Insider’s Guide to Outpatient Surgery with a 5.5-year-old*

*Subtitle: There are worse things, but that still doesn’t mean it’s enjoyable**
** Alternate subtitle: No matter what you think will happen, things will be different so don’t spend too much time preparing for anything (but do bring a snack)

As mentioned and documented on Instagram, Liam had a little outpatient surgery last Friday at our local [awesome] Children’s Hospital. Jack also had outpatient surgery in November 2010; a much more major procedure that resulted in lots of stitches on his foot (where a bone was removed from his toe) and 12 weeks with a cast and brace on his arm (where the toe bone was inserted into his thumb). Liam’s procedure resulted in a few internal stitches (to fix a previously undiscovered hernia), a single internal stitch to close up the small hole in his belly button where the unhealed spot was removed and a small square of gauze bandaged over the “wound.” Yet, our whole experience was completely different for many different factors.

So, for what it’s worth, here’s what I learned and would like to share with you:

• You have to use your own judgement in how you prepare your child for the experience. Liam is very laid back about things and I knew I didn’t have to prep him very much in advance of the surgery for what was going to be happening. After we initially met with the doctor, I told Liam he’d be going to the hospital to have the spot removed (never mentioning exactly how this was going to happen), that they would give him medicine to sleep when this happened and that we’d be there with him. But otherwise, we left it rather vague and it worked for us, though I probably should have mentioned to him that his tummy was going to hurt after the surgery because I think he was surprised by the pain and that upset him more than anything (Jack, on the other hand, didn’t seem at all affected by pain post-surgery).
• Use the hospital staff to help explain the procedure to your child. They had a child/life specialist come talk to Liam and explain to him what was going to happen in terms he could understand that weren’t at all scary. I never would have thought to refer to the IV as a tiny straw that goes in his hand to give his body drinks while he was sleeping since he couldn’t do that while he was asleep. They also had a handy trick where they let the kid pick out a chapstick with a scent they liked and then “paint” the inside of the anesthesia mask with the chapstick so the child smells that rather than the “sleepy” medicine. Seriously phenomenal.

• Defer to the professionals for how you should handle the situation but also follow your own intuition. We had the option of going into the surgical room with Liam to be there with him while he fell asleep but I knew that he didn’t need that from us (if there is a next time, we probably will do this because I think he’d have some apprehension given his experience with this surgery). I think the specialist was trying to encourage us to go but I know it would have been harder on both of us to do that so I’m glad we didn’t.
• Nothing will prepare you for seeing your child curled up on a hospital bed, post-op. Liam’s surgery was pretty tiny and inconsequential but it still broke my heart to see him in the recovery room. It didn’t help that he started crying when he saw us.
• Five-year-olds are more attuned to their feelings than younger children and therefore, harder to calm, soothe and distract. While Jack was out of it post-surgery and just wanted to cuddle, he didn’t think too much about it and wasn’t upset by it all. Liam was more upset about his post-surgical haze because he knew better and knew that he wasn’t feeling right but was confused by what was going on.
• Morphine is good for reducing pain and making your child sleepy, but for us, I’d request a different pain medication because I’ve now learned it really makes Liam nauseous. And nausea makes everything worse. Duh.
• Do not encourage your child to pick the blue slushie as a post-op bonus incentive, unless you want to attempt to clean blue slushie out of and off of any surface that child might throw up on later. Blue slushie on the way back out stains. Thankfully our kid has good aim and an ability to not spill while throwing up into a small container in a moving vehicle. (This would not have gone as well with a small child so there’s a bonus with an older one.)
• Even the bathrooms at the hospital are cool and child-friendly.

• Find a hospital or surgical center with WiFi and bring your smart phone – Simon and I spent our time in while Liam was recovering playing Draw Something, Words with Friends and checking Facebook. Liam wanted the room dark and quiet so TV and reading books were out as options. And since we sat there nearly 3 hours, having WiFi and a smart phone was super handy.
• No matter how crappy he feels, your son will still find it hilarious if you suggest he not wear his underwear home under his sweatpants and if that’s what it takes to get him to smile, you do it. (Also, the thing he will talk most about after the surgery is the fact that he got a robot coloring book and crayons. For free. It was awesome.)
• Try not to have any expectations for how the day is going to go. The person scheduled before us for surgery overslept and was late getting in for their surgery which meant they were late getting started for ours. And instead of the 1-2 hour recovery they said was normal, we ended up staying about 4 hours after the surgery was over because Liam was feeling sick and/or sleeping (in comparison, with Jack were went home much sooner, he never acted nauseous and was packing away the food within minutes of getting home and didn’t sleep any more than normal that day – but then it’s no surprise that even surgery doesn’t keep Jack down – the other day Liam knocked Jack off his feet by accidentally kicking him in the head awhile he – Liam – was coming back on a swing and Jack popped right up and cried for about 30 seconds before running back to play).
• Once your child is feeling better, be prepared to get them anything they want to eat. Everyone will feel better about that arrangement.

Though it sounds dramatic, it really was a good experience, just not what we were expecting. The surgery itself went so well and one day after surgery everything was back to normal with Liam, we just weren’t prepared for the bumps in the road immediately post-op. Your child will likely have a completely different experience than Liam’s because that is one thing I know for sure about parenting… no matter how similar the set-up, the experience can be completely different.

And from the archives: Favorite Finds – 5/1/11