As I write, my eldest daughter is at school, despite two days ago having surgery. That seems mad, but demonstrates her admirable resilience. We are both very much still processing the events of the past few days and, while it’s still painfully fresh in my mind, I wanted to talk about coping with your child’s surgery, what’s involved, and how it affects both them and you.
Pixie’s surgery was the result of an accident that left her with two badly broken bones. I found myself beginning to qualify that it could have been something worse. I’ve deleted that sentence because if anyone else were talking to me about their child’s surgery then I’d tell them that’s a form of toxic positivity and that their experience and feelings are valid regardless.
And the fact is that it’s been bloody awful. Any parent whose young child has had an operation will understand, I’m sure. And for anybody who may be facing a similar scenario, I want to help you to be fully prepared for what to expect.
The reality is that, for us at least, administering the general anaesthetic has been the worst part. It traumatised Pixie, and that was very distressing for me.
What Happens When a Child Badly Breaks a Bone
I took Pixie to A&E in August 2020 following a (silly and avoidable!) accident, caused by jumping off something she shouldn’t have when I was in a different room.
The first I knew of it was a piercing scream which caused me to throw whatever I was holding and race to her. By the time I reached her, she was holding her arm but she was quiet. I admonished her for being silly, and wasn’t too concerned. The thing she’d jumped from was only about a foot high, and our daughter has an unfortunate habit of being a dreadful drama queen.
I’d actually been getting ready to go out for a run at the time, and I’ll never forgive myself for the boy who cried wolf situation meaning I went for my run, leaving Pixie with her dad. I wasn’t gone long – it was a sunny Friday and Dan had taken the day off work so we could enjoy some kayaking as a family. Lockdown had lifted, we were in the midst of ‘eat out to help out’, and we wanted to make the most of the glorious weather after several months of tedium, during which I’d rediscovered running. I decided to get a quick one in before we headed out for the day.
The moment I returned home from my run, after around 20 minutes, I knew something was very wrong. Pixie was sitting quietly on the sofa, still holding her arm. I went straight to her and she wouldn’t let me look at it. I gently but firmly told her if she didn’t let me see then I’d have to take her to hospital. Ordinarily this would have cajoled her into allowing me a peek. We began to make plans to go to hospital.
Within 15 minutes we were on our way. Getting into the car was an ordeal in itself, and Pixie still wouldn’t let anybody near her arm.
When we arrived, I made the mistake of offering Pixie a snack to distract her. She took a single bite, but really had no interest in food. At that point I had no idea the severity of the injury, and still half expected to be sent home. It had certainly not occurred to me that two separate surgeries would be necessary.
We were very quickly triaged, and from that point things moved quickly. Pixie was very distressed, but I had to facilitate the nurse looking at her arm. She had a quick glance, and told me it was ‘banana arm’ and that she was going to give Pixie Calpol there and then, and arrange for her to be given diamorphine within the next ten minutes.
I finally realised that she was quite seriously hurt. I still had no comprehension of surgery being a possibility.
I was so naive I can’t even remember now what exactly I said to the nurse, but I think I asked her if Pixie might need a cast, and even when she told me she didn’t think that would be sufficient, I still didn’t get it.
I called Dan and relayed what I’d been told, telling him that I wasn’t sure what that meant, a splint perhaps?
Of course, we were still in the midst of a pandemic, so I was alone with Pixie and having to attempt to put my feelings and worries aside so I could speak calmly and in code, to avoid frightening her. I didn’t ask for clarification, because I didn’t want to cause further upset to Pixie.
Diamorphine, X-Ray, and a Temporary Cast
Pixie was shortly thereafter given diamorphine and a temporary cast, to make her more comfortable while we waited for further information.
Either before or after the cast was put on her, we went for an x-ray. I was shocked by what I saw – Pixie had broken both bones in her forearm, and one was completely displaced. I finally appreciated that surgery was a possibility.
A doctor explained that the break was about as bad as it could have been; not only was surgery required to reset the bones, they’d also need to be pinned into place. And the pins would have to be removed at a later date, in a second operation.
Unfortunately, the single mouthful of food she’d had in the waiting room meant that it wasn’t possible to operate that day as she had to be nil by mouth for a minimum length of time first. We were sent home, to return early the next day.
What to Expect With Your Child Having Surgery
While surgery isn’t pleasant, the reality is that it’s equally frightening for the parents waiting for news.
Of course, before your child goes into theatre, they must first be knocked out with a general anaesthetic. Without doubt this is the most distressing part for the child.
I wasn’t advised of the available options, and having never done this before I simply followed the lead of the doctors and nurses around me.
An anaesthetist came to see me to discuss what would happen. I was still alone with Pixie, so asking explicit questions was very difficult. I was mindful of avoiding causing unnecessary additional stress to my little girl. I didn’t ask for the clarification I’d have liked.
I was told about the mask that would be used to anaesthetise Pixie. The anaesthetist was lovely and told her she could choose banana or strawberry flavour gas, and that she’d have to blow up a big balloon, and then she’d fall asleep.
The reality was quite different.
It was mentioned to me that some children find the process difficult, and that thrashing around as they drift off can be quite typical. I tried to prepare myself, but I still had no real comprehension of what was to come.
Coping With Your Child’s Surgery
I went with Pixie into theatre. She had her favourite stuffed toy, and a nurse held an iPad to distract her. Everybody spoke in lovely soft voices. I bent over the bed holding her as best I could.
None of these things eased her fear and distress when a mask was firmly held over her face by a stranger who was much stronger than she was, while she kicked and screamed for me to help her.
Rationally I knew it was necessary. But there is nothing like seeing how vulnerable your child is, and listening to them beg you to help, and helping to hold them down. The perceived breach of trust is ferocious.
I watched my little girl pass out, and then I had to leave her to be cut open.
As I left the theatre I broke down, and I was right back to when she was in hospital as a tiny newborn.
I returned to the ward and sat alone waiting for news. The surgery took far longer than anticipated and I was a wreck. I couldn’t answer the phone to my husband because I couldn’t speak.
Eventually I was called to go and fetch Pixie. I found her curled up on a nurse’s lap; mercifully it was only when she saw me that she realised it wasn’t me holding her. That moment traumatised her almost as much as the mask did; sadly due to potential complications with anaesthesia, parents are not allowed to see their child after an operation until they’re fully awake.
But, her first operation was completed successfully.
Administering General Anaesthetic to a Child
I later discovered that there is another option for administering general anaesthetic to a child: it can be done via a canula. In fact, Pixie had been prepared for that eventuality – she was given ‘magic cream’ to numb the back of her hand and inside her elbow.
When I found this out I felt somewhat cheated. I didn’t understand why she’d been given the mask. But I found out during her second surgery…
I was so sure the second time was going to be easier: Pixie was excited. After two cancellations and lots of poor communication about protocol around COVID with regards to isolating prior to surgery, she was looking forward to getting it down and returning to school. (The way things worked out meant that unfortunately she missed the first three days of the first week that schools reopened.)
We bounced off each other – Pixie was chill about the surgery, and so was I. We’d told the surgeon she didn’t want the mask this time, it was on her notes. She was ready and we both felt prepared.
We were third on the list time, which unfortunately meant being nil by mouth for longer than ideal. It also meant Pixie had plenty of time to become worked up and anxious about her surgery. In fact, it was relatively innocuous thing that started it all off, but it quickly escalated due to her temperament and the environment. What started off as discomfort (a numb hand) led to her spiralling into overwhelm.
A play specialist who had sadly been unavailable due to the pandemic when Pixie had her first surgery, came to see us and she was wonderful. She shows Pixie the equipment that might be used for the general anaesthetic, both a mask and a canula. And she repeatedly said:
We don’t like hurting children, we like making them better. We’ll do everything we can so that we don’t hurt you.
In hindsight, despite her best intentions, I suspect this all ramped up Pixie’s apprehension. Everything went downhill from there and I had to try to keep her together for an hour and a half while she sobbed on the ward. She could no longer choose an option for the anaesthetic, because both were bad choices.
I felt so alone and helpless.
Are Children Traumatised By Surgery?
The staff were lovely, but ultimately, nobody could help in any meaningful way: Pixie had to be put to sleep for her surgery. And the process was undoubtedly traumatising for her.
When we went into the anaesthetists’ room, there were about seven people standing around us, all wearing masks. It was very overwhelming even for me. They were lovely, but they were still strangers poking and prodding her when she didn’t want it.
I cuddled her close and the play specialist and I tried to distract Pixie with an iPad while several anaesthetists attempted to insert the canula, having decided it was the quickest and therefore best option. This time Pixie was crying, begging for me to stop them, and screaming that they were hurting her because this option involved having her arm squeezed in order to find a good vein.
The canula failed. They got it in, but they couldn’t get a vein. And so it didn’t work.
At this point I was advised Pixie could try the mask, or be taken back to the ward for something to calm her down. I felt totally unprepared to make a call as I’d done zero research on sedation. Pixie was distraught, and I didn’t know what to do. So I simply followed their lead.
An anaesthetist removed the mask from the tube delivering the gas, and held it close to Pixie’s face while I continued to cuddle her. She protested, but she wasn’t in pain, and I kept reassuring her. Thankfully the element of distress was removed, and Pixie began to calm. When she was sufficiently close to sleep, the anaesthetist put the mask back on and was able to complete the task.
I kissed my daughter on her forehead, left the room, and fell apart again.
How to Cope With Your Child Having Surgery
While the experience is harrowing, and that’s probably inevitable, I hope that having an understanding of the process and options may be helpful.
What advice do I have for you?
- Forewarned is forearmed. Be aware that what I’ve described is the reality of surgery for a young child; don’t expect miracles.
- Research the options for administering general anaesthetic, discuss them with the surgeon and your child if appropriate.
- Find out about the possibility of sedation if you have concerns.
- Don’t wait for the play specialist to use play to help your child process what they’re going through. Role play can be a really powerful way of doing this at home.
- Whilst being anxious in advance is not helpful, lowering expectations is sensible.
And outside of a pandemic, have another adult on hand to offer support to you. Being alone unquestionably made the events far more difficult than they’d otherwise have been.
I was so sure next time around was going to be easier that I failed to prepare myself for the reality of how awful it might be again, and having to deal with that alone for a second time.
Surgery is not nice for anybody. For a child it’s traumatic. And for a parent it is too.
Factor that in, and give yourself time to heal as well as your child, because I can tell you from bitter experience that it can leave you floored and feeling very fragile.
For what it’s worth, I know from my first experience that, a week or so of feeling emotionally drained and battered, and normal life will resume. I’m so relieved it went well and now it’s over.
How to Comfort a Child After Surgery
Finally, a few tips for comforting our child after the surgery:
- Reassure them it’s done and finished (if this is the case);
- Tell them they’ve been brave and you’re proud of them;
- If surgery goes well, tell them it was a success and that they’re going to start healing now;
- Offer lots of cuddles and reassurance;
- Expect big feelings and allow for them (after her first op I told Pixie it was okay to be cross with Mummy for letting the doctors do something she didn’t like and had asked me to stop, and explained again why it was necessary);
- Encourage and answer questions;
- Encourage role play to help your child process their surgery.
I hope anybody else preparing for their child’s surgery has an easier ride and I wish you and your family the very best. And if you need someone to talk to who understands, please feel free to drop me a message.