Sever anxiety related to shots and needles

[cdklyn]

My 4 year old daughter is a recently diagnosed PANDAS case. So recent, that we're still in the testing phase to see what her triggers are. We have a recent order to have additional blookwork and another strep culture. She's been stuck with so many needles in the last 6 months, that it's the first thing she asks when she hears that she's going to the doctor. She gets this panic stricken look on her face when she asks. Bloodwork, tonsils out, MRI done, all involved shots or needles and required at least 5 peole to hold her down to get the needle in (she weight 33 lbs...yes, 5 adults to hold her down).

 

Any suggestions on how to help her decrease this anxiety. I know it's unrealistic to wish a 4 year old would have no anxiety in these situations, but need ideas on what has helped with your little ones in explaining why we're doing what we are, and how to help them be somewhat calm during the process. A 4 year old, do you tell them before the appt or right before the needle prick? Lie when they ask if they'll have a shot...if i tell her yes we would have to tie her down to get her in the door of the doctors office?

 

Any help is appreciated, we have one week before next set of labs.

[PowPow]

No advice, just commiseration.

Mine is 14 and is full size. I have no doubt that this fear/refusal has prevented her treatment

Way past bribery working, right?

[peglem]

Well, we've used valium, emla cream to numb the jab site, and play therapy. It always helped to, to let her know why the doctor needed the blood draw. Still, its never been easy.

[dut]

Hi - only bribes, and expensive ones! Blood draws are super costly in our house but it has worked for us but I can see that some kids may be way beyond bribery... good luck..

[LNN]

My DD is very fearful of needles - totally psychs herself out with panic. When she had to have an endoscope, we numbed her arm with Emla cream and gave her a dose of Versed (like valium). Even in a daze, she freaked when they put the IV needle into her arm.

 

But she also managed to do 18 months of weekly allergy shots because her allergies were so debilitating - and she needs blood draws every 4 months to monitor her liver function and various health issues. So we use a lot of CBT (cognitive behavior therapy). We used the book "What to Do When Your Brain Gets Stuck" and "What to Do When You Worry Too Much" as guides.

 

We named her anxiety and called it a fairy. The fairy is a bad thought that wants all of her attention and energy. So we have the Worry Fairy, the Sad for No Reason fairy, the "I'm no Good" fairy...fairies love the color black and hate the colors yellow, white, other happy colors. They try to steal DDs yellow and make her sad so she feels bad and gives them all of her good feelings. But...they are secretly afraid of DD and they don't want DD to know that she's actually stronger than they are. That if she tells them to leave, they have to listen (it's a cosmic law). No one else has power over the fairies except her. So she has to stand up to her fears and fairies and then they have to go away. They can't break the law. They have to listen to her. Some days, this works well and other days it's still a work in process. But the more you do it, the better the kids get at it. They start to learn it's all in their mind and they have control over their thoughts.

 

The Shot fairy is particularly tough, because there's real pain involved. But I have DD give me a magic hug and bury her face in my shirt and I sing her a song to distract her. It's sung to the tune of Jingle Bells - "I'm so brave, I'm so brave, I'm so very brave. The Shot Fairly has a big butt and I'm going to make her lee-eve!" It's not perfect, There's still fear. But it got us thru 18 months of needles.

 

For my DD, I absolutely had to tell her in advance. If I didn't give her time to use her tools and prepare, it was way way worse. Total flight mode. No reasoning with her. And then the trauma on everyone having to restrain her - not to mention how distrustful it would've made DD over time. Using CBT makes her feel empowered and reinforces that she's the boss of her feelings. We try to give her a few minutes to get herself pulled together. Not every time is pleasant. But generally, the more she feels like a participant instead of a victim.

 

I highly recommend the books for some ideas.

 

Oh - and then yes, we did celebrate with ice cream, a new Polly Pocket, being able to stay up late, plus a big sign taped to her door - a certificate of bravery that has hung there for over a year!

Edited March 28, 2012 by LLM

[cdklyn]

My DD is very fearful of needles - totally psychs herself out with panic. When she had to have an endoscope, we numbed her arm with Emla cream and gave her a dose of Versed (like valium). Even in a daze, she freaked when they put the IV needle into her arm.

 

But she also managed to do 18 months of weekly allergy shots because her allergies were so debilitating - and she needs blood draws every 4 months to monitor her liver function and various health issues. So we use a lot of CBT (cognitive behavior therapy). We used the book "What to Do When Your Brain Gets Stuck" and "What to Do When You Worry Too Much" as guides.

 

We named her anxiety and called it a fairy. The fairy is a bad thought that wants all of her attention and energy. So we have the Worry Fairy, the Sad for No Reason fairy, the "I'm no Good" fairy...fairies love the color black and hate the colors yellow, white, other happy colors. They try to steal DDs yellow and make her sad so she feels bad and gives them all of her good feelings. But...they are secretly afraid of DD and they don't want DD to know that she's actually stronger than they are. That if she tells them to leave, they have to listen (it's a cosmic law). No one else has power over the fairies except her. So she has to stand up to her fears and fairies and then they have to go away. They can't break the law. They have to listen to her. Some days, this works well and other days it's still a work in process. But the more you do it, the better the kids get at it. They start to learn it's all in their mind and they have control over their thoughts.

 

The Shot fairy is particularly tough, because there's real pain involved. But I have DD give me a magic hug and bury her face in my shirt and I sing her a song to distract her. It's sung to the tune of Jingle Bells - "I'm so brave, I'm so brave, I'm so very brave. The Shot Fairly has a big butt and I'm going to make her lee-eve!" It's not perfect, There's still fear. But it got us thru 18 months of needles.

 

For my DD, I absolutely had to tell her in advance. If I didn't give her time to use her tools and prepare, it was way way worse. Total flight mode. No reasoning with her. And then the trauma on everyone having to restrain her - not to mention how distrustful it would've made DD over time. Using CBT makes her feel empowered and reinforces that she's the boss of her feelings. We try to give her a few minutes to get herself pulled together. Not every time is pleasant. But generally, the more she feels like a participant instead of a victim.

 

I highly recommend the books for some ideas.

 

Oh - and then yes, we did celebrate with ice cream, a new Polly Pocket, being able to stay up late, plus a big sign taped to her door - a certificate of bravery that has hung there for over a year!

 

 

Love this story...made me tear up:) Thank you so much for sharing, great ideas. I'm looking into the books now.

[trggirl]

EMLA cream and a huge treat immediately afterward. My daughter has gone from being terrified and screaming at the first few blood draws to actually asking when we can get her blood done again. She doesn't feel the stick at all with the cream so it was just a matter of getting her past the anxiety and realizing she would not hurt and she had a fun treat following the draw.

[mdmom]

EMLA cream and REWARDS. I actually used to think it was bribing and not good parenting until I worked with a behavioral psychologist who suggested it.

 

Have her choose something ahead of time that she really wants and assign a point value to it. Give her points for each part of the process that she has success with. I usually make the points look like money and print them from the computer, but I've also used multiples of something small (pennies, Legos, beads, marbles, stickers). If you use multiples of something, have her hold a cup and fill it with her "points." Things to reward her for:

 

Getting in the car calmly to go to the appt.

Getting out of the car at the dr.'s office

Walking into the office

Staying calm in the waiting area

Walking back to the waiting area

Sitting on the exam table

 

You get the idea?

 

Give her more points for the harder things and less points for the easier thing. Immediately cash in the points for her reward (you can even purchase the reward ahead of time so that she can "buy" it with her points).

 

My son is now 14 and doesn't even require a reward for getting stuck. I won't lie to you...this is a process...but it will get easier.

 

Hope this helps.

[LNN]

mdmom- I really like this idea! I think I'll combine it - give points for every step of fairy fighting. Probably looking at a blood draw next week. Thanks for the new ideas to add to the tool kit.

[momcap]

EMLA cream and a huge treat immediately afterward. My daughter has gone from being terrified and screaming at the first few blood draws to actually asking when we can get her blood done again. She doesn't feel the stick at all with the cream so it was just a matter of getting her past the anxiety and realizing she would not hurt and she had a fun treat following the draw.

 

Ditto. EMLA cream was magic for us! And the treat got us the rest of the way there. DS used to go into full-out fight or flight. Now he asks when he can get bloodwork because he wants a treat. I tried some big bribes, but later found that a $1.50 candy works best. I never used to let the kids get those sugary, food colouring filled nasty candies at the checkouts. Then one day I knew we had bloodwork coming and I agreed he could pick one, bring it to his appointment, and open it as soon as it was done. That was the turning point. And it's the ONLY time they get that stuff, so it makes it pretty exciting for them.

 

EMLA works great for 2 of my kids. The third one has very fair skin, white blond hair, and the deep veins that go along with that colouring. It doesn't work very well for him, and he still has a hard time. But if they don't have deep veins the EMLA is fantastic!