straight jacket for blood work?

[laure]

I need help getting my dd to have blood drawn...the first and only time she has had blood work took 3 sticks, and she nearly fainted afterwards, but that was how we verified PANDAS. Now she needs a full work up prior to first appt with Dr. B. I am certain she will say NO WAY and we are powerless to force her to do much of anything since this horrific illness entered our lives. She won't even admit that she has this disease, OCD, or anything else, although she knows we know, and sometimes takes her meds without a fight. Reading this forum, I don't see anyone else talking about fighting with their child over meds/blood work/procedures. Really???? Any ideas welcome

[peglem]

For years and years blood draws were a 5 person job for us. Put her on the exam table, I'd climb on top, somebody would pinion legs, the other arm and 2 people to hold the "draw" arm. Later, as she got bigger, though she tried to cooperate, she could not avoid the fight or flight reaction- but it would only take 3 people. We give valium before draws now and though she still struggles, has gotten to the point where she can get a blood draw in the chair now. Have you tried using the Emla cream to numb the area first? That sometimes helps. It takes a very good, patient phlebotomist. We found a good one (she has a special needs child w/ a similar reaction) after being sent away from a lab who wouldn't help us.

[dcmom]

Laure- I am sorry. I think most of us have these issues. My dd was great with needles until pandas hit- the anxiety and panic is definately part of the lovely pandas package. My dd, 10, has had several panic attacks: vomiting, near fainting etc.

 

I would definately NOT opt for a straight jacket. This is a teaching moment- you need to use it to develop trust, and teach them they CAN do it. It is not going to be easy, though. Here are a few thoughts: can you get some type of light sedative from the doc if really necessary, use the emla creme to numb the area, bring her to a comfortable and kind lab (and maybe try to be their first appt of the morning), teach her some calming breathing exercises to use and do them with her, stay calm, kind and strong yourself, have her lay down and not look at the needle or blood, put a cool washcloth on her head and maybe have her bring her Ipod and headphones with calming music, tell her prior to the appt- but not too far in advance, maybe that morning. Tell her there is NO option, you would never put her through something harmful, you understand her anxiety. Then, after that don't get sucked into constantly reassuring her (it actually seems increase anxiety in our case). Offer a nice reward afterward.

 

As far as the meds- my kids are somewhat resigned to taking them- but they push hard against me adding something else (which I am about to do). There is NO option for them- I don't discuss it- either they take it- or the doctor can give it to them through a needle (this is the time when the fear of needles is helpful). We are working on swallowing meds.

 

I do try to limit the bloodtests for them, though. I do understand their angst. I think it is important that they learn they CAN do it- but we do limit blood tests to only testing if it will change the course of treatment- not to make the doc feel more comfortable

 

Good luck!

[airial95]

I had to get blood drwan as well when my son had to get his first time, he was nervous, but all for it, he was going to be a big boy, like mommy. He saw me go first, said "mommy, I can do that". When the tech left to get his things - he looked at me and changed his mind "mommy, I can do that, but I'm not gonna" - very matter of fact.

 

They offered the "restraint jacket" for him when he started to freak out, but I opted against it. I held him in my lap, almost in a wrestling hold, and another nurse held his arms. I think he could be heard screaming in a 5 county radius. There were other kids int he waiting room - I felt bad...

 

Afterwards, I promised him a new train if he was brave. When I asked if we should get him a new train for being brave, he actually said "no - I wasn't a big boy". (He got his train anyway).

 

Since then, our pediatrician has offered to do all of the blood draws and send them to the lab. It's easier since he knows all of the nurses in there, and likes "Miss Margie" who is the one who has to poke him. It still takes 3 of us to hold him down, and he still screams, but it's much less traumatic.

 

Will your ped do the draws??

[trggirl]

We use the cream and my daughter cannot feel it AT ALL. We have gone from screaming and fighting the first time to a point where she actually looks forward to going because she knows there is no pain and she gets a treat afterwards. I highly suggest using the cream.

[keeptrying]

my dd is absolutely terrified of needles. If we go to any doctor appointment, she will cry asking me if they are going to give her a shot. She was checked for an ear infection and she cried the entire way there and I was unable to convince her that there would be no shot.

 

This Tuesday we took her for the cam k test. It was awful. She screamed and said I can not make her do it and cried uncontrollably. It took my husband and I to do it but we did. I was terrified and had a lump in my throat and held back tears but looked her in the eye the entire time and she got through it. It was truly awful.

 

We get home, she is drawing on her bandaids and we get a call from the lab saying they think they messed up the test and can I please bring her back for another one.....................................................................

 

I immediately called Madeleine Cunningham and SHE WAS THERE. She called the lab and worked it out for us. All the while my dd is on the floor in her room crying and screaming. I started to cry and thought this will truly send her tics through the roof.

 

Anyway, that is over. We got through it. A good friend reminded me how resilient our children are. I am sure my dd got over it better than I. I could not eat dinner - she did and had a treat after.

[laure]

wow, thanks so much for all the ideas! I had no idea everyone else had these struggles too...because there is no way to talk to her like an adult regarding this issue, (or nearly any issue). Where do I get the cream?

[peglem]

wow, thanks so much for all the ideas! I had no idea everyone else had these struggles too...because there is no way to talk to her like an adult regarding this issue, (or nearly any issue). Where do I get the cream?

Our pediatrician prescribes it for us.

[EAMom]

Yup...Emla cream.

 

Also BRIBERY helps (esp. with the younger one! a webkinz or something like that). I used to bribe her for throat cultures too...now it's not needed.

 

For our older dd (who is actually GREAT for blood...she's now 10), one thing dh told her (she's had a few Cunningham tests) is that in giving blood for that "she is helping other children with PANDAS". This really got her to comply nicely for those draws.

[emmalily]

Personally I have to wait for a day where I'm feeling really well (don't know if you're having those kind of good days yet). If I'm going while I'm having a real PANDAS day I will panic and get incredibly woozy, not over the blood, over the having to be trapped in the chair. It's more a claustrophobic thing for me. Anyway you find out what is bothering your daughter about it? It may not be the actual needle/pain/sight of blood. Will they allow her to sit on your lap?

[parents4eyes]

I

Edited October 2, 2010 by parents4eyes

[Megs_Mom]

Yup...Emla cream.

 

Also BRIBERY helps (esp. with the younger one! a webkinz or something like that). I used to bribe her for throat cultures too...now it's not needed.

 

For our older dd (who is actually GREAT for blood...she's now 10), one thing dh told her (she's had a few Cunningham tests) is that in giving blood for that "she is helping other children with PANDAS". This really got her to comply nicely for those draws.

 

That's a great idea. This is the only residual thing we have left from PANDAS - her therapist says it is not really related, that a lot of kids have needle phobias. I know it was caused by some bad experiences in our case - she was great even in a severe exacerbation until 2 very very bad nurses . We decided she is too old to hold her down & we have to have her participate. I ask her to do SO much, and she needs to trust me - she is claustrophobic anyway, and being threatened with being held down is one of the things that made her start having panic attacks about blood draws. It is one of the worst experiences we have had - we've done over 40 vials, and every run is a nightmare so far. We did therapy at home, EMLA (which is helpful), awards, consequences. At one point, I thought I'd lose my job, we were trying with the lab every day for WEEKS. That nurse was a godsend, and finally came to our home on a Sunday afternoon so that there would not be an "end point" that our dd knew she would win and not have to do it. I would have given her our car if she'd asked for it, I was so grateful! OMG, it makes me want to scream to think about it - and we have a number of tests we should be doing now, and I am putting off because I cannot handle it! I have considered getting a certification myself, as she will let me do it - it's more the nurse and a trust issue, than the needle itself.

 

Sorry not to be of more help - this was so stressful for me, as a parent, to want to keep trust with all the hard things we were asking our daugther to do, feeling heartbroken about her fear and feeling of failure, and needing her urgently to get the draws done. Not a good combination for any of us.

 

I LOVE the idea of telling her that it will help other kids with PANDAS. She feels very strongly about this, and maybe that internal motivation will get us over the hump. She just turned 9, and I told her that 9 year olds have a much easier time with it than 8 year olds. Hoping for the power of positive suggestion!

[matis_mom]

I need help getting my dd to have blood drawn...the first and only time she has had blood work took 3 sticks, and she nearly fainted afterwards, but that was how we verified PANDAS. Now she needs a full work up prior to first appt with Dr. B. I am certain she will say NO WAY and we are powerless to force her to do much of anything since this horrific illness entered our lives. She won't even admit that she has this disease, OCD, or anything else, although she knows we know, and sometimes takes her meds without a fight. Reading this forum, I don't see anyone else talking about fighting with their child over meds/blood work/procedures. Really???? Any ideas welcome

I think we could have caught it earlier if my son had not so afraid of needles (literaly shaking like a leaf). Well, he's had to get over it. It was hard for both him and I, but I just put my foot down and helped him through it. I'm not saying this will work for everyone, but there is no way about it. Do whatever you need to do to get her treated. A couple of things to keep in mind: don't build anticipation (just tell her as late as possible), and don't let them see how many tubes it is (we did Dr. Bs workup last week...I counted thirteen little tubes!). Also I found people at labs are much better than nurses at the pediatrician. I guess they have more practice. Good luck!

[momaine]

For the first draw, when dd was terrified of a blood draw for OCD reasons combined with bad experiences, we got a mild sedative and talked her into it. We also went to a lab (not the nurse at the dr. office) and asked for the most competent phlebotomist (sp) when working with children. And we got EMLA cream to numb the sight. Between those three things we got it done. After that she didn't need the sedative and now after MANY blood draws, she can even have it done without the EMLA cream. (well, she did the IV without the cream, but not a blood draw yet)

 

Best of luck

[laure]

I second EMLA cream at least 45 min before the actual poke. Cover with plastic wrap and secure with a headband or cut the top of an man's dress sock and use that to secure it. Do not use bandaids or tape. I also second an agreed upon reward. A good phlebotomist will talk to the child during the draw asking fun questions about hobbies etc. If the phlebotomist doesn't then you can try to engage your child in a fun conversation. Recalling a funny movie, etc.

Never allow someone to multipoke! If they don't get it the first time, get someone else or walk out.

Prevention on the first draw is essential. But we have had bad phlebotomists too and were able to turn it around at the next draw.

First, asked around among friends. Chances are you will get a list of bad phlebotomists more so than a recommendation, but that is a good list to have.

Next, call around to local labs. Explain the bad experience and ask for the phlebotomist that they send difficult veins to. (not that your child has difficult veins it just means that is a good person.) Most labs will insist that they are all equally good, but keep trying. Ask the lab if they have toys, stickers, juice, cookies, fun bandaids, etc. If your child is young bring your own to give after the draw. We used to drive 45 minutes to a good phlebotomist. It was well worth the drive. If you are able to schedule an appointment, that will help with wait time and building up of anxiety in the waiting room.

 

I highly recommend not holding down your child... I don't know how old your child is but if old enough to reason it will be much better in the long run if you are insistent that it needs to be done but get mutual agreement. Have both parents stand on either side in case you do need to grab and hold.

Can you tell I have a lot of experience. Mine needed monthly draws...