If your child is having a scan with sedation, you’re probably freaking out a little bit. Or it’s the night before and you’ve got raging scanxiety. I will tell you this before all the rest: all of that is perfectly normal. We don’t want anything to be wrong with our kids, ever. We want them to be happy and healthy and eat their vegetables and behave AT THE GROCERY STORE. And most of the time, those things happen.
But sometimes, they don’t.
By now, you know we’ve had plenty of unwanted health scares. Jackson and Abby may share the same last name and hair color, but the extent of their similarities ends there. Jackson would rather run outside hooting and hollering with his friends while his sister sits by her bookcase and looks through every single book we own. So it should come as no surprise that they handle pediatric sedation differently.
Jackson has a tendency to be harder to go to sleep and easier to wake. I often tell stories about Jackson’s radiation portion of treatment. He got so used to being sedated that the anesthiologist would let him push his own Versed in his IV. So Jackson would push it in and laugh and laugh and laugh as the medicine relaxed him, then the doctor would push in the “good stuff” (i.e. Propofol) and out he’d go. Jackson would metabolize his sedation medicine so quickly, often he’d be awake before he even got to recovery. On Jackson’s last day of radiation, he woke up leaving the radiation room and tried standing up on the stretcher on the way back to the recovery room. Literally, surfing. The anesthesiologist was what I call a “Nervous Nelly” and looked near a breakdown. I finally just popped open my stroller, strapped Jack in and wheeled him myself into the recovery room. You should have seen the look on the recovery nurses faces!
And that’s Jackson for ya.
Abby, however, you push in a few drops of medicine in her IV and she’s flat out. I mean OUT. And when she wakes up, she wakes up SPITTING MAD. Or should I say, NICU Abby wakes up. Just as she did as a one-pounder in the NICU, she takes matters into her own hands. If you’re not really careful, she’ll yank her IV out first. Next she starts working on her EKG leads, then her blood pressure and eventually takes all her clothes off. It’s hilarious now, thinking about it, but highly stressful in the moment.
Last time, she was down to just her Pull Up with the pulse ox on her big toe and socks on. But she STILL wasn’t happy until her socks and the pulse ox were off. She refused to eat or be held or lay down or do anything. We finally just got discharged because medically, she was perfectly fine, just mad as a hornet’s nest. As soon as we left the recovery, she was fine. Also, we bribed her with a chocolate chip muffin and Coke. Whatever works!
I tell you these stories because everyone is different! The process is typically all the same, so knowing these things will help you quiet the fear of the unknown:
For sedation medicine, typically there’s nothing to eat or drink by mouth leading up to the scan. It’s called being NPO.
Tip: It’s very important to follow guidelines your doctor/nurse provides. They will ask and if you didn’t do it right, you might have to reschedule.
The first step is checking in with registration and filling out the paperwork.
Tip: This can take awhile if they’re running behind. Bring a bag of books, crayons, toys for the waiting room. NO FOOD or DRINK!
Your child (and you) will be called back by a nurse.
Tip: Typically, it’s just two adults allowed back with the child. Take this time to talk to the nurse in front of your child and mention things your kid likes. Encourage your child to see the nurse as a friend.
When you reach your room, you child will be weighed and have their vitals taken (blood pressure, temperature, etc.). This is when the nurse will go through your child’s medical history. Standard stuff.
Tip: Keep this portion light and fun. I play with Abby and sing “Time for your Check Up” from Doc McStuffins. The blood pressure cuff gives a “big hug.” I count out loud to see how long it takes for the temperature to beep off.
Because IVs are required for sedation, you can’t avoid them. Remember my two stick rule: after two tries to get an IV, try someone new. For kids that are hard sticks (like preemies!), you can ask for the special IV team called the VAT team.
Tips: Distraction and the use of cold spray to numb the injection sight are helpful. Most importantly, parents, KEEP YOUR COOL. The more worked up you get, the more worked up they will get. It’s not about your anxiety, it’s about your child’s.
Your child’s anesthesiologist will come in to review the medicine, side effects, go over any questions and ask you to sign paperwork.
Tips: Ask questions. If you can’t think of any, try these: What’s the medicine being used? How long have you been using it? How do most kids do with it? How long does it take to leave their system?
Once the IV is in successfully and you’ve consented to anesthesia, you’ll travel with your child to the scan room. You will be able to stay with them until they go to sleep. It doesn’t take long before they’re asleep and the medical team is ready to scan.
Tip: It’s always hard to watch your child put into an artificial sleep. Their eyes get that faraway look when the medicine takes effect and it’s just…hard. But as the parent, your understanding face is reassuring and should be the last thing they see. You have my permission to fall apart AFTER they’re asleep.
Depending on the length of the scan, you might be able to stay with them. Or if they’re having multiple things done, you’ll be asked to sit in the waiting room and called into the recovery room once everything is over.
Tip: If you make friends with the nurse, you can ask that they give you updates once an hour.
The scan’s over and your little one is in recovery. It’s over! You can exhale now. Depending on the child, you could be in recovery for 30 minutes or well over an hour. Every child is different.
Tip: If your child is having a hard time waking up, try talking to them, blowing in their face, taking off their blanket, tickling their feet. It’s a lot like trying to wake a sleeping baby.
Your child will need to be medically released from recovery. That means have great vitals, stay awake for at least 10 minutes straight and preferably have a little something to eat and drink.
Tip: You can have your child let the nurse know beforehand whether they prefer Apple or Grape Juice, crackers or graham crackers.
Once you’ve gotten the OK, sign your papers and hit the road.
Tip: A stroller is a necessity unless you want to carry a tipsy toddler all the way out to the parking garage.
My kids usually are groggy/wobbly for a couple hours after sedation. They can be a little cranky too, so this is also a good time for bribery.
Tip: I’d suggest taking the full day off from work, or plan to work from home after sedation. The whole process takes awhile. Plus, you’ll need to mentally recover and your little one may want some extra attention. I always feel zapped when I come home.
That’s an overview of a typical sedation. Remember, I am not a doctor, but a mom. Every child is different and every circumstance is different. But this is what I would tell a friend, just all written down in one place. Sometimes having the knowledge of what to expect takes some of the fear out of the process!