4 year old traumatised after hospital stay, who do I call?

[pinkelephant22]

I don’t know whether i need to get in contact with GP, health visitor, let it all simmer down or just keep her completely away from health professionals.

My 4 year old had her tonsils out last Friday, discharged home. Was absolutely fine apart from the obvious sore throat, pain management etc but was drinking plenty of water eating. Sunday night she coughed up a small blood clot so I thought I better take her even though it says 2 spoonfuls or more. Walked through the doors of A&E and she threw up an entire sick bowl of blood, plum sized clots. So she was obviously terrified but the doctors needed to act quickly hence subsequent restraint to get medicine in to stop bleeding fluids etc. She was shaking when she finally went to sleep stable. Transferred to a different hospital via ambulance who then pricked her again for blood sugars. Woke up screaming. At new hospital needed new cannula involving another restraint and multiple attempts. Got to ward needed bloods another restraint. Was then ready for discharge by Tuesday and she then just upon almost leaving started to wee what looked like pure blood. She was then readmitted under a different team, new line put in old one taken out. Restrained - Settled. More bloods, more restraints - she has become necrotic they said it’s her little body’s response to trauma and her body was firing our protein so it’s an inflammation of something in her kidneys. We finally got home this evening and will see a specialist next week to make sure medicines have treated if not she’ll need now further investigations.

At home all I did was attempt to brush her teeth, she was screaming “stop touching me” for about half an hour and then hid behind her dolls house shaking 🥺🥺 it took 3 hours to calm her down and she made herself sick.

shes absolutely traumatised, we both are. Before the tonsils we wouldn’t go more than 3 weeks without her getting sick. They said her tonsils were grade 3 even when she wasn’t sick. But I completely blame myself. We went in for her tonsils out and came out with a kidney issue and a petrified little girl.

do I address this now via GP if they can access a therapy for her or shall I just keep her away from healthcare, considering she has to go back on Wednesday also!

That was just the first time. The poor child and the poor mum.

I'm so sorry op. My 2yo had a hospital stay recently and there was a 4/5yo boy who was medically traumatised on the ward, every single interaction (even, "open your mouth so I can see inside") left him crying. His Dad was there and I think he handled it really well.

My own ds is only 2 but also had to be restrained a couple of times. The way he dealt with it was talking about it a lot afterwards. It's incredible how much he remembers, right down to the TV show the ambulance lady put on her tablet for him to watch. He was terrified of the GP for a while but he's ok now.

So I'd just let her talk about it loads. Rehash everything she wants to. Keep emphasising how brave she was and how impressed the nurses were etc

It’s take an adult 6 weeks to process a trauma. She needs time, understanding, perhaps later she may want to watch child appropriate hospital programmes, ceebies have a good one, in a few weeks her her a toy medical kit but don’t make a big thing of it just mention it once and leave it somewhere she can access. role play is a really good way for a child to process things.

Oh no op that is awful she is traumatised. I would ring the children's ward she was in and ask them if they have any suggestions, maybe some play therapy or something. In the meantime I would touch her as little as possible let her take the lead, give her space let her do her own teeth etc it doesn't..matter till.she has recovered and decompressed.

Can I just say that if you have a gaming system you could download Tetris and encourage her to play that as much as she wants. When she’s into it, just gently talk to her as she’s playing about the hospital and how brave she was bout how sure must have been scared etc. very gently baby steps. Tetris has been shown to help process traumatic memories and ease ptsd due to the left to right movement of the eyes. Works on a very similar pathway to emdr.

i really feel for your little girl. I had to have surgery when I was about 6-7 and nobody prepared me. I was pinned down by 3 staff and was threading like a maniac. Covered in bruises and it took ages for me to get over it and it really affected my relationship with my mum too. I’m not saying for a second that will happen for you, the 70s were very times and I’m sure you are a much better mum than mine was. But is hard being a kid and not understanding why things are happening etc.

if you are struggling with teeth brushing you can get xylitol chewing gum and lollipops in the short term to help keep decay at bay. Massive take her out and let her bit a novelty tooth brush or a blue tooth one that she can watch the data appear so SHE can have the autonomy to know when her teeth are clean and she can stop. Might give her back some sense of control

Saying this very gently but.. if a child is potentially bleeding to death then there's no time for numbing cream/play specialist. And as for your comment about kindness?!? As an x children's nurse I find this insulting.

And OP.. I'm very sorry for your experience and I think you have got some good advice.

Not your point at all OP but our dentist recommends eating cheese to help neutralise acid on teeth so if you want to back off tooth brushing for a couple days it's obviously not a replacement but at least you won't be panicking about her teeth.
She may also be thinking the tooth brush will make it all bleed again.
Bless her she is very small, lots of space and time, offer her physical touch but don't make it essential for now. She just needs to find her bearings again, and lots of reassurance for future appointments that they aren't emergencies and the restraint was because it was an emergency.
There's a children's programme called Operation Ouch that is really good, might be a bit soon to be showing her but they focus on lots of things that usually can scare kids in a really fun and silly way.

As I have said, and the op has said, that was the first time. Surely some light sedation could have been used after the first time from an holostic perspective and to prevent fear of medics/hospitals in future.

I'm sorry you find the kindness comment insulting. As a mother of years standing, I'm afraid there were times when nurses were not kind to my children in hospital and is why I would never venture leaving a child alone in an hospital. Sometimes a snappy, barked command which may be how a nurse speaks to her own children, and the occasion a nurse handled and spoke to my 4 month baby roughly and made him upset before he had the nebuliser which she was visibly forcing on him. I woke up and was able to stop it, calm my baby, swaddle him and a different nurse did it with kindness.

In my experience parents have to be en-point, present and advocate for their children in hospital.

Done this with two children who are now pre-teens. Tonsillectomy is an absolutely brutal operation but for those who need it it’s life changing. Both kids went back in with infections, second was during the panic about strep A which was tough from an antibiotic availability PoV. Both children took a good 3-4 weeks to fully recover, youngest had his out on December 1st and was only just about ready to return to school in the January.

As a parent it’s distressing but you have a really important role to play in keeping the child calm. What were you doing during the interventions? Did they let you help with the restraint and were you talking to her? A calm voice of ‘it’s ok, I’ve got you, you’re ok’ is often really helpful.

Eldest was already terrified of cannulation by the time he got to the surgical list because he had had sepsis from tonsillitis and IV abx a couple of times. At 12 he’s much better and more prepared, and realistically you’re unlikely to do anything like this again for a long time. I’d not say it’s a GP problem, but if you find more surgery is on the cards then getting the team to be aware of the trauma and anxiety is reasonable. Eg for eldest tonsillectomy he went to sleep with the mask because he couldn’t cope with a cannula (and boy was he pissed off when he woke up with one). He got very good at super Mario that summer though.

Hi OP. Similar happened to me and it's one of my first memories. Tonsils out at 4, ended up vomiting blood after, panic ensued and doctors everywhere. I then have zero recollection of what happened in between that and after it all calmed down but my mum tells me it was not nice. I'm in my 30s now. I have had basically lifelong emetophobia (severe fear of vomiting) and my therapists believe this is probably what triggered it. It had quite the negative effect on my life until I got a handle on it in my 20s. You're a great mum at thinking about what support you can give her from now. When I was a kid this wasn't thought of at all.

I think keep a close eye on her in the coming weeks after she has recovered from the initial trauma to see if there are any longer lasting anxieties or triggers. I think it's important to tackle these asap. I'm so sorry your dd is feeling so upset.

There are some nervous system support things that you can do with her to help... calming music.. the chanting Ra Ma Da Sa Sa Se So Hung by Satnam Kaur helps in many situations, youtube or Spotify.

Have you googled suggestions online of different things you can do. I don't have any suggestions but as a kid i spent a lot of time in hospital and im nearly 40 and still remember being pinned down by loads of drs and nurses when they where trying to put me to sleep for surgeries. So I think you definitely need to be doing something. I know this isn't helpful but what im trying to say although very badly is that it shouldn't just be ignored because it is a big deal.

As a parent it’s distressing but you have a really important role to play in keeping the child calm. What were you doing during the interventions? Did they let you help with the restraint and were you talking to her? A calm voice of ‘it’s ok, I’ve got you, you’re ok’ is often really helpful.

Do you really think op didn't try that?! You think she didn't think to say "it's ok, I've got you" to her own crying child?!

Some of these comments...!

@Kingdomofsleep I genuinely don’t know, it’s not covered in OP’s account, and her position seems to be against rather than aligned with the medical team, at least in the opening post. I don’t think all parents understand how important a role they play as a bridge between the child and the team when it comes to consent - no child would ever fully and meaningfully consent to a cannula, but the parent can. Some parents end up hysterical alongside the child which is unhelpful.

as a parent, I have had the occasional nurse do things in a way that I have found it harder to align with, but by and large the role of caregiver is to enable the team at a time like that.

You were breathtakingly patronising and blaming the mother for her child's medical trauma.

I have not met any mother, from any culture or background, who did not think to attempt to comfort her own crying child with reassuring words.

Do you really think op would react "oh whoops, why didn't I think of saying "it's ok I've got you" to my distressed child, I must try that next time"...!

The point is, having a near-death experience where you are vomiting large amounts of blood and receiving emergency care, goes beyond being fully comforted with a hug and "it's ok I've got you".

Op's child hasn't just scraped her knee!

Light sedation ? You must be joking . They absolutely do not offer sedation for this in hospitals . It can make a child even more distressed and traumatised not to mention it being dangerous in this particular situation . Sorry but you do not have a clue what you are talking about .

If someone is bleeding out then time is of the essence. There isn’t time for numbing cream to take effect. By ‘restraints’ I’d assume it meant being held firmly by nursing staff.

How on earth do you know how this nurse was handling your baby if you were asleep?
Of course a small baby is going to wriggle when having a nebuliser fitted - buy pussyfooting about and not getting it on in a timely manner could be life threatening!

God I had my tonsils out last month and had the bleeding issue too. I’m traumatised too! Poor little lady x

Another thing that helped us was talking about the doctors and medicine in a good way... for example my son had to be restrained to have an oxygen mask (his oxygen levels were dangerously low yet he still somehow had fight in him to resist wearing it!) And afterwards I was saying to dh "that oxygen mask was amazing, his oxygen levels got better so quickly, what a clever medicine" etc and the same about the nebuliser, and then ds was more willing to take the nebuliser again after that. We also talk about steroid medicine and antibiotics in the same way whenever we get prescribed them "hooray we got given the good stuff, I was hoping they'd let us have it, you'll get better even quicker now!"

Even if you think the doctors made mistakes or bad decisions op, try not to share that idea with your dd, as that will make her more afraid next time. The goal is to make them feel like they're in safe hands next time they need to go to hospital

For most people who hate needles, it’s the thought of the needle rather than the actual pain that is the problem. Over a period of time (weeks, months) the use of numbing cream could make it easier, as the child will learn that actually the needle doesn’t hurt. But in an acute setting it has a lot less impact.

Time, compassion and patience in my experience, we reached out to the hospital ( children’s) and there was no post discharge support, CAMHS couldn’t help as she wouldn’t engage - hid under her coat.

She had encephalitis aged 8 - had 3 lumbar punctures - including one were I was expected to hold her down - no pain relief, endless cannula changes that hurt, she couldn’t walk, talk or move without vomiting at one stage.

It took a looooong time - she slept in my bed for over a year. Any dizziness or nausea would trigger a huge panic reaction, she developed a fear of anything medical. It just took time

she’s almost 18 now and so much better, she has a brain injury which impact on memory and concentration so GCSE’s were very stressful but she’s loads better, she still get a bit upset if she feels sick or dizzy but we no longer have flashbacks or medical phobia.

Im sorry your daughter went through this - cuddles, routine, talking at her pace and love will help x

Lots of errors in that post! Sorry