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!

Oh so now you're not just criticising the medical staff, but the OP too?
The OP was present and advocating and the staff were working appropriately to stabilise her dd. "Light sedation" of a small unwell child is tricky and can actually make experiences more terrifying. Or they can react to the sedation by becoming hyperactive (have seen both these effects).
You said something daft, own it. No need to double down.

Our phlebotomists seem to use the spray, but you can buy EMLA cream

The medical staff were excellent I thought every single one of them were kind, even after the initial first instance in the hospital which was the worst the team were discussing her outside of the resus room and the senior doctor came in to first of all say she’s sorry that they’re may have been some shouting as the doctors were shouting instructions towards nurses for bottles medicines calling for blood etc and I said no I completely understand I was grateful they were able to stabilise her and understood it was chaotic but everything at the end of it all my daughter was ready to be transferred.

the second hospital the staff also tried everything to keep her calm, even the flushing the canula she was obviously terrified they would blow bubbles have another nurse talk to her I’d be holding her hand they gave her sticker chats with surprises at the end but she was just not having any of it.

shes pretty much the same this morning, she’s playing with her toys and her baby sister. When she left the hospital the nurses gave her a toy it was a little medical set and some art things, she’s chose to play with the medical set today of her own accord. She tried to have a little poke at my 11 month old with a toy thermometer so in that regard she’s coming back to herself a bit.

they do have an Amazon wishlist for the children’s ward so I’ll be placing an order this evening for them.

then comes trying to give her her medicine. The shaking the hiding the don’t touch me don’t touch me. We eventually got her to take it in the tiniest bits whilst her dad held her water bottle so she could have a sip Inbetween but it was after about 45 mins of crying at just the mention of it. She doesn’t like yoghurt and is still off her food so there’s no chance of mixing it with that as was one suggestion that we tried at the hospital.

After the medicine she’s got in to her bed and gone to sleep, she’s still exhausted .

The phlebotomy dept in my local hospital are amazing, I really recommend taking your dd to phlebotomy, they're so quick. There's no time to even get worked up.

At phlebotomy I sit in the armchair and start babbling about how I'm needle phobic and might vomit and my veins are hard to find and so on but before I've even finished talking they're like "ok you're done, next please" and they've taken 6 vials! An ordinary nurse would still be poking my arm to find the vein in that time.

I’m not normally one for bribery but when ds was little a few chocolate buttons after medicine often worked well.

also if it is in a syringe she may be happier to do it herself to feel a bit more in control of things.

It sounds like she's doing amazingly well. What a brave girl. She took her medicine! That's great progress. Hang in there op, she'll get a bit better every day

Nothing to add for OP but I just wanted to comment that that sounds a really impressive service to help your child, @xjox1983 ❤️

Sedation carries its own risks and would be impractical each time a cannula had to be inserted/changed.

The OP had said she was happy with the care they received.

I agree with this- I always insist on the phlebotomy department for outpatients type stuff - but its not always (or even generally) possible for inpatient treatment (except strangely in the middle of the night when a couple of them roam the wards redoing errant cannulas)

this is actually true

Hello there. My son has a volatile, life threatening condition (he was born with it) and I understand what it's like going through the mill in hospital - he's an adult now. Fortunately, for him, part of his condition meant he was unconscious quite a bit of the time. However, we (as his parents) were not. Please don't underestimate the impact of this on yourself or family. Perfectly acceptable to also consider your own needs at this time and contact your GP to talk about how shocked and shook up you're feeling. I have a standing prescription for calm me down pills for after a crisis phase when everything's back to ticking along. I also have periods of watching 'weepies' so I can let the emotion out.

I wish you all a speedy recovery.

ahhhh bless her 😭 plenty of cuddles when she allows. Would it maybe help if you got her a little drs kit and some cannulas (no needles obvs) play drs with her and explain as you go what the things are and how they help us? X

This book might help. Amazon link getting ready for my tonsil surgery

It is supposed to be for beforehand but might still help her understand what happened a bit more.

You don't call anyone?

She's four

She just need quiet time at home

Time will heal and help her forget

I would allow her to decompress in her own time, my dd has had a few operations and was intubated at one point due to breathing issues.

After a hospital admission I kept life as quiet and safe as possible, she could eat whatever she wanted, watch as much telly as she wanted and I would just keep things simple.

Dd had a toy medical bag and I found she did her own play therapy by role playing with her toys.

I hope your little girl feels better soon op.

You poor thing. I'm no expert, but I'd keep away from medical settings for now if possible. I'd buy books that talk about hospital stays for poorly kids, look up if there are any cartoons that deal with it and watch together, maybe get her a little set of dolls that you can play doctors with. I'd introduce the subject this way and just gently ask her how she felt about her stays in hospital, what she remembers, how she felt. Did it make her scared? I'd explain that this is a normal feeling but that the doctors were trying to make her body feel better, and sometimes these things are necessary. I'd share my own experiences that felt relevant, and just try to keep her talking openly about how she felt and how she's feeling now.

What a terrible time for you both, I’m so sorry. No advice but glad you’ve had lots of good tips from others and it sounds like you’re doing brilliantly and your brave daughter is beginning to recover. Sending you a massive hug, make sure you’re getting chances to offload as and when you need to 💐💐💐

I'm sorry that's so awful. I wouldn't not do anything, my son at 4 when in reception went through something similar and developed health anxiety which turned into general anxiety, he's 7 now and still struggles. Talk to your GP without her there, is she in school? We were referred for a CBT course which is as his parents strategies for dealing with it. There are some good books you can read with her to help explain what happened.

https://www.amazon.co.uk/Paddington-Goes-Hospital-Michael-Bond/dp/0008149240/ref=asc_df_0008149240?mcid=0af28dd4001833d8a083b0c7fa7bdf52&th=1&psc=1&tag=googshopuk-21&linkCode=df0&hvadid=697215344815&hvpos=&hvnetw=g&hvrand=1750202813091836556&hvpone=&hvptwo=&hvqmt=&hvdev=m&hvdvcmdl=&hvlocint=&hvlocphy=1006838&hvtargid=pla-588052685994&psc=1&hvocijid=1750202813091836556-0008149240-&hvexpln=0&gad_source=1

We found making social stories helpful, https://parents.actionforchildren.org.uk/neurodiversity/understanding-needs/making-social-stories-and-scripts-to-support-your-child/

It's a really difficult thing to help them recover from I wish you all well xx

My child had a medically traumatic thing - nothing like yours but still pretty bad. I read this thing that said kids process a lot of stuff by play. So we bought doctors kits etc. Worked wonders! They were always the doctor and I had to be the reluctant patient so so many times. More
fake screaming the better. A few goes in and they were telling me it wouldn’t last long and it would help me get better.

I work for the ambulance service so know a fair bit about trauma. What your dd is displaying is considered normal in the immediate aftermath of her traumatic event and it is counterproductive to do anything about it at this stage. What is important is that you see how she’s doing in about a month and seek help then if she is still displaying these trauma responses. Below is copied from our trauma risk management guidance-

After an event occurs it is normal for there to be a degree of upset and sleep disturbance as well as a wide range of other emotions. This initial phase can last around 72 hours, as the events are processed naturally.

Following the initial processing phase, some of the symptoms can remain for a little longer, usually subsiding after 4-6 weeks. In cases where these symptoms do not subside, it is necessary to undertake a risk assessment to identify the impact on the individual.

Most, if not everyone, will adjust well to what has happened, however, we know that some individuals will experience more problems than others. If you feel that you are continuing to not cope well or are getting worse with each passing day, or if you are concerned about a colleague, please seek advice.

OP, I’m not sure if you responded to the post about Tetris but the PP was correct, there is a lot of evidence that this helps processing so definitely worth doing. Good luck.

Thank you all so much and @AnotherVicethank you also. Tetris I’m going to download it and give it a go with her tomorrow.

I had a few more cuddles today, she got in the bath fine and getting out was “don’t hold me don’t hold me” when I went to pick her up so I put her step on the outside of the bath and held her hands as she got out. So hopefully she’s coming around in her own time. She also brushed her teeth I got her a new oral b frozen toothbrush with the app where you get points and stickers etc and can pick new character’s. I think we’re both quite shell shocked still but I’ve taken the advice of everyone here and not pushed anything on her and letting her navigate everything in her own time. I’ll decompress of an evening and watch a bit of rubbish on the TV, scrolling through Mumsnet.

Give it a week or two and she won’t remember. The more of a big deal it becomes the longer it’ll go on

I work in paediatric healthcare. Standard part of my preop discussion is about altered behaviours post hospital.

i usually say to give it two to three weeks to settle down. A lot happens and they need to process it.

disturbed sleep, behaviour appetite, disrupted toilet training can all happen.

extrapolating from the trauma literature too much psychology type input too soon is probably not going to be helpful.

In general thinking ahead to your follow up I always suggest being honest about what is going to happen in an age appropriate way and timescale (so smaller kids get told closer to event). I also try to be honest but reframe stuff in as positive a way as possible (so a cannula is a plastic tube in your vein not a needle etc., magic cream means that while you know something is happening it shouldn’t be sore).

And I try to give as much control back as possible to the child- do you want to climb on the bed or Mummy to lift you up? Do you want to press the button to check your blood pressure or want me to it? Would you like to choose which toe or finger I put your oxygen saturation probe on?

In my personal life one of the kids I love had a very serious accident and was in ICU conscious for an extended period (most children are sedated so their memory formation is disrupted but as he didn’t need assistance with breathing he wasn’t)

Post hospital he liked to talk through what had happened with his trusted adults - sometimes it felt like a test to see how you were going to react. I tried to keep it bright and breezy but let him talk. His parents had obviously told him that I had hospital knowledge (as did his Mum - we met at medical school) so I got a lot of this kind of chat over bath /bedtime for a while.

It all settled really well and he subsequently had some tests and stuff done without GA at an age when offering a GA is very much an option as kids find it hard to tolerate.

He is now a huge university student and brought it up for the first time with me in about 10yrs a week ago. Only really to check if I remembered it and to ask if I had visited him in hospital. (I hadn’t but there were reasons for that - mostly his younger sibling who was being tag teamed between friends)

My son was ill last year, went to the drs and were given antibiotics, had a horrific time getting them into them, weeks later was still poorly, went to a&e with him, lots of prodding and poking and upset. Urine sample caused trauma as he wasn't potty trained yet. Any observations were upsetting. Then traumatised him hugely when they put in a cannula, I had to restrain him while he screamed and screamed, he was even sick on me, until he just kind of gave up just staring into space and we were all totally shell shocked after. Was discharged later saying they couldn't find the cause for the constant high temps and non blanching rash.

It was worth it in the end as 5 days after discharge I had a call saying he had a kidney infection which was resistant to the antibiotics we'd been given. Had to do another course of antibiotics and couldn't get them into him. Had to restrain him, he was screaming and throwing up with the stress but we had to make sure he got better. We did a reward chart so he worked towards something special to make up for all the upset.

We never mentioned the cannula again or any details of the hospital visit, he was almost 3 at the time and remembers none of it now. All he remembers is the awesome toy he got because he took his medicine.

Personally I wouldn't try to discuss the specifics unless she talks about them. Just try to let time pass while not adding further trauma, if she doesn’t want touched then just leave her be. I'm sure her memory will fade and she'll get back to her normal self soon if there's no reminders of what happened to her. I'm sure it traumatised you too, I hope you're all ok.

Tell your daughter, that was scary , I didn't like it and im still a bit upset about it. It frames it as a shared experience and gives your child permission to have big feelings