Oh boy. How do I help my dd with this one?

[ravinlunachick]

DD (8) had strep infections a few months ago. Two within a month. Both times, the swab for the rapid test was EXTREMELY traumatic to her. She has a very sensitive gag reflex. Simply brushing her tongue with a toothbrush will trigger gagging, and you can forget about her swallowing any kind of a pill. :glare:

 

Anyway, she fought and screamed, and had to be pinned down (!) for those strep tests. She weighs 70lbs. This is no small feat. I was so embarrassed I nearly cried the first time. No amount of reasoning or bribing worked to calm her down at all. DH went back with her the second time, and *he* was barely able to restrain her enough for the tests! Please, no flames for that. Our ped refused to write a script without a positive test, so it was necessary.

 

Fast forward to this week. She's had a cough that's gotten worse. We're getting ready to go on vacation in a few days, so she needed to be checked out before we left. This time we were at a different office, totally different doctor and everything. It didn't matter.

 

She started crying and whining before the doctor even came back! He was very understanding, even fetched her a cup of water to try to calm her down. He promised that he would NOT do a strep test, or hurt her in any way. He explained that he has 7 kids, and would never do anything scary to any child. Unfortunately, that did not help. She refused to even let him look in her ears. He got so frustrated that he finally said, "I can't examine her. She's too big to pin down. Either she'll cooperate or she won't."

 

He went and fetched the other doc (a woman). DD continued to cry and shake in the meantime. Thankfully, this doctor came in and distracted dd with jokes and small talk, and was able to examine her. Not strep, btw. "Just" pneumonia. :(

 

But what are we to do next time? What if she gets strep again? If neither carefully explaining what will happen beforehand, assuring her of her safety, NOR outright bribery will work, what am I supposed to do?!?!

 

Give her a Valium before any doctor's visit? j/k

[ktgrok]

First, I don't think the valium is a joke. I'd give her something to calm her if she is that freaked out.

 

Second, I'd start taking her to the doctor's office once a week just to walk in, get weighed, say hi to everyone, and leave. Call the office and talk to them about this idea. the goal is to desensitize her. Right now classical conditioning has her in fight or flight response when she is in that office. Work on getting her comfortable at the office, then with the doctor saying hi, etc.

 

And in the meantime, yes, if need be, ask for a script to help her relax.

[starwarsmomma]

I've been there.

 

My son has CF. When he was baby/toddler/young child, he did not understand the needed --sometimes painful-- treatments. For him it was DO the treatments or not breathing.

 

I remember many, many times of holding him down forcefully against his will, him screaming and fighting, and begging me nonstop to stop. I would sing, pray, cry with him... nothing would work.

(and afterwards, when he would peacefully go to sleep, I'd spend hours crying over it. It was HORRIBLE and broke my heart every single second!!!)

 

I could not just stop doing the treatments, it would mean his death. So I had to be the horrible, mean mom (and dad too) and do what was necessary. I had no choice but to be tough.

 

I remember begging the doctors for alternate treatments or advice on how to avoid it, but it's just something we had to get through.

 

Fact is, there are times when a kid has to get shots, or a cast on their leg, or medical treatments or bloodwork... It's part of life sometimes.

 

I did offer bribes out of desperation-- special trips for donuts (his favorite), movies, tv shows, video games, staying up late, ANYTHING!!!.. frankly none of them worked enough to avoid the drama and fighting.

 

Bottom line: I got to the point that I don't care if they cry. Or fight. Or argue. If it's TRULY a needed exam, test or treatment, it WILL get done. I'm not going to risk my child's health because they dont want something.

 

But I sometimes HATE being so mean.

[Slartibartfast]

I would tell my kid exactly what they would do and exactly what would happen if they couldn't treat it and the strep got out of control. I would also explain that if they did not comply then they would be held down and it would be done to them whether they liked it or not so they may as well comply. If that didn't work I would hold her down.

 

Dd was about that age and needed stitches, I explained everything to her and she sat there and let them do it. Extra nurses even showed up to hold her down and they weren't necessary.

[amo_mea_filiis.]

I have to pin my 100+ pound 11 year old for blood work.

 

Even though he's ok with it, ds still has me hold his head when his ears are checked, and if they have to look up his nose, his hand has to be on theirs.

 

I agree with frequent visits.

[JennyD]

Oh, hugs to you. I was exactly like your daughter when I was a child. (Sorry, Mom!!!) I have a wildly overdeveloped gag reflex and could not cope with either tongue depressors or dentist visits, but strep tests were the *worst*. My gentle, extremely competent childhood pediatrician had recently immigrated from India and I could barely understand a word he said, but he would say "strep test" and I would just lose it.

 

I honestly don't think there's much you can do other than what you've been doing. My very no-nonsense mother was sympathetic but she was certainly not going to let my carrying on get in the way of my health. "I know it's difficult for you, Jenny, but untreated strep can damage your heart and there is just no way around it. Try breathing through your nose." I don't actually remember being restrained but I am positive she must have had to at least hold me.

 

My father, who also had a very sensitive gag reflex as a child, would not-quite-as-helpfully regale me with stories of how he would throw up at the orthodontist's office and clog the little sinks, thereby requiring them to close the office for the afternoon.

 

FWIW, I am 40yo and *finally* learned to swallow pills a few years ago. The trick for me is eating a bit of food first. I still can't hack dental x-rays, though, to my hygienist's perennial chagrin.

Edited June 26, 2012 by JennyD

[ravinlunachick]

If they would let us come without paying a copay, I would be willing to do that. I'll ask.

 

Sis, we explained several times why the swabs were necessary ; it simply did not matter to dd. I was really surprised at how scared she was today, even AFTER the doctor promised that he would not do a strep test or hurt her. That's what really drove home for me that she has some serious anxiety about the doctor now. :(

 

I can't imagine that they would write a script for anti anxiety meds for a kid without a diagnosed anxiety disorder, but I could be wrong.

[Chris in VA]

I've been there.

 

My son has CF. When he was baby/toddler/young child, he did not understand the needed --sometimes painful-- treatments. For him it was DO the treatments or not breathing.

 

I remember many, many times of holding him down forcefully against his will, him screaming and fighting, and begging me nonstop to stop. I would sing, pray, cry with him... nothing would work.

(and afterwards, when he would peacefully go to sleep, I'd spend hours crying over it. It was HORRIBLE and broke my heart every single second!!!)

 

I could not just stop doing the treatments, it would mean his death. So I had to be the horrible, mean mom (and dad too) and do what was necessary. I had no choice but to be tough.

 

I remember begging the doctors for alternate treatments or advice on how to avoid it, but it's just something we had to get through.

 

Fact is, there are times when a kid has to get shots, or a cast on their leg, or medical treatments or bloodwork... It's part of life sometimes.

 

I did offer bribes out of desperation-- special trips for donuts (his favorite), movies, tv shows, video games, staying up late, ANYTHING!!!.. frankly none of them worked enough to avoid the drama and fighting.

 

Bottom line: I got to the point that I don't care if they cry. Or fight. Or argue. If it's TRULY a needed exam, test or treatment, it WILL get done. I'm not going to risk my child's health because they dont want something.

 

But I sometimes HATE being so mean.

 

:grouphug::grouphug: My brother has CF--I know it's so hard.

Wanted to say my son needed therapy to stretch his heel cords so he could be casted and then walk (he was nearly 2 and not walking yet). I had dh do the home therapy bc I was too weak to bear the struggle. You are an amazing and loving mom.

[Night Elf]

Well for one thing, I think you should stick to the same doctor who will remember your dd and her issues.

 

Another idea is to talk with her now, while she's at home and not in the doctor's office. Talk to her about her fears. Tell her that medical procedures absolutely must be done or severe consequences can develop. I know that strep throat can lead to health problems that are even worse than the strep throat. Ask her if there is anything you can do to help her through this. Offer to take her for a favorite food treat immediately after the appointment. Take a picture of it with you and hold it up where she can see it to remind her where you are going next. Let her take her favorite stuffed animal, if she has one, that she can hug tightly. But that all has to be set in place before you go to the doctor, not when you get there and fear has already grabbed a hold too tightly.

 

FWIW, my dd20 still gets extremely nervous about having a strep test done. She feels like her throat closes up and when she opens her mouth she can't breathe. She would cry at the doctor's office and shake her head no, and she was a teenager! She finally reached a point a few years ago that she would sometimes have to do this and if she doesn't fight it, it will go faster. So, I have to hold both of her hands and she squeezes the blood right out of them. It's like a woman in labor gripping your hand. It's insane, but at least she manages to sit still and keep her mouth open. And yes, I buy her a milkshake afterwards. :)

[ravinlunachick]

Oh, hugs to you. I was exactly like your daughter when I was a child. (Sorry, Mom!!!) I have a wildly overdeveloped gag reflex and could not cope with either tongue depressors or dentist visits, but strep tests were the *worst*. My gentle, extremely competent childhood pediatrician had recently immigrated from India and I could barely understand a word he said, but he would say "strep test" and I would just lose it.

 

I honestly don't think there's much you can do other than what you've been doing. My very no-nonsense mother was sympathetic but she was certainly not going to let my carrying on get in the way of my health. "I know it's difficult for you, Jenny, but untreated strep can damage your heart and there is just no way around it. Try breathing through your nose." I don't actually remember being held down but I am positive she must have had to. (My father, who also had a very sensitive gag reflex as a child, would not-quite-as-helpfully regale me with stories of how he would throw up at the orthodontist's office and clog the little sinks, thereby requiring them to close the office for the afternoon.)

 

FWIW, I am 40yo and *finally* learned to swallow pills a few years ago. The trick for me is eating a bit of food first. I still can't hack dental x-rays, though, to my hygienist's perennial chagrin.

 

Wow, you do sound like dd! She started to cry when she saw the jar of tongue depressors. Somehow, she made it through dental xrays, but that may be because she LOVES her dentist. He is really good with kids. Also, that was before the infamous strep tests.

[justLisa]

Even with a horrible gag reflex, have you explained to her that if she opens wide enough and says Aaaahhh the part they swab won't make her gag? They don't swab your tongue. You could try a mirror and a flash light and show her on yourself?

[DianeW88]

Do not ever be embarrassed in the peds office. Trust me, whatever your kid is currently doing...we have seen worse. :lol:

 

And honestly, if it is a test or procedure that is crucial, they are capable of restraining your child. We do know how to do it in a way that won't hurt your kiddo. It doesn't always look like it, but trust me...they will be safe and the procedure will get done.

 

If your child is absolutely hysterical, vomiting, biting, clawing, etc. (and yes, I've been there), she can be sedated in the office or sent to the hospital for any necessary labs and tests. Their restraining capabilities are a little more...rigorous, but if it is a situation where it has to be done, it will get done.

 

For a standard exam that isn't essential...many docs will tell you they can't examine your child if she's wildly out of control. It can be dangerous to the staff...and we don't like being bitten or scratched. :D

 

Honestly, I'd recommend sedation. It's quick and she'll get through any necessary tests without remembering them.

[Tap]

DD5 has had to have blood work done a few times and she is the same way. She gets the blood work done every 6mths and it isn't going to end anytime soon. A 5yo, 70lb powerhouse of muscle.

 

What we do now, is NO messing around with it. We tell dd what is going to happen and then we just do it. The nurses know that they will get nowhere with cajoling, teasing, etc. We do not go in the room until they are ready for us. Vials are ready, needles are ready, nurses are ready to restrain her. For blood work we do it at her best time of day and we call ahead and arrange a time slot for the 'best' nurse to draw her blood. We walk in, she is restrained (we talk her through it, but we don't back down and don't let her stall), blood is drawn and we leave. It only takes a couple of minutes and it is over. We do NOT do a sneak attack as I don't want her to be afraid of every appointment but we do not tell her before we get to the hospital. She will get herself worked up in the car and that just makes it worse.

 

We have used Valium in the past. A full adult dose....didn't affect her a bit....but in your case, I would not hesitate to try it.

 

In your daughters case, I would likely do the same. Do not try to talk her into it, you already know it isn't going to work...just do the deed and move on. If it takes 4 nurses....use four! (It took 3 nurses, me And a big male paramedic to hold down ds17 for stitches in his forehead at 4yo.)

 

For something like your sitution, I would give all the verbal information over the phone to the nurse so that when you get there, it is just a swab or a poke by the doctor, and you are done.

Edited June 26, 2012 by Tap, tap, tap

[Slipper]

If they would let us come without paying a copay, I would be willing to do that. I'll ask.

 

Sis, we explained several times why the swabs were necessary ; it simply did not matter to dd. I was really surprised at how scared she was today, even AFTER the doctor promised that he would not do a strep test or hurt her. That's what really drove home for me that she has some serious anxiety about the doctor now. :(

 

I can't imagine that they would write a script for anti anxiety meds for a kid without a diagnosed anxiety disorder, but I could be wrong.

 

I know that you can get a nurse's visit without a co-pay. I'm sure they would work something out for you.

 

Also, I have a few friends who receive a prescription of anti-anxiety medication before dentist visits. This is somewhat similar. It's worth asking about. Also, while your child may not have a typical anxiety disorder, I'd bet money that she has a phobia (which qualifies as anxiety). If your insurance would cover it, see if a psychiatrist could help with relaxation techniques, suggestions and possibly medication.

 

I'm also in the "explain" category for my kids. I explain it all and they know that they can do it the easy way or the hard way, but it will get done. They also know that if they act out and the test can't be done, we will come back repeatedly until it is done. With my oldest, we had to show her everything and she was as compliant as it's possible for her to be. My youngest grits her teeth and trembles. My middle is a screamer. I try to be sympathetic but a bit hard at the same time. She is a bit scared, but most of her screaming is for show. She's getting better.

 

I hope you find something that works for your little one. :)

[NorthwestMom]

 

Second, I'd start taking her to the doctor's office once a week just to walk in, get weighed, say hi to everyone, and leave. Call the office and talk to them about this idea. the goal is to desensitize her. Right now classical conditioning has her in fight or flight response when she is in that office. Work on getting her comfortable at the office, then with the doctor saying hi, etc.

 

 

I think this is EXCELLENT advice, and if the doctor won't go for it without charging I would look for another office. I suspect it won't take very many well child/de-phobia visits before she stays calmer when she needs to go to the office. I'm sorry for both of you having to go through it.

 

My 13yo DS passes out when he has to give blood samples. DH now has to take him if he needs to give any as he is too big for me to manage. :(

[ravinlunachick]

Night Elf, that's a good idea to bring a stuffed animal! Why didn't we think of that?

 

Joyfulheart, big (((hugs))) to you and your ds. It's so unfair what some kids have to endure just to breathe.

[Slipper]

My ds has the same reaction to strep tests. He's had too many of them, for his liking! It's never been truly easy, but it's less difficult when we've talked about it at home, letting him know he just has to get through it, and when the dr. has let ME do the swab.

 

That's another thought. While I've never asked to do a swab, doctor have allowed me to be part of the process in different medical procedures, especially with my oldest daughter. I have a rapport with her and if it makes it easier, they have allowed me to do more than most parents (for which I am grateful).

 

If so, you could practice with a q-tip doing a swab on her lip, then inside her lip, then on her tongue, etc. Find out exactly what you need to do and then practice at home.

[Mommyof4ks]

I would tell my kid exactly what they would do and exactly what would happen if they couldn't treat it and the strep got out of control. I would also explain that if they did not comply then they would be held down and it would be done to them whether they liked it or not so they may as well comply. If that didn't work I would hold her down.

 

Dd was about that age and needed stitches, I explained everything to her and she sat there and let them do it. Extra nurses even showed up to hold her down and they weren't necessary.

 

:iagree: My son had to get some traumatic things done just so he would live, so we had no choice. Even at 2 and 3 he understood that he had to comply or be held down. He did not like being held down, so he just gave in. He did not understand what death meant, but he knew that if he did not get treatments that something really bad would happen to him. Your dd is old enough to understand that being hospitalized with out of control strep is much worse than a strep test. It is not using scare tactics, it is sharing the truth of what could happen if illnesses are left unchecked. Good luck, that is a hard age to reason with girls sometimes.