The weeks before surgery — the hardest time for any family
The date is set. From this moment, two questions run through every parent's mind at once: what do I tell my child — and how do I hold myself together? These two questions are deeply connected, because children read us like open books. If you are barely keeping it together, they feel it — even when you say nothing at all.
Over twenty years of practice, I have worked with thousands of families before surgery. I can tell you with confidence: the technical side — tests, admission, fasting — that is our job. The psychological preparation is yours. And it has a real impact on how the first hours after waking go, how recovery unfolds, and how the whole family comes through this period.
This article is not textbook theory. It is what I tell parents during consultations the day before surgery. Practical and to the point.
The core principle: always tell the truth
The first instinct of many parents is to hide things. "We're just going for a check-up." "It's a small procedure." "Nothing to worry about." This is understandable — you want to protect your child from fear. But this approach almost always backfires.
Children understand far more than we think. They overhear phone conversations in hushed voices, notice that mum's face has changed, wonder why grandma came over "just like that." When there is no information, a child's brain fills the void with its own imagination — and those imaginings are almost always scarier than reality.
The truth, delivered calmly, with love and in words the child can understand, reduces anxiety. It gives the child what they need most: the feeling that they are not being deceived, that adults are present, and that someone is in control of the situation. Of course, the truth must be age-appropriate. A three-year-old does not need anatomical details. A teenager does. Let us go through each age group.
Ages 0–3: what matters is feeling, not words
At this age, a child does not understand the word "surgery." But they read your state perfectly — the tension in your body, the tone of your voice, the quality of your touch. If you are anxious, stiff, and speaking in short bursts, they sense danger, even without knowing its source.
What actually works for children under three is the stability of daily routine. The same bedtime book, the same song, the same games — these matter even more in the days before hospital admission. A familiar rhythm is a safety anchor. If you start changing the daily schedule right before admission, your child becomes more unsettled.
Pack things that smell like home: a favourite soft toy, their own blanket, a dummy if still relevant. These are not indulgences — they are real psychological tools. A familiar scent in an unfamiliar place measurably reduces a young child's stress response.
Your job at this age is to stay as calm as possible yourself. Pay attention to your breathing, to how you hold your child, to the tension in your hands. They regulate themselves through you.
Ages 3–6: simple words, honest answers
This is the age of "why" and "what if." The child already asks questions and has real fears — of the dark, of separation, of pain. They can already imagine things they cannot see. That is precisely why silence at this age is especially harmful.
A good conversation looks like this: sit beside them somewhere calm, not right before bed. Speak simply: "Remember we talked about the little problem in your heart? We're going to see a doctor who fixes it. He does this every single day and is very good at it. You'll be asleep the whole time and won't feel anything. When you wake up, we'll be right there with you."
The three questions children this age ask most often: "Will it hurt?" — Don't say no. Say: "While you're sleeping — not at all. Afterwards it might feel a bit uncomfortable, like after a vaccination, but the doctors will give you medicine so it doesn't hurt. And we'll be with you." "Will you be there?" — "I'll be waiting right next to you. The moment you wake up, I'll be there." Never promise what you cannot deliver. "Why is this happening to me?" — "You didn't do anything wrong. Your heart was just born a little different — and now the doctor is going to help it become stronger. It's nobody's fault."
Medical play works very well at this age. Buy a toy doctor's kit — a stethoscope, bandages, a small bag. Let them "treat" their dolls and stuffed animals. When a child plays through a situation, they learn to manage it. This is not naïveté; it is a working mechanism of the child's mind. Reading a book about hospital together, or drawing what the doctor looks like, is another way to bring fear out into the open and make it smaller.
Ages 7–12: information creates a sense of control
School-age children can absorb more detail — and they need it. The more a child understands what will happen, the less powerless they feel. And powerlessness is the primary source of a child's fear before medical procedures.
Walk them through the sequence: "We'll arrive at the hospital in the evening. They'll examine you and take a blood test — a little unpleasant, but quick. In the morning you won't eat anything. Then they'll take you to the operating room on a trolley — it's quite interesting, there are lights everywhere. The anaesthetist will give you a mask with a nice smell; you'll take a few breaths and fall asleep. You'll wake up with us."
Don't skip the uncomfortable parts — they will find out anyway. Better to hear it from you, calmly, than from an overheard conversation or the internet. But do not catastrophise: facts without drama.
Give the child choices wherever possible: which pyjamas to bring, which film to watch in the ward, which game to download. Small decisions restore a sense of control over the situation — which is exactly what is missing right now.
If possible, arrange a visit to the hospital in advance — to see the ward, meet a nurse, look at the outside of the operating theatre. The familiar is no longer strange, and fear decreases. I am always happy to make time for such a visit. Also: let the child ask questions directly to the doctor. Many children hold back when parents are present. Alone is fine. A child who has asked and received an answer feels like a participant in the process — not just a patient.
Teenagers: a different kind of conversation
With teenagers it is both harder and easier at the same time. Harder, because they already know how to search online — and what they find is often frightening: complication forums, medical articles stripped of context, other people's experiences that may have nothing to do with their situation. Easier, because you can talk to them almost as adults.
Open the conversation with a direct question: "Have you read anything about this? What did you find?" Let them tell you. Then quietly correct what they have misunderstood, and add what they have not found. Do not dismiss their worries — that backfires. Acknowledge: "Yes, surgery is serious. At the same time, we do this every day, and the outcomes are good."
Teenagers often worry about things adults do not think about: what the scar will look like, whether they can return to sport, what their classmates will say. These questions matter — no less than the medical ones. Answer them seriously.
Involve the teenager in decision-making as much as possible. Let them write down their own questions for the surgeon. Let them be present for part of the conversation with the surgical team. This is their body and their life — they have the right to be a participant, not only a patient.
What to pack for the hospital: a practical list
These may seem like small things. But the right items genuinely affect how a child experiences the hospital stay — especially the first days after surgery, when they are still weak but already conscious and bored.
For the child: a favourite soft toy or blanket — essential, the familiar smell works as an anchor; a tablet or phone with pre-downloaded films, games and books (hospital Wi-Fi can be unreliable); headphones; pyjamas and slippers from home — hospital ones are uncomfortable; books, colouring books, modelling clay for the recovery period; favourite snacks for when eating is allowed again.
For parents: chargers for all devices; comfortable clothes — you will be here for several days; food and water for yourself, especially for the long wait on surgery day; something that helps you — a book, music, a notebook. Don't overpack. Hospital rooms have limited space. Less, but right, is better.
The day of surgery: what happens and how to be present
This is the longest day — especially for parents. The child is taken to the operating theatre and you are left to wait, sometimes for four to six hours or longer. It is very hard.
Ask the team in advance who will come out to update you and how often. In our practice we try to give parents updates during the operation. Knowing that "everything is going as planned" is incredibly helpful during the wait.
When the child wakes from anaesthesia, the first minutes can be frightening for both of you. They may be disoriented, crying, not recognising you — this is the normal effect of anaesthesia, and it passes within 15–30 minutes. Speak to them quietly, hold their hand, say their name. You don't need many words — you need your presence.
Tubes, catheters, drips — these are alarming for both the child and you. Tell the child in advance: "When you wake up you'll see some tubes — they help your body recover and will be removed soon." A child who has been warned reacts more calmly.
About yourself — separately, and importantly
I tell parents at every consultation: your state is not a personal matter — it is a medical factor. A parent standing at the bedside white with terror, barely holding back tears, sends the child a signal of danger. A parent who looks tired but calm sends a signal of safety.
This does not mean pretending you are not frightened. Being frightened is completely normal. But there is a difference between "I am scared" and "I cannot cope." Share your anxiety with someone other than the child — your partner, a friend, a psychologist, anyone who can listen. Do not bottle everything up until you break. If you feel you are not coping, tell the team. We work not only with the patient but with the family.
Take care of the basics: eat, even when you don't want to. Sleep at least a few hours. Step outside for fresh air while the child is sleeping. This is not selfish — it is the condition of being functional when your child needs you.
And finally: trust the team. We do these operations every day. Your fear is completely understandable — but the statistics are on your side. Let us do our job, and focus on yours: being present for your child.
Recovery: the first days at home
When the child comes home, it feels like the worst is behind you. And it is. But there are still a few weeks ahead that deserve attention.
The child's behaviour during recovery may surprise you. Some children become more clingy, listless, afraid to be alone — this is regression, a normal psychological response to stress. Others withdraw. Teenagers may be angry or refuse to talk about what happened. All of this is temporary. Give more warmth, fewer demands, more time.
Do not rush the return to normal life. School, activities, seeing friends — it will all come back. First comes recovery. Remember: a child heals faster when they see that you are calm and confident that everything is going well.
If you have any questions — call us. We are here not only during surgery, but after it too.