On pain in the child with multiple medical procedures

realisticdreams

So yesterday was our first appt at the neuropsych's office.  She actually has a lady coming down from Baltimore once a week to help us that she is friends with.  She introduced herself as a doctor, and in the email I was told she is a, "pediatric health psychology fellow/resident. She has worked in peds for years and really specializes in pain, anxiety, etc of children."

We didn't do too much background info because I already had to provide them with that before they would know if they could help P, etc.  Did a small developmental screening which P passed.  The blocks they used were red/white in triangle shapes (half red/white) wow that's harder to explain than I thought.  She was having P match what she was doing and when P did it, she had to pay attention to where the lines were and make them all match.  She also lines up her dolls, shoes, etc...sooo she may be a little OCD.  I feel bad for her bc H and I are NOT organizational or clean/neat freaks.

Anywho she told me that A. P may be having legitimate pain to cathing.  She is freaking out so those muscles are tightening and it could hurt more than it should.  (we knew this but don't know how to tell for sure unless she relaxes!)

Then she asked me when P had her first procedure of ANY sort.  2 weeks old. It continues from there..some are invasive with anesthesia, some she was awake and we had to hold her down, some were just small procedures, etc.  I don't think I could count/remember EVERYTHING if I had too.  If I guessed, over 25.  

She told me that new studies/old research shows that when babies are exposed to medical interventions early on that they can actually perceive pain differently than they should.  What is normally just 'uncomfortable' or 'weird' feeling for other people they would THINK is pain because the pain signals to the brain formed wrong, etc.  Because she experienced pain while they were still forming, is what she was getting at.

I had never heard that before, but found it interesting and thought I would share and see if anyone else has heard that before?

We go back in 1 week and our goal for this week is to try distraction during cathing.  She asked in my ideal world who would help me.  In my ideal world I wouldn't need help.  If I take her to the dr office to try this 'distraction' it's going to be pointless bc she will flip.  IF we can't get to a point where she doesn't need 4 people to hold her down this will NEVER work. 

MaxandRuby

Could the lining up of things be anxiety related for P? DS1 (4yr and NT) does this often enough but he seems to have a little bit of an anxious/worry type personality so I've always just related it to that (plus I'm a little like this in that I like things to line up exactly, line things up according to some sort of organizational pattern, etc.). I'm not OCD but there are just certain things I like to be in order. he he he  And with all of her stuff going on, maybe it is just a sort of coping mechanism? I'm not a doctor or psychologist so take what I say with a grain of salt. :-)

As for the pain theory, I could totally see that happening. DS2 has had a couple of really bad and horrible blood draws and now has a fear (IMO) of exam rooms and doctors - like I warn them to only touch him when necessary otherwise he freaks the hell out. Anyway, I could see how with all P has had done how she could perceive things differently based on her expectations and previous experience with various medical procedures. Maybe this is an anxiety thing though too where she may be expecting more pain then there is, so she doesn't relax and therefore it makes the cathing more painful which in her mind is possible even more painful?  Again, I'm not a doctor. Just throwing my thoughts out there.

Overall, I just wish all of you could catch a break and that you didn't even have to go down this path with P.

realisticdreams

MaxandRuby:

Could the lining up of things be anxiety related for P? DS1 (4yr and NT) does this often enough but he seems to have a little bit of an anxious/worry type personality so I've always just related it to that (plus I'm a little like this in that I like things to line up exactly, line things up according to some sort of organizational pattern, etc.). I'm not OCD but there are just certain things I like to be in order. he he he  And with all of her stuff going on, maybe it is just a sort of coping mechanism? I'm not a doctor or psychologist so take what I say with a grain of salt. :-)

As for the pain theory, I could totally see that happening. DS2 has had a couple of really bad and horrible blood draws and now has a fear (IMO) of exam rooms and doctors - like I warn them to only touch him when necessary otherwise he freaks the hell out. Anyway, I could see how with all P has had done how she could perceive things differently based on her expectations and previous experience with various medical procedures. Maybe this is an anxiety thing though too where she may be expecting more pain then there is, so she doesn't relax and therefore it makes the cathing more painful which in her mind is possible even more painful?  Again, I'm not a doctor. Just throwing my thoughts out there.

Overall, I just wish all of you could catch a break and that you didn't even have to go down this path with P.

Thank you sooo much.  Your post really got my brain rolling and able to look at it from different points of views.  I think around 20 months P was horrified of dr's offices.  I mean screamed when we were walking into the building.  Cried if *I* went to the dentist or doctor.  I finally had to just start telling her, we are going to see Dr. X today. He is going to talk to us about X problem.  OR Tomorrow you are going to have to do X at the drs, It might hurt but mommy will be there and we have to do it because of X.  I found that if I talked to her about a 'big' appt a few days before, everyday, she took it a lot better.  AND she never cries anymore, unless they take her diaper off (lol)

I guess we are probably seeing the best person we could ask for to help us with this, from her background.

And you are right, I so wish we didn't have to go down this path but I've accepted that part, my issue now is that I'm stuck in limbo on knowing we need to do it but not being able too.  It makes it 10x worse!