Wednesday, September 15, 2010

Surviving Blood & Needles

I bet I’m not the only one to see their child lose it when trying to get blood drawn. To say that our son hates getting shots is an understatement. The last time he was told, “we need to draw blood”, our son went into a rage that put bruises all over my husband’s arms.

Unfortunately, blood work is a necessary part of treating mental illness. So getting creative and using all the resources you have is essential. Today, we needed to draw blood to prepare for the MRI, as well as monitor the effects of his current medication. In preparation for this lab work, we worked with his psychiatrist and came up with a plan to use 2 new medications to improve his experience.

I have to admit, after our positive experience today, I’m disappointed that we didn’t know about these medications before. I seriously had no idea that we could numb his skin with a cream and with a single pill we could calm his anxiety. It dumbfounds me that these incredible tools have been at our fingertips, yet we didn’t even know they existed.

So for all you parents who dread hearing the words, “We need to do some lab work”, here are some amazing tools you can ask your psychiatrist about, along with a few creative ideas of my own.

First, to help ease our son’s anxieties, our psychiatrist prescribed Ativan (Lorazepam) to be taken an hour before the lab work is done. This helps to relax him and calm down the anxiety that usually brings on the rage. Today was our first time using it. Our doctor described it as having the effect of “being drunk on tequila, it should make him feel really good and relaxed”. There’s a rare chance that your child may respond with more anger, “like an angry drunk”, as she described it, so it’s recommended to do a trial run prior to the lab work to make sure it’s safe.

I was pleased to see that he responded perfectly to the dose we gave him. He appeared calm and peaceful without looking overly tired or acting drunk. Thank goodness!

Next, we applied a topical cream prescribed by our psychiatrist called EMLA (Lidocaine-Prilocaine). It’s like novocaine for the skin. It numbs the area so he doesn’t feel the needle stick him. To apply it, we put a pile of it on his inner arm, then wrapped this area in saran wrap to keep it in place. It takes about 30 minutes to have the full effect.

Once we got into the waiting room, I remembered a new app that I downloaded on my iPhone called Binaural Beats (It’s free!). It has a selection of sounds to influence your brain to concentrate or relax. So I immediately put headphones on him while he waited. He liked it so much that he listened to it through the whole procedure.

Finally, once he was in the chair, I took his opposite hand and gave him a hand massage while I lead him through deep breathing. I wasn’t sure if this helped him, but afterwards, he mentioned that the hand massaged helped him focus on something that felt good, taking his mind off the needle in the other arm.

I have to say, I was totally impressed on how well he did. Not once did he try to run or cry, I think I even saw a small smile when I complimented him on how well he was doing.

I can’t say what one thing worked the best, but I know the medication helped keep him calm. He mentioned in the morning that he wasn’t as scared as last time since he knew he could take medication to help. As for everything else, it was icing on the cake.

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If you’ve discovered your own tips for surviving shots with an anxious child, please share, I can always use a few extra tricks in my bag!

5 comments:

  1. I don't know that this will help you, other than knowing others share your struggles, but we have an agreement with my son that we will not tell him when his blood work is scheduled until the last minute. That way he doesn't have to have the anticipatory anxiety about it. When he was younger my husband had to restrain him, but he is 11 now, and it is mostly just tears (which is heartbreaking too). I wish we had the Ativan option when he was younger, it would have saved much struggle and heart ache.

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  2. The sprinkles are good because he refuses to swallow a pill, but is very, very picky about what he will have the sprinkles on (non-refrigerated chocolate pudding only). The are crunchy and there's no way to hide the crunch. He actually doesn't have an issue with needles so maybe his meds could come in a syringe and I could just poke him with it and be done. Hmmmm....sounds good to me!

    I'm glad there are some interventions for you to take to make it easier on him (and you) for the blood work.

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  3. I agree with the previous commenter who said the less advance warning, the better. We also use the topical cream for my daughter, which has helped. But I think what's helped even more is that after we get her blood drawn, I treat her to breakfast at Denny's, her favorite restaurant. So now that she equates getting her blood drawn with getting her special breakfast, she's much calmer about it.

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  4. That is pretty much what we did, too. The EMLA cream did not ease my child's fear, though, because the pain was not part of the fear. It was the needle being inside her vein, which she did not realize was the source of her fear, at the time. She realized that part later. She wasn't afraid of shots, but she was afraid of IVs, and couldn't stand seeing them given - even on TV - which is when it clicked in her head what made her so afraid of the blood draws.

    The Ativan, though - ah yes - that helped a lot.

    I do want to say that she did eventually get over this! Good thing! The poor kid got so many blood draws that by the time she finished high school she had track marks on the one vein all the phlebotomists preferred.

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  5. Thanks Jeanie for sharing, it’s good to know it gets easier as they get older.

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