Getting your child ready for surgery doesn’t have to be a scary experience.
A good start is to help your child understand what is going to happen and try to bring it to a level they can understand.
Dr. Jeffrey Gander,a UVA pediatric surgeon, is here to discuss and give some tips on how to prepare your child – and yourself – for this big event.
Selected Podcast
How to Prepare Your Child for Surgery
Featured Speaker:
Jeffrey Gander, MD
Dr. Jeffrey Gander is an Assistant Professor of Surgery specializing in pediatric surgery. Transcription:
How to Prepare Your Child for Surgery
Melanie Cole (Host): Getting your child ready for surgery doesn’t have to be such a scary experience, and we’re offering you today some tips on how to prepare your child and yourself from UVA pediatric surgeon, Dr. Jeffrey Gander. Welcome to the show today, Dr. Gander. Tell us a little bit about what are some of the most concerns you hear from families before they have to have surgery for their child.
Dr. Jeffrey Gander (Guest): Hi, Melanie. How are you? Thank you very much for having me on. Happy New Year to you. That’s a great question. I hear a lot of concerns from families before surgery. One is, how is their child going to cope with being separated from them, often for a couple of hours at a time? That’s one thing they worry about, having to say goodbye to their child when the child’s taken off to the operating room. Another thing they ask often is because with surgery, there is incision and opening of other skin in some part of their body and they are worried about are they going to have pain during the surgery and are they going to have pain after the surgery? Another thing we get asked a lot is about anesthesia. What kind of anesthesia, what are the side effects of the anesthesia, things like that? It’s certainly understandable. I have a couple of young ones myself. I understand them well to be concerned when your child is going to have an operation.
Melanie: As a parent myself, Dr. Gander, I have been there. Both my children have had to have surgery at some point. How do you address those concerns, like, for example, I was worried about anesthesia myself, how a child tolerates that anesthesia and what’s going to happen afterwards, how lethargic will they be for that day following. I know it’s individual for each child, but how do you answer those questions that you listed?
Dr. Gander: Well, a lot of times I reassure the families and I’d say that the anesthesiologist we have here at UVA that are going to be taking care of their children are all fellowship trained in just taking care of children. They have a lot of experience. They’re just some of the best doctors we have in the hospital. They are very used to taking care of premature babies who are less than a pound at birth to adolescents and even to early 20s. They are very used to taking care of children. That’s a good thing, is that they have a lot of experience. What they do, what helps also, is that they often get a little medicine to help them to get into the operating room. I know the anesthesiology team – because a lot of families and a lot of children are very anxious – will even give a little bit of something to sedate them a little bit so they can come into the operating room and be a little bit more comfortable and not be as nervous. The reason I bring that up is because often when a child is less nervous, they often need less anesthesia, so that actually helps them to go to sleep a little bit easier and then actually wake up and not be quite as groggy after the operation. That goes with the families, too. Children as you know read off the emotions of their parents, very much so. If a family or a parent is anxious, then the child is going to be anxious as well. Like I said, that even sometimes makes them have to have more of the anesthesia and even sometimes, more medicine. There’s a lot of different types of anesthesia and depending on what type of the operation is, sometimes, it can happen under just a local anesthetic where we give some medicine into the surgical incision so that they don’t feel anything, so it numbs the area. The anesthesiologist will give just give them a little bit of medicine to make them nice and comfortable so they won’t know what’s going on. Along those lines, what I often tell families is the child is going to have no pain and they are going to have no memory of the operation whatsoever because they’re given a little something before that makes them nice and comfortable. They go to sleep, have their operation, and oftentimes, they wake up and say, “Oh, I didn’t even realize that surgery was done already.” I think that’s certainly a common concern is about the anesthesia, but I can certainly say that here, they are well taken care of. Those children are very well taken care of.
Melanie: As far as that medication to help calm the children down, Dr. Gander, I would think the parents need that even more so than the child. What do you tell these nervous, freaked out parents? I give you so much credit working with parents as a pediatric surgeon, Dr. Gander. What do you tell the parents that they should be doing before, during, and after their child goes in for surgery?
Dr. Gander: Right. Before surgery, I tell them just to ask me as many questions as they can. Because like I said, people are well informed. There’s a lot of information. People will often come in with some of their own concerns and their own anxieties about their child having operation. I do sit down with them and spend most of the visits just going over that. What are your questions about the operation? What are your concerns? I do my best as well as the nurses I work with very closely. Here at UVA, we do our best to answer those questions to kind of make them a little bit less anxious. That morning of the surgery, I just tell them, go through their normal routine. We can talk about it later, but the child is not allowed to eat anything, but how the family makes sure that they eat some breakfast, make sure they got a good night’s rest because they need to be there for the child the next day. During the operation, what I often tell people is go out, grab a cup of coffee, go get something to eat and read the newspaper. Oftentimes, they won’t be able to do that because they’d be so nervous. Just try not to think about it for a period of time. Then for after the operation, I’ll always confine them and just go over everything and often, what I’ll do, as in before, I’ll tell them, give them a rough estimate how long the operation’s going to be because then they can sort of say, “Oh, well, they told me it’s going to take two hours, so I won’t be worried because it’s only been an hour-and-a-half.” At least you give them some period, something to anticipate so that they know that there’s a period of time they may be in during the operation and they can expect to hear from us around that time. Then for after the surgery, what I tell families is that their child will have some pain afterwards, some discomfort, and depending on what type of surgery it is, whether it’s a general abdominal or operation or something on the leg or bones, the pain will be different with each procedure. I assure them that our team, the surgery team as well as the anesthesia team in the recovery room, will do our best to alleviate that pain and help control that pain. I think with hearing all those things and just speaking with the families, it often helps out a lot for them.
Melanie: In just the last few minutes, Dr. Gander, what could parents do or say to their children? Based on a child level of understanding of what’s going to happen to them, what do we tell our children to put them at ease from all those lights and the scary people in white coats and then why should families come to UVA Children’s Hospital for their care?
Dr. Gander: Right. Children are very smart and they understand something is going on. Try to explain to them as best we can what is going on and why they need to have the procedure. What we do in our preoperative visit and as well as sometimes we ask the families to do is we have certain dolls and teddy bears that have devices. If they’re having a feeding tube placed or a Port-A-Cath we call, something that goes underneath the skin to help them get the medicine infused, we show them what these things look like and show them on a doll or a mannequin so that they can at least be used to what’s happening or give them an idea about that. We have a child life specialist who works with them before the operation to try to get them used to a mask sometimes that the anesthesiologist will put on for them. Then, like I said, the medicine that they give beforehand sometimes makes them nice and relaxed for when they go back to the operating room. I always ask them what kind of music they like to listen to, so I will try to put a little bit of music on at the beginning of the operation, anything—I like all kinds of music and I know all the nurses do, too—anything they want to listen to, just to make them nice and calm. We all introduce ourselves beforehand, not only to the families, but there’s typically at least six people in the operating rooms, two surgeons, two anesthesiologists, and two nurses, and we all introduce ourselves by our first name and then once they come back into the operating room, we re-introduce ourselves again. Say, “Remember me? I have a mask on, but we’re going to help and take care of you.” I think all those things really often help out these children. As far as coming to UVA, I think, the nice thing about here is everyone works as a team. The kind of olden days of the surgeon as the captain of the ship are gone, and it’s really everybody works together. Like I mentioned, there’s usually at least six people in the operating room, if not sometimes more than that, all working to take care of children. We all communicate pretty well. If someone has a concern, they bring it up to the group and we try to do our best to do that because our ultimate goal is for the child to be safe during the operation and have the operation be successful so that whatever was wrong with them can be fixed.
Melanie: Thank you so much, Dr. Jeffrey Gander. It’s really great information. You’re listening to UVA Health Systems Radio and for more information, you can go to uvahealth.com. That’s uvahealth.com. This is Melanie Cole. Thanks so much for listening and have a great day.
How to Prepare Your Child for Surgery
Melanie Cole (Host): Getting your child ready for surgery doesn’t have to be such a scary experience, and we’re offering you today some tips on how to prepare your child and yourself from UVA pediatric surgeon, Dr. Jeffrey Gander. Welcome to the show today, Dr. Gander. Tell us a little bit about what are some of the most concerns you hear from families before they have to have surgery for their child.
Dr. Jeffrey Gander (Guest): Hi, Melanie. How are you? Thank you very much for having me on. Happy New Year to you. That’s a great question. I hear a lot of concerns from families before surgery. One is, how is their child going to cope with being separated from them, often for a couple of hours at a time? That’s one thing they worry about, having to say goodbye to their child when the child’s taken off to the operating room. Another thing they ask often is because with surgery, there is incision and opening of other skin in some part of their body and they are worried about are they going to have pain during the surgery and are they going to have pain after the surgery? Another thing we get asked a lot is about anesthesia. What kind of anesthesia, what are the side effects of the anesthesia, things like that? It’s certainly understandable. I have a couple of young ones myself. I understand them well to be concerned when your child is going to have an operation.
Melanie: As a parent myself, Dr. Gander, I have been there. Both my children have had to have surgery at some point. How do you address those concerns, like, for example, I was worried about anesthesia myself, how a child tolerates that anesthesia and what’s going to happen afterwards, how lethargic will they be for that day following. I know it’s individual for each child, but how do you answer those questions that you listed?
Dr. Gander: Well, a lot of times I reassure the families and I’d say that the anesthesiologist we have here at UVA that are going to be taking care of their children are all fellowship trained in just taking care of children. They have a lot of experience. They’re just some of the best doctors we have in the hospital. They are very used to taking care of premature babies who are less than a pound at birth to adolescents and even to early 20s. They are very used to taking care of children. That’s a good thing, is that they have a lot of experience. What they do, what helps also, is that they often get a little medicine to help them to get into the operating room. I know the anesthesiology team – because a lot of families and a lot of children are very anxious – will even give a little bit of something to sedate them a little bit so they can come into the operating room and be a little bit more comfortable and not be as nervous. The reason I bring that up is because often when a child is less nervous, they often need less anesthesia, so that actually helps them to go to sleep a little bit easier and then actually wake up and not be quite as groggy after the operation. That goes with the families, too. Children as you know read off the emotions of their parents, very much so. If a family or a parent is anxious, then the child is going to be anxious as well. Like I said, that even sometimes makes them have to have more of the anesthesia and even sometimes, more medicine. There’s a lot of different types of anesthesia and depending on what type of the operation is, sometimes, it can happen under just a local anesthetic where we give some medicine into the surgical incision so that they don’t feel anything, so it numbs the area. The anesthesiologist will give just give them a little bit of medicine to make them nice and comfortable so they won’t know what’s going on. Along those lines, what I often tell families is the child is going to have no pain and they are going to have no memory of the operation whatsoever because they’re given a little something before that makes them nice and comfortable. They go to sleep, have their operation, and oftentimes, they wake up and say, “Oh, I didn’t even realize that surgery was done already.” I think that’s certainly a common concern is about the anesthesia, but I can certainly say that here, they are well taken care of. Those children are very well taken care of.
Melanie: As far as that medication to help calm the children down, Dr. Gander, I would think the parents need that even more so than the child. What do you tell these nervous, freaked out parents? I give you so much credit working with parents as a pediatric surgeon, Dr. Gander. What do you tell the parents that they should be doing before, during, and after their child goes in for surgery?
Dr. Gander: Right. Before surgery, I tell them just to ask me as many questions as they can. Because like I said, people are well informed. There’s a lot of information. People will often come in with some of their own concerns and their own anxieties about their child having operation. I do sit down with them and spend most of the visits just going over that. What are your questions about the operation? What are your concerns? I do my best as well as the nurses I work with very closely. Here at UVA, we do our best to answer those questions to kind of make them a little bit less anxious. That morning of the surgery, I just tell them, go through their normal routine. We can talk about it later, but the child is not allowed to eat anything, but how the family makes sure that they eat some breakfast, make sure they got a good night’s rest because they need to be there for the child the next day. During the operation, what I often tell people is go out, grab a cup of coffee, go get something to eat and read the newspaper. Oftentimes, they won’t be able to do that because they’d be so nervous. Just try not to think about it for a period of time. Then for after the operation, I’ll always confine them and just go over everything and often, what I’ll do, as in before, I’ll tell them, give them a rough estimate how long the operation’s going to be because then they can sort of say, “Oh, well, they told me it’s going to take two hours, so I won’t be worried because it’s only been an hour-and-a-half.” At least you give them some period, something to anticipate so that they know that there’s a period of time they may be in during the operation and they can expect to hear from us around that time. Then for after the surgery, what I tell families is that their child will have some pain afterwards, some discomfort, and depending on what type of surgery it is, whether it’s a general abdominal or operation or something on the leg or bones, the pain will be different with each procedure. I assure them that our team, the surgery team as well as the anesthesia team in the recovery room, will do our best to alleviate that pain and help control that pain. I think with hearing all those things and just speaking with the families, it often helps out a lot for them.
Melanie: In just the last few minutes, Dr. Gander, what could parents do or say to their children? Based on a child level of understanding of what’s going to happen to them, what do we tell our children to put them at ease from all those lights and the scary people in white coats and then why should families come to UVA Children’s Hospital for their care?
Dr. Gander: Right. Children are very smart and they understand something is going on. Try to explain to them as best we can what is going on and why they need to have the procedure. What we do in our preoperative visit and as well as sometimes we ask the families to do is we have certain dolls and teddy bears that have devices. If they’re having a feeding tube placed or a Port-A-Cath we call, something that goes underneath the skin to help them get the medicine infused, we show them what these things look like and show them on a doll or a mannequin so that they can at least be used to what’s happening or give them an idea about that. We have a child life specialist who works with them before the operation to try to get them used to a mask sometimes that the anesthesiologist will put on for them. Then, like I said, the medicine that they give beforehand sometimes makes them nice and relaxed for when they go back to the operating room. I always ask them what kind of music they like to listen to, so I will try to put a little bit of music on at the beginning of the operation, anything—I like all kinds of music and I know all the nurses do, too—anything they want to listen to, just to make them nice and calm. We all introduce ourselves beforehand, not only to the families, but there’s typically at least six people in the operating rooms, two surgeons, two anesthesiologists, and two nurses, and we all introduce ourselves by our first name and then once they come back into the operating room, we re-introduce ourselves again. Say, “Remember me? I have a mask on, but we’re going to help and take care of you.” I think all those things really often help out these children. As far as coming to UVA, I think, the nice thing about here is everyone works as a team. The kind of olden days of the surgeon as the captain of the ship are gone, and it’s really everybody works together. Like I mentioned, there’s usually at least six people in the operating room, if not sometimes more than that, all working to take care of children. We all communicate pretty well. If someone has a concern, they bring it up to the group and we try to do our best to do that because our ultimate goal is for the child to be safe during the operation and have the operation be successful so that whatever was wrong with them can be fixed.
Melanie: Thank you so much, Dr. Jeffrey Gander. It’s really great information. You’re listening to UVA Health Systems Radio and for more information, you can go to uvahealth.com. That’s uvahealth.com. This is Melanie Cole. Thanks so much for listening and have a great day.