Childhood Cancer

Your Child in the Hospital

Preparing your child

Most children cope best with surgery if you prepare them by explaining why the surgery is necessary and what it entails. The amount and type of information you give your child depends on his age and temperament. Using age-appropriate explanations to prepare your child will help him understand what is happening and reduce any fears or anxiety he may be feeling. Siblings also need to be prepared for the upcoming event (see Chapter 13, Siblings). Below are a few general guidelines for preparing your child, keeping in mind that each child is different and you know your child best.

Toddlers (ages 1-2). The day before the surgery, give a simple explanation such as “The doctor is going to fix the owies in your ears.” Give choices about what to pack and say that you’ll be seeing the doctor in a hospital. Looking at a book about a visit to the hospital is very helpful (see the Resources section for suggestions).

Preschoolers (ages 3-5). A day or two before the surgery, describe the type of surgery and when it will happen. Make sure your child knows why the surgery is necessary (e.g., “The doctor is going to fix your tonsils”) because some children this age think surgery is a punishment for “being bad.” Reassure your preschooler that you will stay with her in the hospital. Playing about the surgery helps (e.g., with dolls, toy doctors’ kits) as does talking with a child life specialist and your pediatrician.

School-aged children (ages 6-12). One or two weeks before the surgery, explain what it is, why it is necessary, and when it will happen. Together, read age-appropriate books or watch videos supplied by the doctor. When talking about the surgery, use terms your child will understand, be honest, and answer all questions. If you don’t know the answer, tell your child you’ll find out, and then do that.

Teens (ages 13-18). Parents and teens should be partners in obtaining accurate information and making decisions about the surgery. Your teenager may be concerned about body image, privacy, or things that might affect her relationships with friends, so it is important to talk about these issues and feelings honestly. Encourage your teen to ask the doctors and nurses questions and talk over any concerns.

Your child likely will have questions about surgery that might not occur to you. You can read books about hospitals together to give your child a chance to ask questions (some suggestions are in the Resources section at the end of this book).

My daughter, Claire, has been hospitalized twice, for a tonsillectomy and to have tubes put in her ears. Before both surgeries, we took her to the grocery store to pick out Popsicles® and ice cream for when she came home. We went to the bookstore where she picked books to read and the movie rental store for movies. We also let her choose new sheets for her bed and new pajamas. All these things gave her some control over what was going to happen, as well as something exciting to look forward to after the surgery. It allowed us to explain that she would be sore and tired, but we could still have a fun time.

It’s a good idea to also explain anesthesia: your child will be given medicine that cause a special kind of sleep and, when she wakes up, the surgery will be over. Young children need to understand that sleep under anesthesia is not the same as regular sleep. Explain that she will not wake up during surgery and will not remember what happens.

Try to arrange a meeting between your child and members of the medical team, particularly the surgeon and anesthesiologist. The doctors and nurses on the team can answer questions and are less likely to frighten your child if their faces are familiar. See Chapter 3, Preparing Your Child, about taking a hospital tour and how child life specialists can help prepare your child for surgery. Many hospitals now have online tours and age-appropriate interactive activities to help prepare children for upcoming surgeries.

Young children also need to know that they will ride to surgery in a bed on wheels and, in the operating room, doctors and nurses will wear blue face masks and hair nets and outfits that look like blue pajamas. You can tell your child that, even though he has met the surgeon, it might be hard to identify him among the other blue-masked people.

Your doctor or surgeon can explain to your child what to expect after surgery: an IV, catheter, bandages, stitches, or the need for crutches or a wheelchair. Also, try to prepare your child for any pain. For example, her throat will hurt after her tonsils are removed or his belly may ache after a hernia operation. Most children can tolerate some discomfort, but they do better when prepared for it.

Other things to know before surgery:

Instructions for the night before. Find out when your child must stop eating and drinking. For example, sometimes the instructions say do not eat or drink after midnight before the surgery. Scheduling the surgery for early morning can prevent hunger and thirst from becoming a problem for your youngster.

Prescriptions. If you can get prescriptions for medications ahead of time, it may be easier for you to fill them before the surgery, rather than after.

Diet and exercise after surgery. Ask whether there will be any restrictions on diet or exercise after the surgery. For example, if your child is having surgery of the mouth of throat, you might want to stock up on soft foods ahead of time.

After Claire had her tonsillectomy, she was feeling pretty good. A friend and her three children came to visit her at home that evening. The kids went out and played hard: swinging on the swings and running around. I should have known to keep her calmer and told them to go home much earlier. The visit really stressed her system and she was very ill for the next two days.