Help! 2 year old with broken wrist terrified of doctor

[SweetIrony]

Hi all, I normally just lurk here but I have a bit of a problem and I thought maybe you'd have some ideas for me. The short version is, my 2 year old has become terrified of doctors/doctors' offices, but she has to get a cast sawn off her arm in less than 3 weeks. Here are the details:

 

She's been going to the doctor frequently her whole life (she has cystic fibrosis) and she always used to be fine. At her last clinic appointment she freaked out when they went to do the throat swab, and after they did it she gagged and threw up. When the nurse came back in and put gloves on to help clean up, DD started screaming again just at the sight of her. Then we managed to reinforce this traumatic experience with a trip to the ped for shots a little while later.

 

A few weeks ago DD fell off a slide and broke her wrist. We took her to urgent care, where she was ok until they tried to take her temperature in her ear, then she flipped. The next day we took her for xrays, and she was terrified of the xray machine and wouldn't hold still, she kept screaming and writhing off my lap and running for the door. We waited until nap time, got her to sleep, and brought her back in. So we got the xrays done and found out it was broken. The next day we got an appt with the orthopedist, and I made it at naptime again. She was asleep when they put the cast on. She loves the cast and has been fine about having it on.

 

We went back Friday for a 3 week check, and I tried to prepare her by telling her we were going back to the cast doctor, we were going to take pictures of her arm, etc. She seemed fine and even excited, but when we went in and she saw the xray machine she started screaming again. I tried reasoning with her and bribing her, but to no avail. The doctor said that appt wasn't so crucial, so we cancelled it and we'll be back 3 weeks later to get xrays and take the cast off.

 

But if she won't hold still, how will they get the cast off? Will we have to just wrestle her down and hold her arm still? We probably can't hold her arm still enough to take xrays, right? Not to mention, before that appt we are going back to her cystic fibrosis clinic, and they'll need another throat swab culture. She's going to be having those every 3 months until she's old enough to cough out a sputum sample.

 

Is there anything I can do to help her not be afraid? Should I keep trying to go during naptime and hope she sleeps through it? My mom thinks the dr should give her something so she'll sleep, but he didn't know what he could prescribe to so young a kid.

 

I just don't know what to do. Someone please tell me this is just a phase and she'll get over it!

Edited February 9, 2012 by SweetIrony
Update

[In The Great White North]

Remember Pavlov? Go the the dr every day and give her a treat. Then go every other day. Slowly wean her off the treats, but still occasionally go for ice cream afterwards.

 

It helps if the dr cooperates, so call them ahead and discuss it.

Edited February 7, 2012 by In The Great White North

[SweetMissMagnolia]

my son is 9 and he's freaked out by the tongue depressor thing...They had to do a strep throat culture test and he didn't open his mouth wide enough so they had to do it that way--now he opens his mouth really BIG but still freaks if he sees that coming toward him....

[itsheresomewhere]

One of DS's docs had him come in weekly and then monthly to just walk around and meet the staff. At the end of the tour each time, he got a small treat. It helped so much.

[sassenach]

I would ask for a child life specialist, if there is one available. For a typical kid, I wouldn't be so concerned, but doctors are and ever will be a big part of her life. I would even seek out play therapy for her.

[TrulySusan]

So sorry your DD has so much going on...no wonder she's scared of doctors. DH works in Peds orthopedics and said they often suggest that if you have any Lortab or other Rx left from when she broke her arm, you could give a dose before her appt. to make her drowsy. Otherwise, they usually just hold on to the child firmly and get the cast removed as quickly as possible. The child usually calms down quickly once they realize it didn't hurt. The noise is the worst part. Hope that helps. Hugs to you and your DD.

[Slipper]

I agree with all of the above - see if they will let her come in and just walk around a bit.

 

Also, if there are certain things that she is afraid of, see if you can practice at home. My oldest doesn't do well at the dentist and they gave me plastic versions of almost all the tools needed to clean her teeth and we 'play dentist' a few weeks before the visit. Maybe build a play x-ray machine out of a box and take turns or with dolls?

 

If not, tell the doctor it's simply a thing with her and ask if they will prescribe a one-time sedative. Or see if something that will make her sleepy, like benadryl, will help. I realize it sounds dramatic, but we have been in really crazy situations before and have had some super kind office personnel help us. Call ahead and let them know the situation. (In some cases, we've had pediatrician offices keep a room waiting just for my daughter so we could avoid the waiting room.)

 

Good luck

[gingersmom]

My son has a broken wrist. It takes about 1 minute for them to remove the cast. The saw type device is very loud but fast. Then they just pull the cast apart and its off.

[waa510]

Remember Pavlov? Go the the dr every day and give her a treat. Then go every other day. Slowly wean her off the treats, but still occasionally go for ice cream afterwards.

 

It helps if the dr cooperates, so call them ahead and discuss it.

 

:iagree: I'd also consider using the naptime strategy as well.

[Slipper]

So sorry your DD has so much going on...no wonder she's scared of doctors. DH works in Peds orthopedics and said they often suggest that if you have any Lortab or other Rx left from when she broke her arm, you could give a dose before her appt. to make her drowsy. Otherwise, they usually just hold on to the child firmly and get the cast removed as quickly as possible. The child usually calms down quickly once they realize it didn't hurt. The noise is the worst part. Hope that helps. Hugs to you and your DD.

 

If the noise is the worst part, maybe some music on an ipod?

[3peasinapod]

Remember Pavlov? Go the the dr every day and give her a treat. Then go every other day. Slowly wean her off the treats, but still occasionally go for ice cream afterwards.

 

It helps if the dr cooperates, so call them ahead and discuss it.

 

Great idea. Are there other doctor's appointments that don't need procedures? Appointments for other children that you can take along the 2yo where she doesn't get things done with her? Stickers? I know stickers sounds silly, but it may work. Is there something she really loves, like a blanket, stuffed animal, etc. that she can bring with her? Maybe you can play a game where the nurse/doctor does some procedures on the bear? Anything would be better than to devastate the little one.

 

We had to frequent the doctor when our oldest was 3, as she had problems with one of her kidneys. I was devastated with the screaming she underwent with the multitude of invasive tests they had to do. :confused:

[jennsmile]

Can you take the cast off at home? I know in the old days my MIL would soak off the cast at home and then take in DH for his new cast for his club foot. It was a weekly thing.

[SebastianCat]

You could very well be describing my DD to a tee, except for having a chronic illness and needing chronic care. But when she was 3, she ended up in the hospital for 8 days with pneumonia, and it traumatized her terribly. She was terrified of doctors and anything medical for several years - she's finally gotten over it in the last year or two. She's 7.5 now.

 

So, first off, I will say that I think this is a NORMAL fear for a child her age and for the experiences she is having to go through. And she will outgrow it eventually. But that doesn't make it any easier to go through.

 

The other suggestion I had is to ask your doctor if he can give her something like Versed, which is a mild sedative and amnesiac - it will calm her down and make her not remember the event. I would call the doctor's office who will be taking the cast off, explain her reactions to date, and ask if this is an option.

 

When my DD was hospitalized, she got to the point where she would scream from fear when someone from housekeeping came into the room to empty the garbage. She was in ICU for 3 of those 8 days, which involved contant poking, prodding, and x-rays......it was horrible. Finally, one doctor suggested giving her Versed before a CT scan, and the difference was like night and day. The child who previously screamed in terror was looking around, talking about the big machine, totally calm. If she hadn't had the Versed, there's no way she could have been still enough to get a decent view on the CT.

 

In the long term, I highly suggest getting her a "play" doctor kit and play doctor's office every day. Every.single.day for the next year or two. Let her be the "doctor" and she can ask you for the same sample, listen to your lungs, etc., just like her doctor will do to her. And give her a reward every time she goes to the doctor. She will eventually outgrow the fear, and acting out the "right" response will help her know what to do for the routine visits.

 

But for the really intense moments, I'd ask upfront for medication to help her get through it.

[AK_Mom4]

Hi There! And :grouphug: !

 

I would say you have an intelligent 2yo there! My youngest DD developed a healthy hatred of medical folks about age 3 (she has kidney troubles) when she realized that NO ONE in scrubs was to be trusted! They always ended up doing yucky stuff, regardless of what Mom and Dad said.

 

What helped? Lollipops (given BEFORE the test/exam), an mp3 player with music or a story and kid-size headphones, my cell phone, a DS with a couple of easy games, a new toy from the dollar store (again, given right BEFORE the test).

 

We could never use sedatives because of her kidney issues, but there were certainly times when I wished we could! You could ask her doc.

[scrapbookbuzz]

Honestly, by the time your dd has had the cast on for three weeks, as long as it isn't a full arm cast, chances are you'll be able to just pull it off her arm. Seriously. When my son was 18 months old he broke his wrist. Had a cast on. Two weeks later, w/o thinking about what I was doing, I grabbed his casted arm to make him walk the way I was going but he went the other way. And off slid the cast! So don't worry about it too much; I'm sure it will all work out fine.

[Jennifer3141]

My favorite 2 year old and doctor story:

 

When DD was 2, she stuck a tiny bead in her ear to see if it would come out the other side or out her "privacy" (I kid you not. I have weird kids! :) )

 

So I try to get it out and can't.

 

I take DD to the ER. I explain that the doctor will use a little tool and get the bead out. She immediately starts screaming to the doctor, "You're not a good doctor!! You do not have my permission to touch my body! Get the <insert mild bleep here> out of my room right now!" And she was LOUD. And clear. You could hear her in the hall and several rooms away. Patients were peeking out of their rooms and nurses came running...

 

The doctor was her FATHER. A very mortified father... He finally had to leave the room and let a partner handle DD. And he was shook up. (I helped matters greatly by snickering frequently but hey, it tickled me to see him deal with the insanity of 2.)

 

I had to step out of the room because I was laughing so hard.

 

So part of this is just being 2. And part of it is the trauma your poor DD has gone through in her short little life. At some point in time, she will outgrow some of it. We found out much later that DD had listened into a lot more phone conversations between DH and the hospital than we realized and she was convinced something very bad was going to happen to her. She didn't quite know what death was but she knew she didn't want any part of it.

 

If I were you, I would try to make doctor trips as much fun as possible afterwards and I might even talk to your DD's primary doctor about ways they can make the visits more "fun" since she is going to need more frequent visits than the average child. I'm sure your DD won't be the first child to have to endure fear or hatred of going to the doctor.

 

I know there are some cute kids books about doctors visits too. And maybe a favorite doll or stuffed animal could get examined at the same time?

 

:grouphug::grouphug::grouphug: to you, Mama. 2 is hard enough without dealing with a chronic illness.

[higginszoo]

 

I take DD to the ER. I explain that the doctor will use a little tool and get the bead out. She immediately starts screaming to the doctor, "You're not a good doctor!! You do not have my permission to touch my body! Get the <insert mild bleep here> out of my room right now!" And she was LOUD. And clear. You could hear her in the hall and several rooms away. Patients were peeking out of their rooms and nurses came running...

 

The doctor was her FATHER. A very mortified father... He finally had to leave the room and let a partner handle DD. And he was shook up. (I helped matters greatly by snickering frequently but hey, it tickled me to see him deal with the insanity of 2.)

 

Oh my, now THAT is funny. I would have lost it laughing, too!

 

To the OP, I second the consult with a Child Life specialist. This is a pretty common phase, especially for dc who have a lot of exposure to medical procedures. You probably wouldn't even need an appointment if you just call your Children's Hospital and ask for them, they deal with this all the time.

Child Life specialists are a great resource. Your naptime tactic is great, and I'd continue to use that one as much as you can in the meantime. This will likely pass. As a former high medical needs child, with high medical needs sibs and children, I think we all went through this at some point.

 

At my kids' last hematology appointment, we had a great 'outgrown that phase' moment. Their routine checks involve fairly sizable blood draws, so they were prepared with 2 RNs and the child life lady. She brought all sorts of things to distract them, but they had a great time watching the blood draw with fascination (even when one nurse spilled blood all over the pillow on dd6's draw). Poor CL lady felt a bit superfluous, I think. But my dc were nearly 7 and 11 then. Back when they were 2, though, even simpler procedures were an entirely different matter.

[swellmomma]

The cast clinic that has dealt with ds8's arm and leg casts has headphones the child can wear to eliminate the noise. I think I would bring a special toy or treat to have after the appt. Like a yogurt tube to eat after the xray or cast is off. When it comes to the cast, like with her CF stuff obviously there is no way about it, it must be addressed. Unfortunately that can be traumatic for a little one, and yet you may have to choice but to hold her down for the couple minutes the xray takes and the couple minutes the removal of the cast takes. If she can have a prize ready for being such a good sitter for the xray or for being such a big girl and not crying etc it might be easier for her, but even if you go every day, it still maybe upsetting to her. I know with ds8 he still gets worried about cast removal even though he has touched the blade while it spun to know it will not cut him etc. He still gets spooked by it so I can only imagine how scary that would be for a 2 yr old.

 

For the xray machine I take about it being a big camera (a few of my kids have needed xrays as toddlers and that explaination worked). We played with my digital camera ahead of time and they got to see the pictures taken as we did it. When it was time for the xrays I had then say 'cheese' like a photo, at the cast clinic we use they show the xrays to the parent/child so they liked to see the picture of their bones that we had taken.

 

The cast removal definitely use the head phones if they have them to drown out some of the sound.

[SweetIrony]

Thanks so much for the ideas and encouragement everyone! We tried some of these things, like bringing a stuffed animal, and offering stickers. I like the ideas of playing and practicing before the appointment, maybe that would help.

 

Honestly, by the time your dd has had the cast on for three weeks, as long as it isn't a full arm cast, chances are you'll be able to just pull it off her arm. Seriously. When my son was 18 months old he broke his wrist. Had a cast on. Two weeks later, w/o thinking about what I was doing, I grabbed his casted arm to make him walk the way I was going but he went the other way. And off slid the cast! So don't worry about it too much; I'm sure it will all work out fine.

 

You know, I was wondering if we might be able to pull it off! It looks like that might work. I think I'll call the orthopedic dr and ask him if this would be an option. I'm also going to call her CF clinic and ask what we can do about our upcoming visit.

[Jennifer3141]

You know, I was wondering if we might be able to pull it off! It looks like that might work. I think I'll call the orthopedic dr and ask him if this would be an option. I'm also going to call her CF clinic and ask what we can do about our upcoming visit.

 

I would think carefully about calling. For liability only, he's going to tell you to come in to have it removed. Now if it just so happens to accidentally sort of slip off around the time you would have had it removed anyway...

 

Remember the old expression about it being easier to apologize later than ask for permission first? :001_smile:

 

And the orthopedist is going to want to check it one more time at the end to close out her case too.

 

But if Mama thinks slipping the cast off herself would be far less traumatic, then go with your gut. :grouphug:

[jjins]

This will likely be hard for you and your daughter. I would suggest using suckers, given before the appointment. One for everyone in the room with her (in our case mama, dad, brother and DR). My daughter was able to give out suckers. She picked one for the dr which seemed to help her feel comfortable with him. We did this to remove a cast. OH... most important. Told my daughter, they are taking off the cast and YOU CAN KEEP IT! She was also two, liked her little pink cast. I believed it to stink and was able to get her to trade me for a new toy about two weeks later!

 

Biggest difference she was not afraid of the dr already.

 

As for the dr fear. I agree with the advice you have been given. Frequent visits, toys before going, playing dr, maybe a special backpack that has items ONLY for the dr office. Try to have as many good visits as possible. Be honest about the ones that will be difficult, but do not put the news out there until last minute. She does not need to dwell on them and work herself (and you) up!

 

:grouphug:

[SJ.]

Did the ortho specifically say they had to saw off the cast? DS2 has broken his arm twice and they used a cast that peels off so as not to scare the little ones with the saw. I'm sorry you have to deal with this and I hope you find a way to help your dc. :grouphug:

[ktgrok]

I'd use drugs if need be. Every time she is afraid she wires her brain to be afraid of doctors. Given her history, that sounds awful.

[SweetIrony]

Well it turns out it IS possible to pull her cast off..... when I pulled her shirt off her last night the cast came right off with it! 2.5 weeks too early. :( We have an appt today and I guess they'll probably put another one on... wish us luck!

 

------------------

 

So, she seemed fine until we got into the exam room, then she started screaming and threw herself down on the floor. I got her calmed down and took her into the xray room, where she screamed and writhed so much I thought she was going to throw up. (She didn't.) The dr said at her age after 3.5 weeks with the cast on, it's entirely possible she might be all healed, but without the xray we can't be sure. They gave us a brace that she let me put on her, and she'll wear that until her next appt in 2.5 weeks. I think we should be able to take her in asleep to do the xrays. Her CF clinic appt I'm still not sure about, but I'm going to call them and talk it over. I'm actually really glad it turned out this way, since we don't have to worry about using the saw!

Edited February 9, 2012 by SweetIrony
Update