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Original poster

Help with toddler needing a cannula pleaae

27 replies

SinkGirl · 02/04/2019 11:42

I have twins who are 2.5 - both have ASD, one has multiple other disabilities / health issues and has had a lot of investigations / monitoring / treatment involving needles from birth. He used to handle it very well when he was a baby and still now he has his blood sugar tested every day and doesn’t even flinch. However, the last few blood tests have been very distressing for him (and for me), and the last time he had a cannula (for a general anaesthetic) he was utterly terrified - he was trying to get away and so distressed until he went under and I felt absolutely dreadful putting him through it.

He’s been called in for a test on Wednesday that will involve having a cannula put in, blood drawn, a medication administered and then blood drawn at 30 and 60 mins through the cannula and then we can go home.

I’m really dreading it (I am terrified of needles myself due to ones in my childhood, although I was slightly older than him - mainly having my tonsils out age 4 and the jabs around that time). I try so hard to stay calm and not show that I’m worried or nervous and I don’t think he picks up on any anxiety from me. I think having his arm or leg held so still is a huge part of the distress for him as he dislikes being restrained.

He can’t talk or understand words so I can’t explain to him what’s happening, why and that it will be over quickly, which I’m sure would help.

Aside from shoving a tablet playing Hey Duggee in front of him, can anyone suggest anything that might help? I’m sure there are lots of people with more experience than me.

His twin is going to need his first blood tests in ages soon too and that’s even more of a worry as he’s simply not used to it at all, and more liable to fight back!

OP posts:
Imnotaslimjim · 02/04/2019 11:45

Try with the videos on tablet, it isn't for long. It's so hard when you can't explain yo them what's going on.

stucknoue · 02/04/2019 12:00

The tablet is your best option, whatever distractions you can use

Sirzy · 02/04/2019 12:04

Go with the tablet!

Also ask them for a play specialist because they are trained in these things and in my experience are miracle workers!

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CommunistLegoBloc · 02/04/2019 12:07

Ask for the play therapist. Take bubbles and blow them in the opposite direction to the needle site. You could try new and fascinating toys to whip out and distract him but his autism might mean that their newness upsets him so sorry if that’s a rubbish suggestion!

Mummabear12345567889 · 02/04/2019 12:09

Does he have the numbing cream? Agree with everyone else, needs must- show him hey duggee.

JeanMichelBisquiat · 02/04/2019 12:17

Definitely contact the hospital in advance to make sure you have a play specialist there.

Are you able to ensure that you have someone really experienced doing the cannula? Anaesthetists can usually do it really rapidly, whereas if you get a very junior doctor it can be an excruciatingly hit and miss process (and by contrast, an experienced nurse can have it done in no time!).

Are they doing the "magic cream" in advance, keeping it on for long enough and taking it straight from the fridge?

I'd also highly recommend the position where DS sits on your lap, facing in the same direction as you, being distracted by a play therapist with bubbles, Hey Duggee, whatever works....while this is going on, you get one of his arms between your side and your arm, so the hand is popping out behind you, and the medic can do their magic behind the scenes there while your DS is still facing the front and distracted, so he's not aware of what's happening. Apologies if the ASD means keeping him in one position is an impossibility!

Finally, and possibly most importantly, massive massive hug to you - handling chronic conditions with these sorts of interventions is so incredibly hard as a parent xx

GayParee · 02/04/2019 12:17

With my dd they used to put the numbing cream onto both hands, and have a nurse each side. One would with faff about a lot and talk to dd, holding the hand etc, whereas on the other side another would quietly get the needle in and cannula stuck down before dd even noticed - would something similar work. Throw in bubbles and ipad and he may not even notice?

Good luck

Geneticsbunny · 02/04/2019 12:24

There is something called a buzzy which buzzes near where the Camila is going whilst they insert it. Might work for your son? But I would second asking for a play specialist they are amazing. I have seen skin biopsies done with the child not even noticing.

Pythonesque · 02/04/2019 12:34

JeanMichelBisquiat describes the best holding position perfectly. In your situation I'd also consider whether to ask for someone else to hold them if you think it might go better.

Years back I worked in paediatrics for a while, the "where's wally" books were excellent distractors for a wide age range - are your sons ready for looking at these intently yet? Hope you get a good play therapist (the ones I've met have always been excellent), and can keep everything relaxed long enough for it to go really well this time.

Sirzy · 02/04/2019 12:43

Instead of the cream ask for the numbing spray - that works instantly, I know for my son the cream on his hand before added to the anxiety

Original poster
SinkGirl · 02/04/2019 12:49

Thanks so much for all your suggestions - the info on how to hold him is really helpful. He is normally such a happy, placid little boy and I find it so hard seeing him so distressed. Sadly he’s not very interested in toys or much really so we will definitely have his favourite programmes to watch and some good snacks for when it’s done. Will ask about a play therapist but as it has to be done early in the morning I’m not sure they will have one there - will check.

OP posts:
gigglingHyena · 02/04/2019 12:49

If you think the tablet distraction has any chance of working, then go with it. For DS it has always been more about distracting him so that the medical staff can quickly and safely do what they need. Talking him round to to the idea has never really been possible.

Keeping him calm before hand is a big help. Can they give you a quiet area to wait in, or I have in the past left my phone number and taken DS back out for a walk rather than stay in the waiting room. If possible an appointment first thing makes things easier, and there is less chance of delays having built up.

Ear defenders, or headphones to listen to the tablet and cut down on external noise.

DS is very sensitive to smells, so I have been know to pack a muslin with some essential oil that he likes for him to snuggle/sniff.

Good luck, it's not easy having to stay calm when your child is distressed.

JeanMichelBisquiat · 02/04/2019 14:46

I got the holding position from the most wonderful anaesthetist who did my kid's first general when she was 1.5. Even though she was tiny, he still bothered to make sure she was out of earshot before he told me the exact plan. I was completely in love with him Grin

I just hope it's of some help - will have fingers very firmly crossed for you xx

Nofunkingworriesmate · 02/04/2019 14:50

Been through it myself really felt for you, remember it’s you that suffers not them at all as it’s forgotten
Tell them there’s a problem, we did and we got a lovely play therapist, big bar of chicolate crisps ice cream new toy whatever to get through it
Xxxxccc

Original poster
SinkGirl · 02/04/2019 15:35

Thanks so much everyone, really appreciate the support - I just hate that he has to go through all this but this test is so important and would be really serious if he had this issue but went undiagnosed so I have to put on my big girl pants and get on with it!

OP posts:
Sirzy · 02/04/2019 15:41

Can you take someone with you to support you?

JeanMichelBisquiat · 02/04/2019 19:01

You do have to put your big girl pants on, but do also remember that it's part of their job to minimise the distress for your son - it's so easy as a parent dealing with this type of thing to be head-down and strong about it all, just to get through it, but you're entitled to advocate for the extra help that you need.

It might be worth asking for a phone call with the consultant in charge of his care, or if that's not possible then with PALS (patient advice and liaison), to put together a strategy of exactly how he can be helped and by whom. For eg, I'm surprised that no one had already tried out doing the hold I recommended.

If you can have some strategies in place that have been discussed in advance, there's less risk of it being ad hoc and potentially more distressing.

Hope that makes sense - conscious I'm telling you to take extra steps when you're already dealing with twin toddlers with ASD and serious health conditions, but it may conjure up some additional support for him if you raise it formally. Flowers

Original poster
SinkGirl · 02/04/2019 21:15

Unfortunately no one can come -DH will be at home with the other twin, since he’s a bit of a bull in a china shop and we don’t need the stress of him grabbing a needle or something!

I will definitely speak to his consultant - everything has been quite disjointed and as hoc (thanks to four different consultants dealing with him, and the ASD diagnosis happening since the last time needles were needed) but he has a new general paediatrician who seems on the ball (his endocrinologist has apparent wanted this test for a while and his last paediatrician missed it) so I will talk to her about it - sadly not in time for tomorrow but will see how it goes. He’s going to need regular screening indefinitely so it’s not a problem that’s going to go away any time soon.

OP posts:
Sirzy · 02/04/2019 21:18

Also ask about a hospital passport. Ds has one and it shows his areas of struggle and how they can help him so you can just give it to staff to save having to explain

starfishmummy · 02/04/2019 21:19

Agree with a PP in saying ditch the numbing cream. DS - SN - knew what it meant so there would be 45 minutes or so of anxiety while they left it to work. And they'd often have to go in somewhere else anyway. He was much better without it.

Original poster
SinkGirl · 02/04/2019 21:29

I agree, I don’t think the cream actually helps him the times he’s had it in the past. About a year ago he was in for a controlled fast. They put cream on both hands and feet but they kept his leg so still that he was screaming before they even got the plastic off. Much the same with the GA. Blood tests tend not to be as bad as they’re quicker and the nurses at our local children’s unit blood test clinic are brilliant with him. We normally just opt for the spray as hanging around for extra time will be worse for him overall.

Will definitely ask about the passport. He has some other medical info that really needs to be known about if he ends up in A&E - it’s flagged on his notes already but it would be useful to have something concise and in one place.

Thanks so much everyone - really appreciate the support. Obviously it’s so hard having kids with health issues but it’s the things like this that I struggle with most in reality - the thought of putting him through distress when he can’t understand it, and worrying he will resent me for it. I’ve made DH take him for blood tests a few times so that it’s not always me, but I always end up with the more difficult / long / invasive stuff.

Luckily he’s an absolute trooper and such a brave little dude - once the cannula is in he’ll be flashing his gorgeous grin at the nurses and they’ll be swooning over his lovely hair and eyelashes while I’m still panicking :)

OP posts:
JeanMichelBisquiat · 03/04/2019 17:00

Hope it's gone OK today, OP.

Original poster
SinkGirl · 04/04/2019 12:14

Thank you - it was a bloody logistical nightmare (the one hour test took five hours in all, and for two of those he was supposed to lie down 😳) but he did brilliantly. The hold really helped, barely even a yelp and he was an absolute angel. Phew.

OP posts:
JeanMichelBisquiat · 04/04/2019 15:52

Flipping nora - five hours?! But so glad you both survived without it being so traumatic this time - and particularly pleased the hold was successful! I hope the results are helpful in his care xx

Jammiebammie · 04/04/2019 15:57

I can empathise, good luck for the test, pp has described the best hold perfectly.
My dd is disabled and has asd and any medical treatment (which is a lot) completely freaks her out. She has to get a pre med even just for blood tests, which is a big help actually but I don’t know if they can do it at your dcs age. She definitely had gas and air at that age which calmed her down a lot though (once we got past the mask!)
The play specialists are fantastic though, and they see this a lot.
The numbing cream is a no-go for my dd as she knows what’s coming and it actually makes her worse, they can use a numbing spray at the time which is instant.