Distressed 6 year old facing 3rd GA.

[roundcorners]

Please can anyone recommend a book or dvd that might reassure a 6 year old about staying overnight in hospital and having a general anaesthetic? He is no stranger to hospitals but has not stayed overnight before. He also remembers his last 2 GAs and they were both upsetting and recent experiences. I have a few weeks to prepare him but he is very unhappy. Thank you.

[vjg13]

Sorry no help with books or DVDs but my daughter has had a lot of general anaesthetics and usually has a pre med, it makes her less resistant to the anaesthetic but also also gives an amnesia type effect that makes her forget it more easily and is less apprehensive for the next time.

Just an idea if he may need more procedures after this.

[roundcorners]

Good idea. Thanks. I'll definitely ask for one. I think he might have had one last time as he had an early injection and then he was barely with it when he was put under (about an hour later). I didn't know about the potential for amnesia though. I hope so, I may have foolishly promised it wouldn't happen again. I'm normally always a glass half full person but I'm struggling to find a good spin to put on the next procedure.

[BagelDog]

Lots of paeds wards have play specialists who know all about the right books and DVDs to introduce the idea of staying in. Some also do tours of the ward and anaesthetic room and recovery especially for kids to help make it all less scary. Maybe call your hospital and see if they do any of this? The ward clerk on the paeds surgical ward will know or the play therapy coordinator. Xx

[Andro]

A lot depends on what he found upsetting on the last 2 occasions; the feeling of going under, the side effects of the meds, the lack of control, the effects of the procedures etc.

Just as importantly, find a positive reason for the procedure - if it wasn't going to help him you wouldn't be doing it...would you?

[roundcorners]

Thanks Bagel, the play specialists are really great and will be a big help when we're there.
Andro, he hated everything about the last 2 GAs from arrival to finally getting home. The worst part was probably in recovery both times. You've made me think though. It would probably help if I got myself into a better place about the situation. What's the phrase? Something like 'fake it till you make it'?

[Andro]

Fake it till you make it is good, being able to give an age appropriate reason for the procedure is better!

The reason it's better to be able to frame is positively is because it helps you to help him; your son needs you to help him get this into perspective, that's the main way you make this less distressing for a shorter period of time.

I hate GA's; I detest the hospital procedures (and being there in general), hate the sensation of going under (no amount of pre med has ever blocked the memories) and I experience severe panic and disorientation as a side effect when waking up - the same applies when I'm sedated to have my airway secured during an anaphylactic reaction. Understanding why I have to go through it helped me process, having a nurse or my dh there who understands my reactions also helps.

Recovery can be tough, some people are affected by the meds for an extended period of time and it makes recovering from the procedure more difficult - it helps when that's not minimised.

[elliejjtiny]

My 3 year old has had 11GA's for various things. He hates them but thankfully is too young to experience anxiety before getting to the hospital. My ds is younger so this might not work with a 6 year old but I find giving them as much control as possible helps. He will choose a favourite toy to take to theatre, his pyjamas, an episode of something on TV to watch in the anaesthetic room etc.

He has midazolam as well. It's still not great, we still have screaming and he still tries to hide when the nurse tries to weigh him but it helps a bit.

[Blu]

You will be able to stay with him overnight. Does he know this ?

It is v tough, roundcorners, I know. DS had had 8 GAs by the time he was 7, including one huge operation.

I always discussed the reason for it, and was very matter of fact. We always said that sometimes things would be sore or stingy but that bad feelings last for a short while and then stop.

Have they anaesthetised him with gas, or via a canula? I always just chatted to him non stop until he was unconscious .

[roundcorners]

Andro, elliejjb, Blu - thank you for sharing your experience.
Andro - I won't minimise it and will stay matter of fact about why. Your posts have really helped me remember I can make it better for him by remaining calm. He is the one who has to go through it all.
Blu - I raised it again and made sure he knows I'll be there. Thank you. I wouldn't want the day to be a shock. For the second GA they wanted him to have a canula and different drug to try and prevent such a bad time in recovery. Unfortunately even with a pre med and numbing cream they had to go with gas as the anaesthetist said he was in too much pain. He had silent tears running down his cheeks. The recovery was better though. I'll do some research and find out if there is another way.
Ellie jj- I really like the idea of him choosing his favourite PJs and toy to take in. I was thinking about taking an old portable dvd player and headphones for him. Does this sound sensible?

[Blu]

What was the problem with the recovery? Was it sickness? tell the anaesthetist this - they can give ant-sickness meds along with the anaesthetic.

It is hard with little ones getting a canula in, and DS had all is operations using gas to begin with. They knock them out using a mask, it takes about 10 seconds, and they do have to breathe in. It can be distressing because they don't always like it but it doesn't hurt and it really does take less than 10 seconds - I can tell you having done the count down several times! Then once they are unconscious they can look for a vein and put the lines in.

You have to talk about this in advance because they need two anaesthetists present to do gas, because they have an unconscious child and no line in to administer drugs if there is a reaction. At our hospital, anyway.

The method by which they knock them out shouldn't make any difference to recovery: it's all the same drugs one way and another, just in a different order.

If the problem was pain when he came round, also discuss this with the anaesthetist: they can do all sorts before your child wakes up, in advance of recovery to prevent post-op pain. Nerve block, pessary, IV painkillers etc.

We had a gallery of stuffed animals who accompanied us to hospital, tell him you will be on a be next to him, they will bring him dinners to have in his bed like a picnic, and ask if there is a special new DVD / film he would like to watch when he recovers. Aldo the operation will only take a short while - they won't be doing things to him all night. There are all sorts of things that children assume or misunderstand. We once had a bad moment when DS realised we had to go down to the operating theatre - he thought they would be doing the op there and then in his bed.

So it may be an idea to talk the whole thing through with him 'so that he can explain it all to his teddy''. And then get him to do that. We accomplished a lot via the menagerie.

[Blu]

In recovery, the more they breathe, the faster the anaesthetic wears off - as air / oxygen replaces the anaesthetic gasses in the blood. We use breathing a lot: in through the nose, out through the mouth, translated into 'smell the cake, blow out the candles'.