, there's two separate issues here: your daughter's fear, and your own fear. They're fears of very different things.
I've been under general anesthesia. I've also seen anesthetized patients. Anesthesia is not frightening. Seriously, you wake up and go, "Are they done? WTF!"
So anesthesia isn't really the issue.
Let's divide this up, because it'll make understanding everything easier.
You're worried about general anesthesia: You have certain rational fears about this. You know that anesthesia is associated with occasional, really bad events. This isn't something I want to dwell on, but I know that it's not really ethical to hide these.
Sometimes, people die when under anesthesia. Sometimes, anesthesia is inadequate, and people have memories of pain. Sometimes, anesthetists are incompetent or are diverting drugs, and so anesthesia is inadequate.
Since I have to say this, and you have to know it, I think that you should think about it heavily. I don't say that because I think that general anesthesia is a bad idea. I say that because I want you to focus on the worst that can happen, and be really afraid until you can't be any more afraid. When you're afraid, I want you to spend as little time around your daughter as possible. Okay? Take a couple of days.
Now take a deep breath, and relax a little bit, because these things are all really unlikely. We've known about these problems for a long time. We've built a whole lot of checks into the system so that these really bad things don't happen with any kind of frequency. Nobody wants little girls to die. Nobody wants to face lawsuits. Okay? You're still scared. That's okay. Think about meteorites dropping on your girl's head. That'd be a tragedy. It's unlikely enough that you don't make her wear a helmet all the time. Right? So keep on breathing, and let's spend a little bit of time thinking about why your daughter's scared.
She's scared for a lot of reasons. First, this whole thing is fucking weird. Seriously. And you don't trust stuff that's weird. She's scared because going to the doctor hurts. And she's scared because her folks are scared. She knows that they know what's up a lot better than she does, and so if they're scared, it's serious.
Your daughter doesn't have to be fearless about the whole situation. Even if she could be, that wouldn't really be appropriate. But more, you're probably not going to be able to fool her well enough to make her think all this stuff is everyday-- and when you pretend not to be scared, it's just going to scare her more.
So you don't. I know she's just three, but she's probably a hell of a lot more clued in than most people give three-year-olds credit for. She's probably really curious about what'll happen. Can you talk about what will happen with her? Do you know yourself? If you don't, you should find out.
Here's how I would describe the experience:
"We're going to go to the dentist. The first part's going to be pretty normal: we're going to check in, and then we're going to wait for a long time. There might be toys. After that, an assistant is probably going to do things like check your blood pressure and how much oxygen is in your blood. They're going to do that by inflating a special balloon around your arm and by shining a laser into your finger. The balloon might be a little uncomfortable, but it won't be bad. Then, after even more waiting, a doctor is going to come in and talk to you. It's probably going to be a doctor that puts in an IV. An IV is a little tube that goes into your vein so they can give you medicine that works really fast and that you don't have to swallow. When they put in the IV, it's going to hurt a little bit, but just for a second; after that, it shouldn't bother you. I'll be with you this whole time, if that's what you want. After they put the IV in, there's probably going to be more waiting, but they might move you to a different room. One of the doctors is going to give you medicine in your IV, and you probably won't even notice it going in. The medicine is going to make you fall asleep. They're going to wait until you're asleep, then start working on your tooth. Normally, it'd hurt, but since you're asleep, it won't. When they're all done, they'll wait for you to wake up. The way the medicine works, you'll have been so deeply asleep that might not even believe them when they say they're done. Afterwards, it's going to hurt a little bit, like when we got back from the ER and your arm still hurt a little bit, but it's not going to be bad. I'm a little bit scared too, because I've never done what you're about to do, and I know it takes being really brave, but I'm not that scared, because I know how brave you are."
So, yeah, she's three, so that description probably won't occur in one sitting, and she'll have lots of questions-- which you should try to answer. Knowing more is what's going to relieve her fear and your fear.
So there's one more component to this, which is that it sounds like GA scares you because you feel like it's helplessness, like you're at the mercy of everyone. I have a feeling that idea doesn't scare your daughter at all, just based on the kids I've known. I don't think there's a good way to get around this except with more experience with GA. Your own daughter's experience is going to help. Yeah, when you're under GA, people could do whatever they want to you, it's true. You think you'd be willing to let them do surgery otherwise? There's a lot of trust involved. But there is no memory, no sense of paralysis or helplessness. It's okay. Sometimes you put yourself in another person's care. You only do that when you trust somebody. That's what you're doing with anesthesia. If you don't trust the people involved, don't do it. It's not worth the anxiety.
A lot of this stuff is really particular to the parents and children involved. I can't tell from your post what kind of person you are or what kind of person your daughter is. I can tell that I've been most successful at relieving the fears of children when treating them as older than they are, and by making it clear that I need them to help-- they don't have the spare attention to be afraid when they've got a job to do. And while the most effective way of treating fear might be to lie, this isn't something I want to do, even to very small children, and it can backfire really awfully.
posted by nathan v at 9:53 PM on May 9, 2010 [1 favorite]
I've been under general anesthesia. I've also seen anesthetized patients. Anesthesia is not frightening. Seriously, you wake up and go, "Are they done? WTF!"
So anesthesia isn't really the issue.
Let's divide this up, because it'll make understanding everything easier.
You're worried about general anesthesia: You have certain rational fears about this. You know that anesthesia is associated with occasional, really bad events. This isn't something I want to dwell on, but I know that it's not really ethical to hide these.
Sometimes, people die when under anesthesia. Sometimes, anesthesia is inadequate, and people have memories of pain. Sometimes, anesthetists are incompetent or are diverting drugs, and so anesthesia is inadequate.
Since I have to say this, and you have to know it, I think that you should think about it heavily. I don't say that because I think that general anesthesia is a bad idea. I say that because I want you to focus on the worst that can happen, and be really afraid until you can't be any more afraid. When you're afraid, I want you to spend as little time around your daughter as possible. Okay? Take a couple of days.
Now take a deep breath, and relax a little bit, because these things are all really unlikely. We've known about these problems for a long time. We've built a whole lot of checks into the system so that these really bad things don't happen with any kind of frequency. Nobody wants little girls to die. Nobody wants to face lawsuits. Okay? You're still scared. That's okay. Think about meteorites dropping on your girl's head. That'd be a tragedy. It's unlikely enough that you don't make her wear a helmet all the time. Right? So keep on breathing, and let's spend a little bit of time thinking about why your daughter's scared.
She's scared for a lot of reasons. First, this whole thing is fucking weird. Seriously. And you don't trust stuff that's weird. She's scared because going to the doctor hurts. And she's scared because her folks are scared. She knows that they know what's up a lot better than she does, and so if they're scared, it's serious.
Your daughter doesn't have to be fearless about the whole situation. Even if she could be, that wouldn't really be appropriate. But more, you're probably not going to be able to fool her well enough to make her think all this stuff is everyday-- and when you pretend not to be scared, it's just going to scare her more.
So you don't. I know she's just three, but she's probably a hell of a lot more clued in than most people give three-year-olds credit for. She's probably really curious about what'll happen. Can you talk about what will happen with her? Do you know yourself? If you don't, you should find out.
Here's how I would describe the experience:
"We're going to go to the dentist. The first part's going to be pretty normal: we're going to check in, and then we're going to wait for a long time. There might be toys. After that, an assistant is probably going to do things like check your blood pressure and how much oxygen is in your blood. They're going to do that by inflating a special balloon around your arm and by shining a laser into your finger. The balloon might be a little uncomfortable, but it won't be bad. Then, after even more waiting, a doctor is going to come in and talk to you. It's probably going to be a doctor that puts in an IV. An IV is a little tube that goes into your vein so they can give you medicine that works really fast and that you don't have to swallow. When they put in the IV, it's going to hurt a little bit, but just for a second; after that, it shouldn't bother you. I'll be with you this whole time, if that's what you want. After they put the IV in, there's probably going to be more waiting, but they might move you to a different room. One of the doctors is going to give you medicine in your IV, and you probably won't even notice it going in. The medicine is going to make you fall asleep. They're going to wait until you're asleep, then start working on your tooth. Normally, it'd hurt, but since you're asleep, it won't. When they're all done, they'll wait for you to wake up. The way the medicine works, you'll have been so deeply asleep that might not even believe them when they say they're done. Afterwards, it's going to hurt a little bit, like when we got back from the ER and your arm still hurt a little bit, but it's not going to be bad. I'm a little bit scared too, because I've never done what you're about to do, and I know it takes being really brave, but I'm not that scared, because I know how brave you are."
So, yeah, she's three, so that description probably won't occur in one sitting, and she'll have lots of questions-- which you should try to answer. Knowing more is what's going to relieve her fear and your fear.
So there's one more component to this, which is that it sounds like GA scares you because you feel like it's helplessness, like you're at the mercy of everyone. I have a feeling that idea doesn't scare your daughter at all, just based on the kids I've known. I don't think there's a good way to get around this except with more experience with GA. Your own daughter's experience is going to help. Yeah, when you're under GA, people could do whatever they want to you, it's true. You think you'd be willing to let them do surgery otherwise? There's a lot of trust involved. But there is no memory, no sense of paralysis or helplessness. It's okay. Sometimes you put yourself in another person's care. You only do that when you trust somebody. That's what you're doing with anesthesia. If you don't trust the people involved, don't do it. It's not worth the anxiety.
A lot of this stuff is really particular to the parents and children involved. I can't tell from your post what kind of person you are or what kind of person your daughter is. I can tell that I've been most successful at relieving the fears of children when treating them as older than they are, and by making it clear that I need them to help-- they don't have the spare attention to be afraid when they've got a job to do. And while the most effective way of treating fear might be to lie, this isn't something I want to do, even to very small children, and it can backfire really awfully.
posted by nathan v at 9:53 PM on May 9, 2010 [1 favorite]
My four-year-old is about to get her tonsils out. We have a mask like the one she'll have to wear, and she wears it and knows what it's for. She's a year older than your daughter so explanations may not help, but at least she can get a feel for the procedure. We keep repeating to her that she won't feel the surgery, because she'll be asleep. She knows there will be a bit of a sore throat when she wakes up, but on the plus side, she gets lots of soft food. She's focusing on that at present. Be honest, but reassure her and give her something positive to look forward to also.
My mother in law is a theatre nurse and she has explained the process to both of us, separately (we haven't had our pre-surgery consult yet). One thing you need to be aware of is that as your daughter goes to sleep, she will quite likely fight the anesthetic. It's normal, but it sounds scary. I'm going to be allowed to stay with her in theatre until she's asleep, and she'll be allowed her favourite toy with her until she's asleep too. Ask if these things can be done for your daughter. I'll be waiting in recovery so I'll be there when she wakes up, for cuddles and "You did it!"
I'm worried too, as any normal parent would be, I think. But she won't know that. It helps that I can tell her about when I had my tonsils out, when I was 4, and that it wasn't a huge deal (sore throat aside). Ask around and find out if other parents and their children have been through similar procedures so she can hear what it's like from others, and you (hopefully) can be reassured by positive outcomes.
posted by tracicle at 12:10 AM on May 10, 2010
My mother in law is a theatre nurse and she has explained the process to both of us, separately (we haven't had our pre-surgery consult yet). One thing you need to be aware of is that as your daughter goes to sleep, she will quite likely fight the anesthetic. It's normal, but it sounds scary. I'm going to be allowed to stay with her in theatre until she's asleep, and she'll be allowed her favourite toy with her until she's asleep too. Ask if these things can be done for your daughter. I'll be waiting in recovery so I'll be there when she wakes up, for cuddles and "You did it!"
I'm worried too, as any normal parent would be, I think. But she won't know that. It helps that I can tell her about when I had my tonsils out, when I was 4, and that it wasn't a huge deal (sore throat aside). Ask around and find out if other parents and their children have been through similar procedures so she can hear what it's like from others, and you (hopefully) can be reassured by positive outcomes.
posted by tracicle at 12:10 AM on May 10, 2010
From the child's perspective:
They told me that there would be a little stick and then things would hurt less. Since I was in a lot of pain at the time, that seemed like a good deal. After that little stick I was calm enough that placing an IV was easy, and the last thing I remember was a mask going on for inhaled anesthetics. They introduced the mask like a play thing (an astronaut mask!).
It's not that traumatic for the kid, the parental anxiety is a bit worse. The reason the anesthesiologist is there is that they really really know how to handle an emergency. Your kid will be ok, maybe try chatting with other waiting parents.
posted by a robot made out of meat at 6:15 AM on May 10, 2010
They told me that there would be a little stick and then things would hurt less. Since I was in a lot of pain at the time, that seemed like a good deal. After that little stick I was calm enough that placing an IV was easy, and the last thing I remember was a mask going on for inhaled anesthetics. They introduced the mask like a play thing (an astronaut mask!).
It's not that traumatic for the kid, the parental anxiety is a bit worse. The reason the anesthesiologist is there is that they really really know how to handle an emergency. Your kid will be ok, maybe try chatting with other waiting parents.
posted by a robot made out of meat at 6:15 AM on May 10, 2010
Our daughter had a very similar procedure at the same age. Two things stand out for me, although they're about her waking up, not going to sleep: first, there was some blood around her mouth, which I did not expect and that, most of all, freaked me out - be prepared to see some blood, and it's okay; second, she woke up very out of sorts and was crying - the hospital gave her a teddy bear and book that distracted her, so you might think about having a new toy there to keep her mind off things.
posted by Addlepated at 12:11 PM on May 10, 2010
posted by Addlepated at 12:11 PM on May 10, 2010
1) Even now, at 30-something, I always come out of G.A. with tears streaming down my face for a half hour or so, though I am not remotely sad at all. It is just a reaction, and it could be your kid's as well. It does not necessarily suggest emotional distress.
2) Personally, I would just emphasize the cool aspects of it. She doesn't have to worry about how 'it will hurt,' because she will be asleep while they do it! That's pretty fun and interesting!
posted by thegreatfleecircus at 12:47 PM on May 10, 2010
2) Personally, I would just emphasize the cool aspects of it. She doesn't have to worry about how 'it will hurt,' because she will be asleep while they do it! That's pretty fun and interesting!
posted by thegreatfleecircus at 12:47 PM on May 10, 2010
My 7-y.o. had general anaesthesia this spring to set a badly broken arm. My wife was upset to see him "fall asleep," but I just stayed there and talked to him as they added the stuff to his line. He blathered a little about fishing (his favorite thing, which the friendly young doc told him to think about) and his eyelids fluttered shut: no big deal. his mom's fears were, as was said above, totally separate from his own -- which, frankly, didn't exist.
It was tough to get him to wake up after but only because it was aroundmimdnight and he was hours late to go to bed. The nurses said it was always tough to wake up kids late at night. *shrug*
I really think that kids take their cues from their parents. I didn't make a big deal about it and my wife hid her upset, so our little guy was very cool about the whole thing.
posted by wenestvedt at 7:42 AM on May 11, 2010
It was tough to get him to wake up after but only because it was aroundmimdnight and he was hours late to go to bed. The nurses said it was always tough to wake up kids late at night. *shrug*
I really think that kids take their cues from their parents. I didn't make a big deal about it and my wife hid her upset, so our little guy was very cool about the whole thing.
posted by wenestvedt at 7:42 AM on May 11, 2010
Response by poster: Thanks so much for the ideas and reassurances. I really appreciate it. We are going on the hospital tour soon, which will hopefully be a help to all of us. I also showed her the fillings in my own mouth. I'm definitely going to incorporate the above suggestions.
posted by Knowyournuts at 1:50 PM on May 12, 2010
posted by Knowyournuts at 1:50 PM on May 12, 2010
This thread is closed to new comments.
I, personally, would be honest but vague with my daughter if it had to happen again "The doctor is going to put you to sleep. Isnt that weird?"
posted by shothotbot at 6:00 PM on May 9, 2010