Children’s experiences of surgery

What’s it like for a child to experience an operation? This is more than just an idle question if your child is having surgery, and one I suspect has caused you more than one sleepless night. Hospitals have greatly improved how they support both the child and you, but even with the best care the experience can still be scary, stressful, emotional and long-lasting.

Age matters

While it’s even more scary for you if it’s your precious baby having surgery, operations carried out by 18 months – 2 years are fantastic for your child, because he or she is highly unlikely to have any memory of the surgery or staying in hospital. A hospital is a strange and frightening environment with its own smells, rules and people. While research shows that children can still be traumatised at a very early age, it does seem to be less likely.

Toddler age and up to school age is perhaps the most difficult. Your child’s grasp of language is still developing, as is their way of thinking. They don’t understand why they’re in hospital or why these things that aren’t nice are needed.

For older children the fear is more tangible, and they’ll understand something of what’s happening – and hopefully why. Doctors and nurses are better trained to treat children this age as people rather than items who move but don’t think, which is really useful.

There are a number of academic papers on this subject – if you are interested and able to access them I’ve provided a reading list at the end.

Temperament matters

Does your child think only of now, of the future, or the past? Some children are timid (I was one of those). Others suffer knocks but have a never-ending thirst for life. How your son or daughter reacts to all life throws at them will make a huge difference to how they cope with the operation, and is why I can’t generalise how they will react.

Your feelings matter

Are you terrified of your son or daughter having surgery? Do you picture them in pain or undergoing a painful procedure? Are you scared of how it will be? If so, you’re not alone (you’re a normal human!). Can your child pick up on your fears, however much you think you’ve hidden them away? Yes.

Children can pick up on your anxiety, it gives them a guide as to whether to be anxious themselves. The best way you can help your child is by trying to relax as much as possible; not put a brave face on but actually be calm. If that doesn’t come naturally now may be the time to seek some help from a counsellor or therapist so you can give your child the best help possible.

The hospital staff matter

Kind, friendly and understanding medical staff can make all the difference. Make sure you choose well if you have the choice. While it’s passed into folklore that the best surgeons have the worst bedside manner, that isn’t always the case, and especially not in paediatric surgery! If possible, ensure your child is treated by a specialist children’s surgery team, and not a general surgeon. This is harder to ensure for simple/minor operations (like an undescended testicle, tonsillectomy etc) or if you live near a smaller hospital. Always ask if it’s possible, and find out how much experience with children the surgeon has – it’s your child and you want the best for them.

Conclusions

In spite of everyone’s best efforts, keep an eye on how your child develops after the operation

..If clinicians fail to look through a trauma lens and to conceptualize client problems as related possibly to current or past trauma, they may fail to see that trauma victims, young and old, organize much of
their lives around repetitive patterns of reliving and warding off traumatic memories, reminders, and affects.

Reading list (academic)

Hägglöf, B. “Psychological reaction by children of various ages to hospital care and invasive procedures.” Acta Paediatrica 88, no. s431 (1999): 72-78.

This one looks to be a very interesting paper, backing up my own experience and findings from talking to others.

Caldas, J. C. S., Pais-Ribeiro, J. L. and Carneiro, S. R. (2004), General anesthesia, surgery and hospitalization in children and their effects upon cognitive, academic, emotional and sociobehavioral development – a review. Pediatric Anesthesia, 14: 910–915. doi: 10.1111/j.1460-9592.2004.01350.x

http://www.ncbi.nlm.nih.gov/pubmed/7527524

http://www.ncbi.nlm.nih.gov/pubmed/20546356

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