Talking to dd about upcoming oral surgery - Mothering Forums

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#1 of 11 Old 01-10-2008, 12:27 PM - Thread Starter
 
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This isn't really a dental issue; it's a "when and how do I have this conversation" issue.

Dd is 4.5, gifted, sometimes anxious. On 1/18 she'll be going in to the hospital to have her cavities taken care of under gen. anethesia.

I don't want to talk about it with her too soon, or she will become more and more anxious every day. I'm not sure it would be good to spring it on her the day before either.

Regardless of when I talk about it with her, I thought about talking about the hosp. in terms of "lucky you - you get to have all your teeth fixed at once, while you're sleeping!" but she's pretty savvy, I'm concerned she'll sense my anxiety.

Who's had these types of conversations with 4-6-ish yr olds before?
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#2 of 11 Old 01-10-2008, 01:10 PM
 
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To be honest, I'd ask the pediatric oral surgeon or his nurses. They may have excellent advice.
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#3 of 11 Old 01-10-2008, 05:43 PM
 
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Has she ever been to the hospital? Maybe you could read her a book that explains how hospital looks like and what to expect once she is there.Even if it is not about oral surgery it will help her be prepared for the event. I know there is a "Franklin goes to hospital" book but it may be too young for your dd.

I would probably want to talk to her earlier than a day before. If she is smart, try to be honest but keep it simple and posititve, yes, you need not to be anxious LOL.
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#4 of 11 Old 01-10-2008, 07:09 PM
 
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My DD (about to turn 5) had dental work done at the hospital under general anesthesia a few months ago. She knew about it long before it actually happened. It was presented to her as an alternative to having the work done in the dentist's office with local anesthetic, and she had been really worried about that, and liked the idea of being asleep better. We were expected to take her to the hospital about a week before the work was scheduled, to meet the nurses, see the post-op room, learn a little about what to expect the day of the procedure, and get a bag of stuff. She thought all the people she met were really nice, and she seemed to feel better about the whole thing after that. (But she hadn't been terribly anxious before.) We told her she could sit and watch videos the whole rest of the day after she got back from the hospital if she wanted to, and she was happy about that. (She actually only watched one or two videos, and then she was back to normal, eating and rollerskating around the house.) We were pretty low-key and matter-of-fact every time we talked about what was going to happen, and she seemed only slightly worried about it.
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#5 of 11 Old 01-10-2008, 10:19 PM
 
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Is she actually going to be "under" or on Versed?

This is a bit off topic but if she is just going to be on Versed I would ask to be in with her to comfort her. She probably will not consciously remember it but it is my belief that you can have lingering trauma from pain and restraint under Versed. It's weird stuff.

I read today somewhere else that they suggested you introduce the medical event 1 day ahead per year of age. So 4 days beforehand.
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#6 of 11 Old 01-11-2008, 01:19 AM - Thread Starter
 
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Quote:
Originally Posted by pigpokey View Post
Is she actually going to be "under" or on Versed?

This is a bit off topic but if she is just going to be on Versed I would ask to be in with her to comfort her. She probably will not consciously remember it but it is my belief that you can have lingering trauma from pain and restraint under Versed. It's weird stuff.

I read today somewhere else that they suggested you introduce the medical event 1 day ahead per year of age. So 4 days beforehand.
It's going to be gen. anesthesia. I've been under G.A. many times and have had Versed several times; I know can both be horrible for different reasons.

The "one day ahead per year of age" makes sense. That will give her time to process the info and have time to ask questions, without having too much time to become confused about it or overwhelmed with fear.
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#7 of 11 Old 01-11-2008, 01:36 AM
 
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My son is the same as your DD as far as anxiety. Each day would be like extra torture for him. If it was my son I would start reading books now about dental/hospital visits. Then about 2 days before I would tell him about it.
Thats how I would do it with my son. My son had to have a crown down on his molar and I did the above and it went pretty good. He was not put out or on any meds besides laughing gas and I was right there with him.

Hugs to you mama! s
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#8 of 11 Old 01-11-2008, 02:53 PM
 
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When my DD was 3.5 she had to have a common outpatient surgery for her eye muscles. Our ophthamologist gave us a book that we read over and over and over (per my DD's request.) The book took away some of the mystery. Then, about 1 week before the event we took a tour of the surgery facility and met specifically with the nurse who would be attending to us. In the tour they showed DD the special smells they put in the mask and let her pick out her favorite "flavor". She chose watermelon, and got to take home a mask and a cotton ball with that smell on it (non-medicinal). For the remaining week before the surgery she played doctor and continued for weeks afterward. She was absolutely a champ! And I will add that our situation was a bit more nerve-wracking as the facility normally would give the child a liquid form of versed before the GA (to affect the memory) and we opted out of that. (DD has terrible response to food colorings and we didn't think it necessary to get a shot.) DD chose to get carried to the surgical room by the nurse and was ready when they put the mask on. I, on the other hand, cried as soon as she was out of sight. Kids are amazing and as long as you are strong they'll be strong too.

Good luck with this.
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#9 of 11 Old 01-11-2008, 10:29 PM
 
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I would find out what all is going to happen with the GA. Ds had GA for dental surgery, just before his 5th birthday. We discussed the options with him: multiple in-office visits, or one big visit at the hospital. He choose to have it at the hospital all at once. We took a portable DVD player, with a new Thomas DVD and he was happy as a clam while we waited. I sipped Rescue Remedy.

The big issue for me was that I did not want him to go under upset, nor taken from me in distress. I discussed the pre-anesthesia sedation options with the dentist and anesthesiologist. And ds had nasal Versed and became loopy in my arms. It stings! I informed ds well before the surgery (a week) about the stinging nose spray and what all would happen about oxygen masks, IV insertion, etc. It was totally smooth. There is an oral form of the Versed, but it has artificial colors and flavors, which hype ds up. So, I insisted that we not use it and potentially need more GA to calm him. Ds was nonchalant about being handed to the OR nurse, came out of anesthesia and I was able to be with him immediately as soon as he roused around.

Also, I gave him Arnica Montana 200c the morning of surgery, before arriving at the hospital and immediately when we got in the car to leave. He had "minimal bleeding" in OR and no bruising, no discomfort and no bleeding afterwards. He had caps, which I wouldn't be inclined to do again though, as two of them have cavity retained.

There are natural and nutritive ways to cure cavities, which I didn't know about then. We are doing that instead now.


HTH, Pat

I have a blog.
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#10 of 11 Old 01-12-2008, 02:36 AM
 
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talk to your child on what exactly is going to happen....

from the night before when she cannot have any thing to eat so her tummy is empty to getting up, 'letting her' wear her pajamas (if she has special ones or you can afford new ones and make them specila) ask her what she wants to take with her, a blanket, stuffed animal, doll, book, crayons, 1 or 2 things that she picks. then go in to what will happen once you get to the hospital .... here's a guess on a probably what will happen....

drive to the hospital, walk up to the door, go inside, go to a waiting room, get an armband, mommy fill out paperwork, a nurse will take you back and they will weigh, see how tall you are, take blood pressure (if she hasn't had this one done before or seen it done explain) maybe take blood, taken to a room with a fun mechanical bed, a new set of special hospital pjs to wear, a nurse/doctor will come in and start an iv... (that one's tricky, it's a scary one and you really have to play it by ear on whether you actually tell this beforehand... depends on her reaction to the other parts if she's hanging with you and not turning green then you might, but then you might white lie and forget to tell her that one) and then give you some medicine by mouth that makes things a little goofy, then you will be wheeled on a gurney back to a special place...... that's it..... do not go into what will happen once she is under the GA, the whole sticking tubes in, strapping down... find out at what point she will still be alert to the world and her surroundings and only go there, she does not need to know the little things of drilling, pulling, blood, risks..... (that's your job to worry about, not her's ) they may not give her the oral meds to calm her and may just take her back and give her the gas so she may still be 'awake' until after she has to leave your side. tell her tht she will be given medicine and that they will "fix her teeth" or whatever generic term you are using (we used they are going to fix your teeth and put your new pirate teeth in... stanless caps)

so skip the yucky/scary part and continue with what will happen she will start to wake up and things will look and feel a little weird, that her mouth will hurt/be tender/ don't tell her how bad it will be, because you don't know, let her know that it will be different... but don't put an idea in her head that it will HURT, let her decide that one for herself once she's out..... then the wole exiting the hosptial routine, getting her home pj's back on, being wheeled out in a wheel chair.... oh and the toy/sticker treats that they will give, if there's something special that you want her to have or a type of toy you don't want her to have then be sure to take your own

call the hospital and ask exactly, yes exactly - don't let them give you the grown up version- what will happen if you need to ask to speak to someone in the family relations, case management section. tell them your daughter isanxious and that you are just trying to prepare her with things and you want them to walk you through the intake process and what to expect. If possible ask if it would be possible for a tour. if you get a weird reaction for the folks at the hospital.... say something like "I know it's only one visit to the hospital, and an outpatient type thing.... but this experience is the 1st big medical event in her life and Iwant it to go as smoothly as possible for her so that she does not cause problems later on......

okay there's my into to my book I'm writing here.....

How soon? I wouldn't wait until the day before, that' like springing it on her, I'd mention someting now, normal converstion, just something about having her cavities fixed/taken care of... maybe while brushing your teeth... if anyone you know has fillings, caps, missing teeth get them in on this and let her look in their mouth so she has an idea what things will look like, she may start asking questions so don't let her talk to the 'uncle' who will start telling horror stories of dental visits.

I've been dealing with hospital visits, procedures, office visits since birth with my 4 year old son and yeah he's experienced, probably too much so on these things but I find it sooooo much better to let him know beforhand what's happening, for us it depends on whether he has 1 appointment for the month or 4 in one week on how soon beforehand we "tell"

think of it in terms of you guys going to a park and on a picnic, wouldn't you tell her all the things that are going to happen? I personally think the monkey bars and slides are scary, would I tell my child that? no way! so the hosptial isn't 'fun' but that's from us grownup eyes who have been taught to think things aren't. You can teach her that the hospital isn't a bad place or a scary place.

just my 4 and a half cents.
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#11 of 11 Old 01-12-2008, 03:01 AM
 
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Lightheart's advice sounds good to me. Just thought I'd mention that they did NOT start an IV on my DD until after she was unconscious, so you may not have to worry about that. Have you been given a pretty detailed rundown of what's going to happen? I felt like it was important for me to know what to expect, so I'd know if there was going to be anything that was likely to be a big problem for DD. Fortunately, our hospital was good about informing us ahead of time. (And doing their part to keep it from being a bad experience.)
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