How do we prepare our son for surgery?

Q: My son just turned 6 and will be having surgery to repair amblyopia (lazy eye) in about a month. We would like some tips on preparing him for the surgery—it will be outpatient, and by the next day he is supposed to feel substantially back to normal. He has had one other hospitalization when he was 3, and it was an emergency so it was quite traumatic. He likes doctors now a great deal because he believes, rightly, that they made him better after he was sick, but he is fairly afraid of needles still (although he's trying to get over that, too). So, we may need specific advice on what to tell him.
A: Stacy, it’s good that you have time to prepare your son for his amblyopia (lazy eye) surgery, so this hospital experience won’t be as traumatic as his previous one. Over the past 3 years, as you’ve helped your son discuss and work through his fears about doctors and needles, you’ve been doing a lot to prepare him well. Here are a few more tips to prepare your son for his surgery:
  • Explain the surgery at the level he can understand. Explain that he has a problem with his eye muscles and the doctor will fix it so he’ll see better. Try to avoid explanations that might scare him like, “They’ll cut your eye and sew you up with a needle.” Tell him that lots of kids get their eyes fixed at the hospital.
  • Reassure him about any misunderstanding and fears he might have. He might be afraid they’ll hurt his eye, but you can reassure him that his eye will be better than ever after the surgery. Reassure him that you’ll be there with him when he goes into surgery. Then a special doctor will give him medicine to make him sleepy so they can fix him, and he won’t feel anything. If he’s particularly afraid of needles, ask the anesthesiologist if they can put on medicine to numb his skin where they’ll put in the IV, or wait to put in the IV when he’s drowsy from the sedative. Remind him you’ll be there with him when he wakes up. If he’ll have an eyepatch after the surgery, let him know in advance so he’ll expect it, and tell him when it’ll come off.
  • Encourage him to ask questions and express any fears he might have. Answer his questions and reassure him to the best of your ability. Also tell him that the doctors and nurses will answer his questions.
  • Help him “practice” beforehand. Read a children’s book about preparing for surgery. Consider buying a doctor’s kit and let him practice putting on an eyepatch on his stuffed animal, taking his temperature, and listening to its heart and breathing. Encourage him to ask the stuffed animal how it’s feeling and to reassure him that it’s doing well.
  • On the day of surgery, cuddle and reassure him as much as possible.
  • Try to stay calm yourself. If you’re with your son until he goes into surgery and in the recovery room when he wakes up, it’ll seem to him as if you never left. Since it’s an outpatient surgery, you can reassure him that he’ll be back home the same day, with all his favorite toys and stuffed animals, and maybe even a new special “congratulations-for-getting-your-eye-fixed” gift.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician