2 THE MESSAGE TO PARENTS This book is designed to help you and your child know what to expect on the day of surgery. It also describes ways parents can emotionally prepare a child for his or her operation. HOW YOU CAN HELP 1) Prepare yourself for you child s surgery. The staff at the Cleveland Clinic Hospital realize that a child having surgery can be stressful for the parents. A child who senses a parent s anxiety tends to become more anxious, which limits his or her ability to cope effectively. Make sure that your questions and concerns are addressed by the appropriate personnel and that you receive enough information so that you are as comfortable as possible. Prior to the day of surgery, specific and more detailed information regarding your child s anesthesia is available by contacting the pediatric anesthesia department. Pre-operative tours are a way to familiarize you and your child with the hospital environment. 2) Your presence is an essential part of your child s well being. Separation between child and parents is often one of a child s greatest fears when encountering surgery. Assure your child that you will be with him or her as much as possible. 3) What do I tell my child and how do I start? Children need to know: 1) that he or she is coming to the hospital. 2) why and when he or she is coming to the hospital. Children usually have questions and many different feelings prior to surgery. Encourage your child to ask questions and share his or her feelings about having surgery. Simple, honest answers and explanations work best. Be mindful of the language you use. For instance, instead of cut say make an opening or remove. It is not uncommon for children to view surgery as a punishment or to be afraid of waking up during surgery. Child Life Specialists and other hospital staff can help explain these and any other concerns that may be expressed during discussion with your child.
3 MY GOING TO SURGERY BOOK This book belongs to: I am having surgery on: Date: My doctor's name is: I live in: When I am at home I like to: One thing that I would like everyone at the hospital to know about me, is:
4 MY GOING TO SURGERY BOOK created by Gary Kitaoka, B.A., CCLS, Child Life Specialist Michelle Shannon, B.A., CCLS Child Life Specialist Mandy Post, B.A., CCLS, Child Life Specialist edited by Ashley Wood, B.S., CCLS, Child Life Specialist illustrated by Ken Kula With encouragement from Frederick Alexander, M.D. THANK YOU TO: FOR YOUR GENEROUS FINANCIAL SUPPORT The Child Life Program would like to thank all those who helped with this special project, especially: Center for Medical Art and Photography Pediatric Anesthesia Pediatric Surgery Pediatric Subspecialties Pediatric OR/PACU Nursing Social Work Back cover artwork by
5 Your family and doctor have decided that you need to have an operation. Some people call it having surgery. You may have many different feelings about this. This is a book that will help you learn more about your surgery. 1
6 Can you make a circle on this picture on the part of the body your surgery is going to be? FRONT BACK 2
7 Sometimes it helps if you bring something to the hospital that you really like, such as a stuffed animal, a game, a special toy, a book or even your favorite music. What will you bring? 3
8 On the morning of your surgery, you will not be allowed to eat and drink like you would on ordinary days. This is because you will be getting a special kind of medicine called anesthesia which works best when your tummy is mostly empty. Make sure you ask your parents and doctor when you are allowed to eat or drink. 4
9 Some kids feel excited, some feel unsure, and some may even feel a little nervous. It is important to share your feelings with your family and people at the hospital. 5
10 6 Inside, a nice person behind a desk will tell you and your family which room to go to next.
11 After you enter your room, you will be asked to change into special pajamas. What color do you think they will be? The room has a bed, a television, and some special equipment inside. 7
12 thermometer 2 name bracelet 3 pulse oximeter 8 Soon a nurse will come in to meet you. This is the nurse who will take care of you before your surgery. She will give you a special bracelet to wear. She will ask you and your family some questions, measure your temperature, and place something called a pulse oximeter on your finger which measures your oxygen level. If you look closely, you can see a bright, red light.
13 You will meet many different people on the day of your surgery. All of them are there to help you and your family. Surgeon Transporter Anesthesiologist Child Life Specialist Nurse 9
14 In the operating room, you will be given a special kind of during your surgery. This will make you fall asleep. This is a different sleep than the sleep you have at night. You will stay asleep until your surgery is done. Then, the doctor will stop giving the anesthesia medicine, and you will slowly begin to wake up. There are two ways that anesthesia is given. 10 The first way is to breathe the medicine through a clear, soft mask which fits over your nose and mouth. If you like, you can pick a flavor to put inside your mask. Sometimes it helps to practice while you are waiting.
15 The second way is through a very tiny plastic straw which is often placed in a vein in your hand. This tiny straw is called an IV. Now your medicine can go through the tube which is connected to the tiny straw. 11
16 12 Before you go to the operating room, you may need to take some medicine. This medicine may help you feel a little tired. It may help to drink it fast.
17 After talking to your anesthesia doctor, one of your parents may be allowed to go to the operating room with you. They will have to wear a special long sleeved gown, a paper hat, and mask which covers their mouth and nose. OPERATING ROOM What color do you think the gown is? 13
18 14 Soon it will be time to go to the operating room. This is the room where your surgery will take place. The sides of your bed will be put up and someone will roll your bed down the hall to the operating room.
19 The people in the operating room may look strange to you, since they will be wearing paper hats, masks and special clothing. This is to help keep the room as germ free as possible. The operating room is bright with big, round lights on the ceiling, different machines, some of which make beeping sounds, and a long bed with green sheets on it. The nurses and doctors will help you move on to this bed. 15
20 While you are in the operating room, the doctors and nurses will watch you closely. One way they do this is by attaching three different kinds of monitors to you.
21 Heart electrodes Stickers which measure your heart beat during surgery. 1 Attaches to your chest and back Blood pressure cuff Measures how fast your blood is moving through your body. 2 Wraps around your arm or leg Pulse oximeter - Measures your breathing during surgery. 3 Placed on your finger or toe 17
22 Soon, it will be time to breathe through the soft, clear mask which we talked about earlier. It may help to count slowly or to think of a place that is familiar and comfortable. The air that you breathe may smell funny, but that lasts only for a short time. If you already have an IV, then the doctor can put your anesthesia medicine through that tube. You will fall asleep quickly. Now it is time for the doctor to do your surgery. 18
23 When you wake up, your surgery will be all over and your family will be nearby. Most kids say that if feels like it took a very short time. You may feel tired and some kids even say they feel yucky, but soon you will begin to feel better. You will still have on some of the same monitors that you had on before surgery. If you did not have an IV before, you will notice that one was put in during your surgery. 19
24 20 Before you go home, the nurse will take out your IV, and put a Band-Aid there. Now it is time to get dressed. Since you may still be a little sleepy, someone will push you in a wheelchair to your car.
25 At home you will be able to rest until you are feeling better. 21
26 ADMISSION TO HOSPITAL You may need to stay overnight or even longer in the hospital. This is up to your doctor. 22
27 If you need to stay in the hospital, you will ride on a bed with wheels to your room. When you get to your hospital room, you will meet a new nurse who will help take care of you while you are in the hospital. 23
28 24 While you are in the hospital, it is OK for one of your family members to spend the night with you. If your room has two beds, you might have a roommate. Each room has a button to call the nurse if you need help. To make your room feel more like home each room has a telephone and a television.
29 The doctor will tell you when you are well enough to go home. On that day, you will get to ride in a wheelchair out of the hospital. Remember to say good-bye to your new friends at 25
31 4) Pre-operative tours Tours of the hospital are available by Child Life Specialists. Children and families may meet staff members, become more familiar with some of the medical equipment, and address any specific concern you or your child might have about the day of surgery. 5) Play Give your child opportunities to rehearse surgery events and play hospital. A doll or stuffed animal can be used to show a child where on his or her body the surgery will be and to demonstrate and practice procedures that he or she can expect to experience. Take home hospital materials such as surgical caps and masks are provided during pre-operative tours. Child Life Specialists utilize medical play and rehearsal to help prepare children for surgery. 6) Encourage your child to participate in preparing to go to the hospital. Encourage your child to help select and pack items to take to the hospital. Favorite dolls/stuffed animals, books, music, games and toys often make children feel more comfortable. 7) Read this book with your child in a calm, quiet environment. Many of your child s questions will be answered in reading this book. Your child s specific surgery may require additional equipment and experiences not described in this book such as casts, additional IV lines, tubes, or a stay in the ICU. For many children, it is important that they are prepared for these experiences. Nurses and Child Life Specialists can assist you with this process. 8) What to Expect When Your Child is Having Surgery. This DVD can be requested from your child s doctor s office or through the Child Life Program. IMPORTANT TELEPHONE NUMBERS Pediatric Anesthesia 7:00 a.m. - 5:00 p.m. after 5:00 p.m. Office (216) (216) ask for the Pediatric Anesthesiologist on-call Child Life Program (216) (pre-operative tours) Your child s surgery office
32 The Cleveland Clinic Foundation PWO 9990 Rev. 5/10
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