Transcription:
How to Help Children Cope with Having Surgery

Introduction: This is BayCare HealthChat, another podcast from BayCare Health System. Here's Melanie Cole.

Melanie Cole: Welcome to BayCare HealthChat. I'm Melanie Cole. And today we're talking about how to help our children cope with having surgery. Joining me is Rachael Ziemer. She's a Certified Child Life Specialist with BayCare. Rachael, it's such a pleasure to have you join us today, and let's begin with how we prepare our child for surgery. And as we're preparing ourselves for this kind of a scary situation, how honest should we be? I know it will depend on the child's age, but how do we explain whatever the doctors just told us to our child and let them know that this is something that's going to happen.

Rachael Ziemer: It's really, really important to be honest with kids. I know a lot of times parents get the news that their child has to have surgery, and they may be worried about how the child is going to take that information and how they're going to cope with that. And a lot of times parents are fearful to tell their kids about having surgery for fear that it's going to make them more anxious regarding what's coming up. But it's actually really, really important to be honest with our kids. And the reason is, a lot of times, if we aren't honest, it can cause anxiety and more fear in the child when they're not prepared for what's coming. So we always encourage parents to be honest and prepare their kids in a way that best fits them and their development. So a lot of times, if we know something's coming up, that may be scary. It's important to tell kids ahead of time so that they have time to process and cope with what's coming. And we do that in a variety of ways. Preparing kids is different at different ages.

So of course, you're going to tell a kid who's five, a little bit differently than you're going to tell your child who's 10. And that's just based on how they understand and cope with medical experiences. So our kiddos who are a little bit younger, we typically encourage parents to use play to prepare them. So using a doctor kit and talking about, you know, your upcoming surgery and how we're going to get sleepy medicine, that's going to help us fall asleep. And then the doctor is going to, you know, fix your tonsils. So keeping it pretty basic with our younger age, but also incorporating play is really important because that helps us kind of understand where the child understands about surgery and what's coming. And then it also helps us kind of clear up any misconceptions that that kiddo might have. With our older age group, 10 year olds, they can understand more concrete what's happening and why they have to have surgery.

But with this age group, they also really like to know more of the details, and you can prepare them a little bit earlier on. So you can start talking about having surgery, you know, up to a week or two before, just so that they have time to process what's coming and ask any questions and clear up any misconceptions they have and that you guys, as a family and a team can come up with a good plan for that child and prepare them the way that best fits them. So a lot of times, again, I said it, but these kids really want to have specifics. So, what am I going to experience? How is it going to feel? Going over all the senses is really important when preparing any child. But for our older age group, they definitely need to know if anything's going to hurt and if so, how they're going to get through it.

Host: Wow. That's a lot of information and thank you so much for that. So what are some common worries and misconceptions that kids have about surgery and specifically anesthesia? Cause I know that my teens were concerned with anesthesia. And so what do you hear? And then what do we tell them about that?

Rachael Ziemer: So, you're right. There are a lot of misconceptions kids have about anesthesia and getting the medicine to make them sleep. And the most common ones we hear often are, you know, I sleep at home. I would wake up if someone came in, you know, grabbing my arm or, you know, shook my foot. But how does that, how is that different in the hospital? We say, we're going to give you medicine to make you sleep well how is that sleep different? So we need to really explain that, you know, the medicine makes you sleep, that you won't feel anything. I always tell kids, if we had a dance party on your bed, you would just sleep right through that dance party. So, you're not going to feel anything. The medicine makes you sleep and stay asleep the whole time. And then when the doctor is done, we stopped giving you that medicine and you wake up. And a lot of that misconception is, am I going to wake up? Am I going to feel anything? And so really explaining and clearing up any of those misconceptions regarding the medicine, and that you will wake up, you have a doctor with you the whole time, making sure that you're safe and asleep.

And that, that medicine is going to make sure that you don't feel anything. And that we wake you up when you're all done. Another misconception that I hear a lot of times with our kids is when I'm asleep, they're going to, you know, cut my toe off or something crazy like that. And so when we don't prepare them, a lot of times, kids imaginations run away with them a lot more than what's really going to happen. So again, we go back to that piece of preparation and how it's so important to have those open and honest conversations so that you can have those questions out in the open so that you can clear them up for your kids prior to them coming for their surgery.

Host: So, if we've got little kiddos and we want to show them books and things that kind of help us to get this narrative going. And this discussion with them about what they're going to experience. Should we even consider going online with our child, looking at pictures of the hospital, because all the hospitals websites have these beautiful pictures of the unit, the surgery center. Do we do that or give us some book recommendations as well? Things that maybe we can use with our kids?

Rachael Ziemer: Sure. Yes. We definitely recommend reading books and looking at pictures of the surgery center or the hospital, or wherever your child's going to be having surgery just to give them a visual on where they're headed. So a lot of times, again, with our school agers, elementary and above, they really like to know specifics. And so if we can show them pictures of the hospital, the unit, where they might wake up even of the room, that's wonderful. And here St. Joseph’s Children’s Hospital, I will typically if parents need that extra preparation, I can email them pictures of our unit. If that's helpful for the kiddo. We typically do that, also with our younger kids, just reading books about going to the doctor or going to have surgery really helps them feel connected and kind of understand what may be happening. And my favorite book for kids that are a little bit younger is Bastian’s Surgery [Bastian’s Surgery by Sofia Berga]. You can find it on Amazon. And it really talks about going and meeting your health care team, getting ready, using the mask to get medicine, to fall asleep, waking up, and who's going to be there. It's wonderful. So I really enjoy reading that one, to kids. And then again, yeah, the older kids, just helping them kind of see if possible where they're headed and give them the opportunity to ask any questions.

Host: What about comfort things? Should we have them bring things from home? Are they allowed even now to bring a stuffed animal and how does this help them to promote relaxation and provide comfort during their visit?

Rachael Ziemer: Yes, we really encourage any kiddo to bring anything that helps them feel comfortable and bring a sense of comfort while they're in our hospital setting. So if they want to wear their favorite PJ's in that morning, that's wonderful. If they want to bring a blanket or a stuffed animal that brings them comfort, we encourage it, as well as if they have their own personal, you know, tablet that they want to play on, or they have their favorite game they want to play or books they want to read, bring it all. If anything helps you, we want you to bring it. So we encourage parents to pack, whatever helps them. And typically a stuffed animal can head back to the surgery room with the patient to help provide a little bit of comfort on the way. So yes, whatever brings comfort and provides distraction for that child, we encourage it to be brought with the patient.

Host: And then there's surgery itself and after surgery, how do we best advocate for our children for pain reducing options and positions of comfort for our children. And especially now, when we're looking at stewardship for opioids and pain medications, what should we be discussing with our doctor and kind of explaining to the kids, well, this may make you a little drowsy or, you know, that kind of thing, tell us about pain options?

Rachael Ziemer: So here in our hospital, we try to use a lot of pain free measures, especially for our kids who need to get IV placements or pokes. And so we always encourage parents if we know that there is going to be an upcoming poke for your child, if they need to get an IV before surgery, is that you are always encouraged to ask your medical team, if there is a pain reducing option that might work for your kiddos, whether that be freezy spray, or numbing cream if that's an option. So we always encourage parents. If that's not already discussed with your health care team to always ask if there is something that we can utilize as well as comfort positions and a comfort position is where a parent helps kind of hold and comfort a patient either within their lap or at the bedside during an IV start or a poke. And that just, again, helps, you know, secure the patient, but also provides comfort where that parent is close by and they're able to be that support system. They know their kid best. That's what we always say is that parents are a child's best advocate and they know them best. So just to be confident and talk to your health care team regarding what best fits your child's needs, whether that be a comfort position or pain-free measures, or if we can, you know, provide some sort of distraction during, we just want parents to feel confident in bringing any of those things up to the health care team to make the patient’s and the child's experience, the best it can be.

Host: This is really great information for parents, Rachael. So as we wrap up, help us to think about how we should go about talking to our child about what to expect after surgery and with surgery and giving them something to look forward to after the fact, if we should think about some rewards or special things, we get to watch a movie together or have ice cream because you had your tonsils out, whatever it is, kind of wrap it up for us with your best advice for parents on how we should help our kids to cope with surgery.

Rachael Ziemer: Well, the number one thing is to be honest. So definitely prepare your child before the big day so that they understand what's going to happen and can really come up with a good plan that best fits them and then preparing them for what's going to happen after surgery is just as important as preparing them for what's going to happen for surgery. So letting them know, you know, you're going to wake up with maybe some pain in your throat. If you had tonsils removed, that's normal, and that we're going to be eating popsicles and cold things when we get home to help with that, but just preparing them for what they're going to experience afterwards. If that means, oh, you know, you're not going to be able to go to soccer practice for a few weeks because you have to heal and your body needs time to rest so that they understand that prior to, and it's not a surprise for them after surgery.

And then of course providing a reward and kind of trying to make this experience somewhat fun. So back to our tonsils, you know, if a kiddo is going to have their tonsils removed, having fun, going to the grocery store prior to, and picking out, you know, some fun popsicles to look forward to, or a fun cup that they can use or new PJ's that they can look forward to laying around in. Gives them something to pick out as control and reward, but also help them with their recovery. And then again, if you are able to look forward to something even bigger, like a prize or a favorite movie you get to watch at home, that helps at the end of this to help with coping and make this experience a little bit better.

Host: Thank you so much, really, really great information, Rachael, and thank you for joining us today. To learn more about the child life department at BayCare, please visit our website at BayCare.org for more information, and to get connected with one of our providers. And that concludes this episode of BayCare HealthChat. Please remember to subscribe, rate, and review this podcast and all the other BayCare podcasts. Share this show with your friends and family on social media. If you know someone whose child has to have surgery, this is really great information on how to help them through it. Thanks for listening, I'm Melanie Cole.