The author of the article is Dr. Rasik Shah, Sr. Consultant (Paediatric General & Laparoscopic Surgery, SRCC Children’s Hospital, managed by Narayana Health)

Parents often get overwhelmed when their child is recommended for surgery. And once they come to an understanding that surgery is the only option left, multiple anxieties start being hatched up in the amygdala, an almond-shaped structure in the brain, considered to be a human’s communications hub. These multi-layered anxieties simultaneously trigger one’s fight-or-flight stress response mechanism. One’s ability to address this phase by being positive, calm, and composed ensures a pragmatic and constructive outcome. So, parents should take the steps to prepare themselves first. 

Prepare yourselves first:

In our life, it is majorly the dearth of information that creates confusion leading to anxiety. It is little or no knowledge about how things run in a hospital, or about any surgical procedure that often turns the panic button on. So, it is always advisable to clear your doubt regarding the procedure the surgeon has recommended. Ask your surgeon whatever you are required to know to convince yourselves. Try to reach out to those parents, if possible, whose children have undergone any surgical procedure of late. Once convinced, then you need to sit for a discussion on how to initiate the conversation regarding the ensuing surgery with your child.  

Why do you need to prepare your child ahead of time for surgery?

The process will help your child to

• understand the necessity of the surgery
• address the worries and thus calm his/her anxieties
• co-operate more at the time of hospital stay and surgery
• recover fast

If your child is a toddler or a pre-schooler:

Your little one has almost no idea about any surgical procedure and hence he/she does not have any associated notion of fear. So, it is always advisable not to discuss anything related to the ensuing surgery in your child’s presence. Instead, start the communication on the following hospital visit, how the people in the hospital like doctors and nurses work there, day and night, to cure us of our illness. If possible, read books about going to the hospital and show pictures of doctors and nurses, and hospital interiors. Then tell your kid that as he/she is having the problem, we require to visit a hospital soon and we have to stay there for a day or two. And encourage your kid to put his/her favourite doll or book in their luggage for their hospital stay.  Playing with a doctor or nurse kit is a fun way to get your kid accustomed to the process, so allow your kid to act out the surgery on a doll. Pre-schoolers and school-age children have very vigorous imaginations, therefore, make sure they do not have any wrong ideas about the surgery.

If your child is a tween (10 to 13 years old) or a teen (13 to 19 years old):

Generally, older children need more time to prepare themselves psychologically as they have more exposure to the world around them and they have a relatively vast scape of imagination. As a result, they form their apprehensions leading to inhibition and repulsion. So, at the time of conversation, you have to be more careful. You have to bring yourself to the state of your child to initiate the discussion. Explain clearly why the doctor has recommended the surgery and that the surgery is the only available treatment option in his/her case to have a cure form the ongoing problem. Explain in detail what the surgeon will do on the day of surgery. If possible, take your child to the surgeon who will explain the procedure in detail and tell when your child will be allowed to go back to the normal routine. Also, explain to your child the procedure related to anesthesia in detail as well. Many have the fear of not waking up once anesthetized.  Tell your child that the anesthesia is just like going to sleep, and once the procedure is over then you will wake up normally.

What you need to avoid at the time of conversation: 

• Loosing of confidence
• Sign of confusion
• Mark of anxiety/stress
• Word/expression like “cut you open”
• Any negative word
• Any effort to hide the fact

What you require to do on D-Day:

Try to remain calm so you can help your child. Do strictly follow the directives handed over to you by the hospital authority or the treating surgeon. Encourage and ensure your child that you are there right in the waiting area and once the surgery is over, you will meet him/her in the recovery room.  

The more you lose nerve or become upset, the more it pushes your child to throw tantrums. So, even if your child starts showing the early sign of a tantrum like the followings, it should not make you upset:

• your child may become mercurial
• your child may turn utterly uncooperative
• Your child may start behaving abnormally

Make your child aware and explain the Peri-operative Instructions which are likely:

• Fasting for 8 hours (solid food) before surgery/procedure
• Clear fluids two hours before surgery/procedure
• Breast milk 4 hours before surgery/procedure
• Top feeds 8 hours before surgery/procedure

Implementing these simple steps will make your child’s surgery a more comforting experience as your child will be able to sense and may react to your stress level. In order to help your child, remain at ease before, during and after surgery, it is important for you to also take care of yourself.