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What is a Pediatric Surgeon?

When your child needs medical treatment, you want him or her to have the very best care available. So it stands to reason that if your child needs an operation, you will want to consult with a surgeon who is qualified and experienced in operating on children.

Surgeons who specialize in general surgery often provide surgical care for children, and they are fully qualified to perform many operations on children.

In more urbanized areas of the country, another kind of surgeon—”the pediatric surgeon”—is also available to provide comprehensive surgical care for children.

Pediatric surgeons operate on children whose development ranges from the newborn stage through the teenage years. In addition to completing training and achieving board certification, pediatric surgeons complete two additional years of training exclusively in children's surgery. They then receive special certification in the subspecialty of pediatric surgery.

This information is brought to you by APSA. For more information on pediatric surgeons, click here.

How do you explain surgery to your child?

Giving your child accurate information when preparing him for surgery is essential to their being calm before and after surgery. Explain the procedure to your child as accurately as possible, telling your child “I don’t know but I will find out” if you do not know the answer to a question. For example, don’t tell your child that you will accompany them to the operating room if you are not sure this is possible.

A normal part of surgery, like saying goodbye in the pre-surgery area, can be traumatic when the expectation was that goodbyes would occur after being escorted into the operating room.

"I don’t know" is preferable to providing information that is wrong, which can cause significant distress for the child when their expectations are different from what they are experiencing. Just remember to obtain the correct answer, especially if your child asks the same question repeatedly while waiting for an answer.

What should your child know before surgery?

Children are very wary of surgery and may have questions or concerns that they never mention. These are important topics that you may want to address before your child has surgery, depending upon their age

  • Anesthesia prevents pain during surgery.
  • You are not having surgery because you were bad, surgery is not a punishment.
  • If there is pain after surgery, medication is available to make it better, so you have to tell your parent, doctor, or nurse when you hurt.
  • Your surgery is not the same as ____’s (grandma, brother, friend, person on TV) surgery.
  • Your ____ may hurt more (or less) after surgery.
  • After surgery, your _____(body part) will have a (cast, bandage, IV, stitches).
  • We will see you when you (wake up, leave the OR, surgery ends, you are back in your hospital room).
  • The doctors and nurses will be dressed in hats and masks and some even wear funny glasses to see better during surgery.
  • Surgery in real life is different from surgery on TV.
  • You will get special medicine to make you sleep during surgery, the medicine makes sure you don’t wake up before the surgery is over.
  • You will wake up after the surgery when the doctor is completely finished.

What should you NOT say to your child before surgery?

Children are very sensitive to the words used to explain what surgery is, what will happen and how surgery is performed. These are some key phrases to avoid using, as children are prone to misinterpreting what is being said.

  • They will give you “gas” - To children, gas is something that we put in cars or a rude substance that comes from one’s bottom.
  • “Anesthetize” - This word sounds like euthanize and can cause problems if your child knows the word euthanize, searches the internet or hears the word euthanize used in another setting. Anesthesia is a foreign word to children and needs to be explained.
  • They will give you medicine to “knock you out” - To most people, being knocked out means being hit hard enough to be rendered unconscious.
  • “The doctor is going to make you take a nap” or “It’s just like bedtime” - Try to avoid confusing surgery with a normal daily ritual at home. If your child is afraid of surgery, they could become afraid of naps at home. It could also lead to fears of waking prior to the end of surgery.
  • “You will be put to sleep” - Many children are aware that when we put animals to sleep they die and may assume they too will die.
  • “You won’t wake up” - It is important to stress that they will sleep through the surgery without feeling pain, but that they will wake after surgery is completed. Children fear both never waking and waking during the procedure.
  • “Be a big boy and don’t cry” - Children need to be encouraged to talk about their fears prior to surgery and their pain after surgery. Surgery is scary and children need to be encouraged to discuss their fears so they can be discussed and alleviated.
  • “It is just like on TV” - Surgery isn’t like the surgeries on TV, where actors jump on top of patients and perform CPR and patients die after the less than successful heroics of the fictional staff.

How do you prepare an infant or toddler for surgery?

At the infant and toddler stage of development preparing for surgery is mostly about preparing the parents for what is happening and what to expect after surgery. Toddlers will require very simple and straightforward explanations of what is happening with minimal information. For example, you may want to say “the doctor is going to make your leg better”, rather than a detailed explanation that will merely confuse your child.

Before surgery children may be tearful or fussy, as they will be required to go without food or drink before surgery as an adult would. The hospital, with different noises, faces and activities can be upsetting, and your child may require much more comforting and want to be held more than usual.

Like their older counterparts, children will often take on the attitudes of their parents, so if you appear to be upset and concerned, they will also be upset. Presenting a calm, happy attitude when around your child will help considerably when trying to keep them calm and comfortable.

After surgery, you can expect your child to be fussy, and in some cases, difficult to console. The combination of pain from the procedure, an empty stomach, and feeling strange due to the anesthesia typically results in a crying baby that will need to be held and comforted.

How do you prepare a preschooler for surgery?

Children at the preschool level of development are old enough to be scared by the thought of surgery. Preschool-aged children tend to fear separation from their parents, mutilation of their bodies and fear pain from any source.

These typical fears can guide your conversation with your child, giving you the opportunity to explain that you will be with them, that the surgery will make them better and not hurt their body, and that medication will be available if they have pain.

Keep in mind that your preschooler may be comforted by having familiar objects present with them, such as their favorite blanket and stuffed animal. Consider bringing their typical activities with them to the hospital, such as reading a book before nap time or brushing their teeth before bed.

After surgery, expect your preschooler to be irritable and much more difficult to deal with than is normal. This should be a temporary phase, decreasing as your child’s pain level is relieved and life returns to normal.

How do you prepare an elementary age child for surgery?

Children of elementary age are old enough to require clear and concise information about surgery. While they are old enough to have significant fears about surgery, they tend to keep their worries to themselves and will silently worry about concerns that may seem strange to an adult. Your preschool-aged child will require reassurances that they are not being punished, that they will survive the surgery and that their pain will be controlled.

Depending on the age of your child, they may worry that they will be left alone and may repeatedly ask where you will be during the procedure. They may also fall into the “are we there yet” syndrome, so giving children more than a week’s notice may not be a good idea, based on the maturity of the child.

After surgery, your child may be caught between feeling like a child and wanting to be mature at the same time.

How do you prepare an adolescent or teenager for surgery?

Older children, such as those of junior high and high school age, share many of the same fears regarding surgery. As a whole, children in these age groups fear dying during surgery, being disfigured or obviously different from their peers after surgery and showing weakness or a loss of control.

Your child is old enough to understand what happens during surgery and will require a more detailed explanation than younger children. Children of this age may feel information is being withheld from them if they are excluded from decisions and discussions about their health.

This age group is more likely to deny having any pain when they are indeed in pain after surgery, in an effort to maintain control of the situation. They are more likely to deny they have any symptoms of surgical complications, especially if the complication is potentially embarrassing like constipation or the inability to urinate.

One way to help this age group deal with the stress of surgery both before and after the procedure is to allow them to bring their headphones, books, or other personal items that provide a distraction with them.

How do you prepare a child for surgery and anesthesia?

Preparing a child for surgery emotionally is one of the most important things parents can do when their child is facing a surgical procedure. Surgery, without proper explanations and preparation, can traumatize children.

Preparing a child for surgery is not difficult, but it is essential to understand that many children will adopt their parent’s attitude about healthcare and surgery. If the parent is frightened or hysterical, the child is much more likely to be frightened or hysterical.

It is also important that your body language matches your words. If a parent is saying, “It’s going to be OK," but their body language says, “I’m terrified”, the child will usually adopt the attitude of fear. This may be easier said than done, as most parents do feel fear when their child needs surgery, but being aware of the issue can be helpful.

The worst thing a parent can do before surgery is to not prepare the child at all, so surgery is a surprise and they are completely unaware of what is happening to them. Children who are shocked by the fact they are having surgery often act out, crying, screaming, and attempting to bite, kick or hit staff and family members. These children can be left with a fear of hospitals, surgery, doctors, nurses, and healthcare in general.

How do you prepare yourself as a parent or guardian for a child's surgery?

Having a sick child who needs surgery can be extremely stressful for a parent. It is important to know that you are not alone and that many parents experience the stress of a child having surgery each day. Have a support system during this difficult time can be very helpful for both you and your child, as children are usually very aware of their parent’s state of mind.

You don’t need to do everything yourself, every minute of the day. If you have a support system of family and friends, seriously consider enlisting help before the procedure in preparation for the time following surgery, especially if your child is expected to be tearful and will need to be held and consoled after surgery.

Remember that your child will be cared for by professionals while in the hospital and that it is absolutely encouraged that you take some time for yourself to sleep, shower and eat. Taking care of yourself will help you provide the support your child needs.

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