The O, My in Tonsillectomy & Adenoidectomy: How to Prepare Your Child for Surgery, a Parent's Manual, 2nd Edition

The O, My in Tonsillectomy & Adenoidectomy: How to Prepare Your Child for Surgery, a Parent's Manual, 2nd Edition

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Product Details

ISBN-13: 9781615990535
Publisher: Loving Healing Press
Publication date: 08/01/2010
Pages: 32
Sales rank: 1,002,672
Product dimensions: 8.00(w) x 10.00(h) x 0.08(d)

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CHAPTER 1

Phase 1: Introducing the Topic to Your Child

1 to 2 Months before Surgery

You may want to ask your ENT doctor to recommend a child's book for you to read to your youngster. Your T&A Journey (2005) and Good-Bye Tonsils! (Hatkoff & Hatkoff, 2001) are among such references that share information about the procedure, while Barney is Best (Carlstrom, 1994) is suited for a very young child. At some reasonable time before the surgery (several weeks if you have the luxury of time), leave the book within your child's reach to casually investigate. After you have noticed some interest, begin to read it to your youngster for the first time. You probably will not have a chance to get through the entire story. Every few days, begin to read it over from the beginning, trying to add a paragraph or page at each new reading. The aim is to familiarize your child at his own pace. Stop reading if your child becomes upset. Put it down for a few days and try again at a later time. Whatever amount you accomplish at this point is fine, since your goal is just to set the stage for future discussion.

Several weeks before surgery, indicate to your child that one day, but not yet, he will have his tonsils out too, just like the kids in the book you read. Then he will feel better (i.e., not have to be absent from school and be able to sleep better at night). Be specific about the improvement of his particular recurring symptoms.

A Child-Friendly Explanation

Your child may ask you what tonsils and adenoids are. You can say something to this effect (see illustration on the page 4):

Lots of parts of our bodies have special jobs. Just like our legs are for walking, our nose is for smelling and our tongue is for tasting, our tonsils have a job too. We have two of them way back in our mouth, by our throat. If we open our mouth wide, and look in with a flashlight, it sort of looks like a stage with the lights off before a show. There is a thing hanging down in the middle. It's called a uvula, and it's like a gymnast who is hanging from the ceiling on the stage. If we look to the sides, we'll see a pink bump on each side that looks like the curtain. Those bumps are the tonsils. Their job is to help our body fight sickness and infection by catching germs that come into our body. When the tonsils get full of germs and stop working well, they are not doing their job and we end up getting sick. Lots of times, the doctor will say that if we get rid of sick tonsils, the rest of our body will feel better.

Another part of our body that has a job like the tonsils is called the adenoids. They're behind the stage, so they're too far back to see when we look in our mouth. When the adenoids get sick, they get bigger and take up a lot of room in our mouth. If we have big tonsils and big adenoids, they take up a lot of space and then it's sometimes hard to breathe (Children's Hospital and Health System, 2008). When that happens, we breathe loud in the daytime, and we snore at night.

But if we take out these parts with all the germs in them, we will breathe easier and feel better. Those parts of our body are extra and we don't need them. There are special doctors who know just the right way to take out tonsils, since a gazillion kids need to get rid of theirs. Mommy and Daddy called a lot of doctors and found just the right one we liked the best. His name is Dr. ENT, and he will help your mouth and throat get better.

Once you have selected the date and place for surgery, determine where it falls within a time frame that your child can understand. Then use that personal frame of reference in all your future references (e.g., "Your tonsils aren't coming out yet. We will go back to Dr. ENT (after Christmas vacation, after your birthday, when camp starts, etc.) By linking the date of surgery to a personal reference point or major event, your child will be able to gain a more concrete understanding of its occurrence while allaying his fears of an immediate procedure. It will also allow for ample opportunities to bring it up whenever you talk about the holiday, birthday, etc. preceding it. At this point, you should not be giving a drawn-out explanation, but merely a mention of it when the opportunity presents itself.

Within a few weeks, you should be able to ask your child what will happen after Grandma comes to visit (or whatever you have selected as your personal reference point), and his response should become an automatic reply about tonsils, even though he will not yet fully understand the procedure. That's okay at this stage. Use the words, "tonsils" and "adenoids" as often as you can because the more you do, the more you are helping your child to become desensitized to what is likely to be a frightening situation. The more chances he has to talk or to think about it, the more it will inevitably help him to better deal with the procedure. Playing out the procedure using dolls or puppets and a toy medical kit will give your child the opportunity to express her feelings as well as to recognize what questions or worries she may have. The Milton Bradley game "Operation" also introduces the theme of removing and fixing ailing body parts. You may want to make a simple calendar indicating the personal reference point and the date of surgery, so that you can cross off the days as they draw near. This, too, will help your child to feel more in control, since children are in a vulnerable situation where only the grown-ups get to call (and, ahem ... give) the shots.

CHAPTER 2

Phase 2: Tackling the Subject

What to Tell Your Child 3 to 4 Weeks before Surgery

About 3 weeks before surgery, your descriptions and references to the procedure will increase. By now you will have made several attempts to read your book to your child. If you have been unsuccessful until now, set aside time when both of you are not distracted and try to read it aloud, even if your child becomes fearful. At this point, read a little more, even through the tears, but keep reassuring him that surgery will not take place until after the personal reference time you have selected. Experts believe that anxiety diminishes as you are able to get mental or physical exposure to the event that is feared. Furthering the discussion is now necessary, and should not be avoided at the child's first sign of discomfort.

Read and talk slowly, and be careful to stay calm when your child protests. Let your child know that you understand what he is feeling. Say something like, "This seems very scary for you." Reassure your child that you will help him to become less afraid. ("Mommy will be there with you the whole time, and will hold you. We will be together. Maybe we'll even bring your teddy bear.")

Do not try to talk your child out of what she is feeling. She is afraid, and telling her not to be will only make her think that you don't understand. Trying to choose the right words to say is not as important as conveying the gentle tone and message that you understand and are trying to do everything you can to help. Let your child know that she can talk about her worries any time she thinks of them. You also want to give the message to all of your children that sick tonsils are not caused by anyone's behavior or anything a child thinks about or wishes. Children can't make someone need a tonsillectomy.

What to Tell Your Child 2 to 3 Weeks before Surgery

Most people wilt when they hear the words "operation" or "hospital." They have an image in their mind, formed by personal experience, which is frequently exaggerated by "horror" stories or graphic portrayals seen on television. It is your mission to avoid creating these associations for your child. Instead of using the word "operation," describe simply that Dr. ENT will "take out" his tonsils because they have been hurting and you want him to feel better. Rather than using the word "hospital," describe it as Dr. ENT's "other" office at the Day-Op Center. Referring to Dr. ENT by name reduces the mystery and the tendency for your child to invent information. Your child has already had contact with him and has established a frame of reference. An office is a place where children have frequently seen doctors and nurses, and is far less intimidating in one's imagination than a hospital would be.

You may choose to call the operating room a "special room" where the doctor has all the things he needs to fix tonsils, and the term "resting room," because after surgery (in recovery), that is indeed what your child will do. However, if your child is already familiar with other terminology, do not deny the correct terms. The idea is to help your child conceptualize the experience in advance by describing the sequence of events in terms she can understand.

To put this all together as your first explanation to your child, find a time during which you will not be disturbed and when your child is likely to be responsive to you ? not while he's watching TV or waiting with bated breath for a playmate to come over. Introduce the topic with reference to the book (which you have now completed together at least once), or by asking what will be happening after (your personal reference point). When your child responds that his tonsils/adenoids will come out, then is your opportunity to take the conversation further.

You might begin by asking your child what he remembers about your prior talks. Then tell him what the day will probably be like. He may stop you several times to talk about something else, or may ask for vivid details about any one procedure. If you don't know the answer to a question, be honest and say so. Tell your child that he asked a great question and you will try to find out the answer. Then make it your business to do so. Even if your child does not seem particularly attentive, try to describe, even superficially, what he can expect on the day when his tonsils come out. If your child doesn't seem to be giving you his full attention, don't worry. He is probably absorbing some of it and taking in what he is able to handle at the time. This might be a good opportunity to play with dolls and a medical kit, puppets or the Milton-Bradley game Operation™ (without batteries installed) to acquaint your youngster with the experience.

By now, you will also have some idea as to who will be accompanying your child to the medical center. If possible, two adults (with whom he is most comfortable) should be there so that one can attend to the child while the other completes the necessary paperwork. You may also need to take turns later as you sit at your child's bedside, allowing each other to take a break. Additionally, your child may also want someone to sit with him on the ride home as the other one drives. Keep in mind that usually only ONE parent will be allowed into the operating suite. Decide ahead of time whom that will be, if indeed you feel that one of you can be there without getting upset. Then tell some version of the following scenario (see p. 8), and vary it as you see fit for your youngster, personalizing it for your own situation.

Explaining it all to your 3 to 7-year-old child:

"On the day when your tonsils come out, you will wake up and watch TV like always (or do what you typically do in the morning). Then you will get dressed and can play a little, but we won't have breakfast on that day. After we play, we're going to go in Daddy's car and drive to Dr. ENT's other office at the Day-Op Center. Remember we saw that place already? (Refer to Phase 3 in this manual). When we get there, you and Daddy can play in the playroom while Mommy fills out papers and talks to the lady in the office. When they call our name, we'll go into a little room and a doctor or nurse will look in your ears and nose and mouth and listen to your heart with a stethoscope. Remember what that is? Dr. (your pediatrician's name) wears that around his neck and puts it on your back and chest when he listens to you breathe. The nurse at the Day-Op Center might even take your temperature and blood pressure with that squeezy thing they put around your arm.

"Then we'll go into another office and they will give us different clothes. You can go into a bathroom or dressing room to change. You'll take off your shoes and socks and pants and shirt and underwear. (Some children get very upset at removing their underwear. If you expect that to be the case, speak to the nurse.) They'll give you a costume like a soft pillow case (it's called a gown) that we will tie closed, and maybe even special socks that'll keep you warm and keep you from slipping when you walk. The nurse will also give you a plastic bracelet to wear that will have your name on it and some numbers. And Mommy will have to put on a special costume also. Then we will wait again. We might even see other people in the same kind of gown who are waiting, too. And we'll see doctors and nurses who will be wearing special clothes and even a puffy kind of hat so their hair won't get in the way when they work. Dr. ENT will come out and say hello to us.

"A little while after that, you might get on a riding toy and drive it right into the "special room" while mommy walks with you. There will be a lot of people in there who are Dr. ENT's helpers, and they will all be wearing the same kind of clothes and maybe a matching cover over their mouth so they can't give us germs if they cough or sneeze. But we'll be able to see their eyes, and when they crinkle, we'll know they are smiling underneath.

"There will be a lot of silver machines and lights in the 'special room,' everyone will be busy and it will feel cold, since the air conditioner will be on. You'll climb onto a skinny silver table and will lie on your back, or you might sit on Mommy's lap. Mommy will sit on a chair right next to the table and will hold your hand. Then Mommy will give you an astronaut's mask to breathe from that the nurse will hold over your nose and mouth. After a little while it will make you feel dizzy and sleepy. Mommy will stay there until you fall asleep and you will stay asleep until it is all over.

When you wake up, you will be in a different bed and you will see a nurse first, before you see Mommy or Daddy. You'll feel different and your nose and mouth will feel scratchy and will hurt. You'll probably be shivering for a little while. Your stomach might not feel so good either. You might feel like throwing up, but soon you will feel better. Then Mommy and Daddy will come to see you and wait with you while you take a nap. Other children may be taking a nap also in the same room. When you wake up, your arm and hand may have tape on them, and there may be a board under them. There might even be a tube or long straw under your arm and a see-through bag at the other end of the straw which will be hanging on a silver pole right next to your bed. That bag has special medicine and vitamins in it to make you feel better faster.

A different nurse will come to visit you and examine you. She will ask you what you like to drink or what kind of ices you like to eat. You'll feel a little cranky, but if you eat and drink stuff, and make urine ("pee-pee," "sissy"), then you might be able to go home soon but sometimes children have to stay there longer. When you're ready, Mommy will help you get your own clothes on and you'll be wheeled to the door in a chair with big wheels on it. Then we will go back home in Daddy's car. If you're not ready yet, the doctors might say that they want you to sleep over so they can check you the next day to make sure everything is just right.

When you get home, you will sleep a lot and you may get mixed up whether it's daytime or nighttime. You will have to stay in bed for a while and can only play quiet games. People might send you cards or presents and everyone will ask how you feel. Your voice will be very low for a few days. Sometimes you will feel good and sometimes you will feel bad. But medicine will help you feel better. You will stay home from school for a lot of days and your voice will probably sound funny for a while. Then, after seven days, you will visit Dr. ENT and he'll look in your mouth. It will not hurt. He will tell you when you can go out and play and when you can eat pizza again and when you can go back to school. By then you will have a lot of energy and will feel like doing everything you used to do. You will be all better and will not get sick so much anymore. You will feel happier and will probably grow a lot and get bigger very fast. And you won't ever have to get your tonsils out again.

(Continues…)



Excerpted from "The "O, My" in Tonsillectomy & Adenoidectomy"
by .
Copyright © 2011 Laurie Zelinger.
Excerpted by permission of Loving Healing Press, Inc..
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Table of Contents

Foreword,
Preface to the 2nd Edition,
Uh-Oh, Surgery! Making Your Decision,
Phase 1: Introducing the Topic to Your Child,
1 to 2 Months before Surgery,
A Child-Friendly Explanation,
Phase 2: Tackling the Subject,
What to Tell Your Child 3 to 4 Weeks before Surgery,
What to Tell Your Child 2 to 3 Weeks before Surgery,
Explaining it all to your 3 to 7-year-old child:,
Phase 3: Getting Closer, Getting Ready,
1 to 2 Weeks to Go,
3 to 7 Days to Go,
Counting Down the Days: 3-2-1,
Phase 4: The Day of Surgery ? It's Here!,
On the Morning of Surgery,
During Surgery,
Immediately After Surgery in the Recovery Room,
At Home after Surgery,
The Ultimate Preparation List,
What About Complications? (parents only!),
Bibliography,
Caregiver's Organizer,
About the Author,

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