Preparing Your Child for Surgery
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F can find information on embargoes, Annual Meeting press registration and more below. Tonsils are the two round lumps in the back of the throat. Abscesses around the tonsils, chronic tonsillitis, and infections of small pockets within the tonsils that produce foul-smelling white deposits can also affect the tonsils and adenoids, making them sore and swollen. Cancers of the tonsil, while uncommon, require early diagnosis and aggressive treatment. When should I see a doctor?
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You should see your doctor when you or your child experiences the common symptoms of infected or enlarged tonsils or adenoids. Your physician will ask about problems of the ear, nose, and throat and examine the head and neck. He or she may use a small mirror or a flexible lighted instrument to see these areas. Sleep study, or polysomnogram-helpful in determining whether sleep disturbance is occurring because of large tonsils and adenoids.
One sign is swelling of the tonsils. Sore throat, sometimes accompanied by ear pain. If the tonsils and adenoids are enlarged, breathing during sleep may be disturbed. How are tonsil and adenoid diseases treated?
Bacterial infections of the tonsils, especially those caused by streptococcus, are first treated with antibiotics. This can lead to frequent ear infections and buildup of fluid in the middle ear that may cause temporary hearing loss. In adults, the possibility of cancer or a tumor may be another reason for removing the tonsils and adenoids. In some patients, especially those with infectious mononucleosis, severe enlargement may obstruct the airway. Be with your child as much as possible before and after the surgery. It may be helpful to talk about the surgery with a friend who has had a tonsillectomy or adenoidectomy. Your otolaryngologist can answer questions about the surgical procedure.
For at least two weeks before any surgery, the patient should refrain from taking aspirin or other medications containing aspirin. Your doctor may ask to you to stop taking other medications that may interfere with clotting. If the patient is taking medications, has sickle cell anemia, has a bleeding disorder, is pregnant, or has concerns about the transfusion of blood, the surgeon should be informed. A blood test may be required prior to surgery. A visit to the primary care doctor may be needed to make sure the patient is in good health at surgery.
You will be given specific instructions on when to stop eating food and drinking liquids before surgery. These instructions are extremely important, as anything in the stomach may be vomited when anesthesia is induced. The patient will then be taken to the operating room and given an anesthetic. Intravenous fluids are usually given during and after surgery. After the operation, the patient will be taken to the recovery area.
Recovery room staff will observe the patient closely until discharge. Every patient is unique, and recovery time may vary. Your ENT specialist will provide you with the details of preoperative and postoperative care and answer your questions. These include swallowing problems, vomiting, fever, throat pain, and ear pain.
Occasionally, bleeding from the mouth or nose may occur after surgery. If the patient has any bleeding, your surgeon should be notified immediately. It is also important to drink liquids after surgery to avoid dehydration. Any questions or concerns you have should be discussed openly with your surgeon. Reproduction or republication strictly prohibited without prior written permission.
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But not everyone knows what tonsils do or why they may need to be removed. Knowing the facts can help alleviate the fears of both parents and kids facing a tonsillectomy. Tonsils are clumps of tissue on both sides of the throat that help fight infections. If you look down your child’s throat with a flashlight, the tonsils may be red and swollen or have a white or yellow coating on them. Enlarged tonsils without any symptoms are common among kids. Left alone, enlarged tonsils may eventually shrink on their own over the course of several years. Don’t rely on your own guesses, though — it can be hard to judge whether tonsils are infected.
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If you suspect tonsillitis, contact your doctor. Recurrent sore throats and infections should also be evaluated by the doctor, who may order a throat culture to check for strep throat. Surgery, no matter how common or simple the procedure, is often frightening for kids and parents. You can help prepare your child for surgery by talking about what to expect.
Your child will receive general anesthesia. This means the surgery will be performed in an operating room so that an anesthesiologist can monitor your child. The anesthesiologist will also keep your child safely and comfortably asleep during the procedure. The operation will take about 20 minutes. Your child will wake up in the recovery area.
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Expect to spend several hours or perhaps overnight at the hospital. Many kids go home on the same day, though some may require observation overnight. Rarely, kids may show signs of bleeding, which would require a return to the operating room. Depending on the surgical technique, the typical recuperation after a tonsillectomy may take up to a week or more. Expect some pain and discomfort due to the exposure of the throat muscles after the tonsils are removed.
This can affect your child’s ability to eat and drink and return to normal activities. Intracapsular tonsillectomy, a variation on traditional tonsillectomy techniques, is surgery in which all involved tonsil tissue is removed but a small layer of tonsil tissue is left in place to protect the underlying throat muscles. As a result, the recovery is much faster because most kids experience less pain, don’t need as much strong pain medication, and are more willing to eat and drink. Are Kids With No Tonsils More Susceptible to Infections? What Happens in the Operating Room? What’s It Like to Have Surgery?
For specific medical advice, diagnoses, and treatment, consult your doctor. Preparing Yourself Your child needs elective surgery and a date has been scheduled. Unlike emergency surgery, an elective procedure isn’t done as an immediate matter of life and death. Having an elective procedure gives you the time to prepare your child for the hospital and the surgery. Good preparation can help kids feel less anxious about the anesthesia and surgery and get through the recovery period faster. But, like parents everywhere, you’re probably uncertain about the best way to prepare your child. The key is to provide information at your child’s level of understanding, correct any misunderstandings, and get rid of fears and feelings of guilt.
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Help your child understand why the surgery is needed and to become familiar with the hospital and some of the procedures he or she will undergo. Kids of all ages cope much better if they have an idea of what’s going to happen and why it’s necessary. To do that, prepare yourself first and correct any misconceptions of your own. If a parent is anxious and nervous, a child will often reflect these feelings and behaviors. So educate yourself, feel comfortable with the process, and make sure all your questions are answered. Hospitals have changed greatly and are more family-friendly and patient-centered. After the surgery, you may return to your child in the recovery room.
As your child awakens, he or she will not even realize you left. Ask the doctors, nurses, or staff for the information you need about what will take place so that you can prepare your child and deal with your own fears or concerns. To parents, one of the most fearful aspects of surgery is anesthesia. Anesthesia is much safer today than in the past, but still carries some risk.
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You should discuss any concerns you have in advance with the anesthesiologist. When hospitalization is needed overnight or longer, most hospitals avoid separation anxiety by permitting at least one parent to stay with the child day and night. Check with the hospital about its rules regarding parents staying over and when other close family members can visit. Explain the Problem Now that you’re more at ease, start preparing your child. Begin by explaining the reason for the surgery in simple, calming words. Explain — at your child’s level of understanding — about the medical problem and why surgery is necessary. Don’t use alarming language like “the doctor will cut you,” “open you up,” or “sew you with a needle.
Although they seldom express it, kids may fear that their parents aren’t telling them everything — that their health problem is worse than they’ve been led to believe. To build trust, don’t mislead your child — tell as much of the truth as your child can understand. Handle Fears Many kids fear that an operation will be painful. It can help to explain that a special doctor, called an anesthesiologist, gives medicine to make patients sleep very deeply so they won’t feel anything during the operation and once it’s finished, they’ll wake up.
Older kids, in particular, need special assurances that they will wake up. Again, avoid frightening language — don’t say, “You’ll be given gas” or “You’ll be put to sleep. Young kids may confuse “gas” with the fuel that can poison or kill and “put to sleep” with what can happen to sick pets. Explain that you’ll be there when your child wakes up — and a favorite toy can come along, too. Tell your child that if anything feels sore right after the operation, a doctor or nurse can give medicine that will make it feel better. School-age kids also fear needles, knives, and damage to their bodies.
Give a child this age clear, rational information as well as assurances that the surgery is to fix an existing problem, not create a new one. The fears of teens go well beyond those of younger kids. Besides pain or change of appearance, a teen might be afraid of losing control, missing out on events, being embarrassed or humiliated in public, and sounding childish by expressing fear, anxiety, or pain. A teen also may be afraid of waking up during the operation — or not waking up afterward. Correct any misconceptions about disfigurement or injury.
And explain that anesthesia is very safe today and that patients do not wake up during operations but will certainly wake up afterward. Encourage your teen to read up on the medical condition and share the information with the family. Reading and sharing information is an excellent coping mechanism. One further fear that affects kids of all ages is being seen naked and having their “private parts” touched. If the operation involves the genital or anal area, your child will cope better if you explain in advance that although it might be embarrassing, doctors and nurses will need to examine these private areas, especially to check if they’re healing after the operation. Explain that doctors, nurses, and parents are the only exceptions to the rules about privacy.
Encourage your child’s questions about the health problem and hospital experience, so that other fears and anxieties can be expressed. Take all questions seriously and answer them to the best of your ability. If you don’t know an answer, tell your child that you’ll find it out, and explain that the doctors and nurses are happy to answer questions, too. Relieve Guilt Children often believe that their medical problem and operation are really punishments for “being bad.
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They might not say so, but they may feel guilty and believe that they’ve brought events on themselves. Explain that the medical problem is not the result of anything your child may have done or failed to do, and that the operation is not a punishment, but simply the way to “fix” the problem. On the other hand, if the medical problem was caused by an accident that could have been avoided by obeying safety rules, make sure your child understands the reason for the rules and will follow them in the future. Explaining What Will Happen Find books, appropriate to your child’s level of understanding, about what to expect at the hospital. Reading together and discussing the surgery will make the hospital seem less threatening. Discuss each idea and encourage your child’s questions.
Young kids also will benefit from practicing on a doll or stuffed teddy bear with toy doctor-kit “instruments. Your child can take the toy’s “temperature” and “pulse” and listen to its “heartbeat” and “breathing. Ask your doctor for suggested videos or multimedia tools for parents or kids that can help explain the procedure. As you discuss the hospital and surgery, remember that in addition to your words, your nonverbal cues convey assurance: your tone of voice, facial expressions, gestures, and body language send powerful messages. If you appear fearful, your child is likely to feel fearful regardless of the words you use.
Pre-Operative Orientation and Tour Many hospitals offer special pre-operative children’s programs, family orientations, and hospital tours, led by specially trained nurses or licensed child-life specialists. Child-life specialists are a valuable resource for parents and children. Call the hospital to schedule a pre-operative tour, program, or orientation as soon as possible, even from the doctor’s office when the appointment for the surgery is made. It’s best to schedule the appointment for a few days before the surgery. An orientation program can remove the mystery of the surgery for kids and their families by making the hospital familiar and friendly and the experience predictable. On the Day of Surgery When you arrive on the day of surgery, your young child can play with toys and books you bring from home or sit on your lap and be cuddled during the waiting time. You won’t be allowed to stay in the operating room during the surgery, but afterward, you’ll be escorted to the recovery room to be with your child as he or she awakens.
Upon discharge, you’ll be given instructions for further care at home and for a follow-up visit to the surgeon. During recovery, there may be times of discomfort for your child. So explain that even if this happens, your child will get better. Distracting your child, whether with a new book or a visit from a relative or friend, also can make recovery more pleasant. Just make sure your child gets plenty of time to rest and recuperate. What Happens in the Operating Room? What’s It Like to Have Surgery?
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For specific medical advice, diagnoses, and treatment, consult your doctor. Each year, close to 200,000 people choose bariatric procedures to drop excess weight. Recovery from weight loss surgery requires both a short-term plan and a long-term plan. To manage the effects of morbid obesity and bariatric surgery, your post-weight loss surgery care plan may involve several different types of health care professionals, who will work together to help ensure your overall health, manage your food addiction and provide a smooth transition to new day-to-day activities. Weight loss surgery is a genuine life-changing experience. Changes in your life may include the ability to fully perform day-to-day activities, the reduction of your risk of disease, the possible resolution of some medical conditions and new opportunities for jobs or relationships.
The benefits from weight loss surgery should outweigh the personal commitment and financial investment associated with the surgery and its aftercare. It is important to follow your surgeon’s instructions for a safe recovery and a long-term plan that will help you maintain the benefits of massive weight loss for the rest of your life. For recovery considerations for teens, read our special report on adolescent obesity and weight loss surgery. Activity After Weight Loss Surgery Before you leave the hospital after surgery, you will be asked to stand up and move around a bit. You will also be directed to try to walk around the house several times throughout each day, over the course of your recovery.