of surgery and communicate it with the anesthesiologists, who are very used to such things. For example, many medications can be taken on the child's schedule with a sip of water. Other times, the child will take additional medication during anesthesia. Depending on the drug, this may be an extra dose of steroids during the surgery.

The Waiting Time: When coming in for surgery, you will need to come in early enough to check in with different people. Come prepared to have some downtime in between meetings with the specialized members of staff that all play a crucial role in the operation. The surgeon and OR team will take as much time as necessary to safely guide your child to their intended surgical destination. Though it may test your nerves, take comfort in that fact as you wait.

Making the Child (And Parent) As Comfortable As Possible: Many children are frightened during the appointments before surgery, because depending on their age and development, some believe the surgery is happening that day in the office. It is important to always reassures them that the surgery is not taking place. Remind children of this on their way to the appointment to help, as much as possible, with the child's nerves. In those pre-op appointments, the doctor might help to emotionally prepare the child by asking the child to think about a favorite dream, so that on the day of surgery, the child is ready to think about this dream in the seconds when the child counts down to their "nap" (being sedated for the operation).

The mental realities of preparing for surgery can be just as challenging as the physical, sometimes even more so. Bring a go-to comfort object, like a favorite stuffed animal or blanket for the child on the day of surgery, to help calm and soothe. This is particularly important for children with special needs. It is also recommended that the parents bring something interactive, like a beloved puzzle or another interactive toy. Parents should bring something to distract themselves during the waiting period, like a book, an iPad, or Sudoku.

Most children's hospitals have child life specialists who distract the child leading up to the surgery with various interactive, age and development-appropriate activities. These individuals are exceptionally versed in working with kids with special needs. The child life specialist is critical for children with special needs, because they play a huge role in getting the child comfortable, engaged, distracted with something, and helping them to communicate.

While most operating rooms in community hospitals do not allow a family member to be present, children's hospitals often permit a parent to stay in the operating room until their child is sedated. Parents should ask their doctor way before the surgery, to prepare mentally. The parents may expect to hold their child's hand throughout the surgery, which is never the case.

AFTER SURGERY

Waking Up: After a surgical procedure, parents meet their child, as they rest in the recovery room. Parents should not be alarmed if their little one is still sleepy, disoriented, upset or if they do not immediately recognize or respond to them or other family members. Kids wake up in a sterile room with bright lights and beeping noises. For many children, especially those without an intellectual or emotional understanding of the event, this can be terrifying. They usually just need a few moments to re-adjust and be comforted by their parents and medical team.

The First Meal: Many parents want to reward or perk up their children after surgery with some of their classic favorite comfort foods especially those children who may be struggling. The first post-surgery meal should steer clear of things like pizza, ice cream, or French fries to avoid an upset stomach, and furthering the child's discomfort. The child should first consume liquids and then advance to something simple. After being able to keep down fluids, simple carbs, such as, pancakes and scrambled eggs tend to go down easier, and what child doesn't get excited about breakfast for dinner?!

Recovery: The length of the recovery process will generally depend on the child's age and the type of surgery. Just like in adhering to pre-surgery guidelines, it is extremely important that parents follow the surgeon's instructions for post-surgery care, including monitoring the child's pain levels and administering prescribed pain medication as directed.

It is also essential to monitor for signs of infection, such as fever, redness, or swelling at the incision site. Parents should be mindful of any activity restrictions and specific restrictions related to any areas of incision. Additionally, children and their parents should manage any dressing well by keeping it dry. Dressings can sometimes be taken off at home, but other times, an appointment is required.

All pediatric surgeons know surgery is scary and that parents have a million questions, and will sometimes need to ask them multiple times.

Like any post-surgery patient, children may feel tired or have a decreased sense of appetite, but they should gradually return to their regular spirits and energy levels, as they recover from their operation. Nevertheless, parents and caregivers should reach out to their medical provider for any specific questions that might be unique to their child, or just for reassurance as they help their child recover.

CONCLUSION

Surgery is scary, and all pediatric surgeons know this. They have chosen to work with a more vulnerable client base and are very much aware that parents have a million questions, and will sometimes need to ask them multiple times, which is OK and even encouraged.

At the end of the day, parents of special needs children are the ultimate experts on their children, equipped with abundant medical knowledge, because they have had to arm themselves with information for their child's whole life. Parents are encouraged to work very closely with their child's healthcare provider, lean on them as a resource, and lean on their close friends and family as resources, too. •

ABOUT DR. BASS:

Dr. Kathryn Bass serves as Section Chief of Pediatric Surgery at Carilion Clinic and Professor of Pediatric Surgery at Virginia Tech Carilion School of Medicine. She is triple board-certified in general surgery, pediatric surgery, and wound care. In her more than two decades as a surgeon, she has held many leadership roles, including Director of a Level 1 Pediatric Trauma Center and Co-Director of a Pediatric Wound Care Center. Her peers have recognized Dr. Bass as one of the nation's leading pediatric surgeons, and she was honored as a "Top Doctor" in Western New York from 2010 - 2019. Dr. Kathryn Bass is a pediatric surgeon of over 20 years, who works with children with special needs daily in her practice — ranging from small children to young adults who continue to receive care from their parents.