12yo refuses medical treatment - what to do?

[Ollivander]

My DS(12) has no SEN diagnosis although his school suspect ADHD/ASD. Started referral process last year but was shelved due to covid.

He has two ingrowing toenails which have been getting steadily worse over the last 4 months. I manage to get him to various podiatry appts but it took half an hour the first time just to get his shoes and socks off. Next time podiatrist managed to inspect and clean, then three attempts at local anaesthetic to numb the toe to remove part/all of the nail. My son understands what needs to be done but won't go ahead with the injection - he will get to the point of it touching his skin then pulls away. He's in agony every day and also refuses to take antibiotics for infection. I've tried different podiatrists, and GP just says to keep trying.

Has anyone any tips for how to calm a very anxious child, I've tried lining up a reward etc. He has a history of not taking meds, will only ever take calpol. Am concerned that no-one seems to take this very seriously and no-one I've spoken to has any ideas. My son overthinks and dramatises any situation, then gets himself into a panic and ends up swearing and shutting down (he's run out of the dentist before, and usually swears at dr or dentist). He does want it done as he knows it's the only way to be rid of the pain, but once in the chair he's in turmoil as he won't go through with it.

Thanks in advance for any suggestions.

Oh bless you! I have experience with this. Even down to the ingrown toenails.

Ds gets them, he picks his nails and they rip down the edges and ingrow. He doesn’t let me cut or touch his toenails so sometimes they get too long and rip off aswell.

He got referred to podiatry once when it was a bad one and she couldn’t do anything as he won’t co operate at all so I’ve had to become a master at home treatment instead.

This particular one was rank! It was yellow and oozy and his toe was so swollen the skin started shedding and his toe turned dark purple and he was struggling to walk.

What I did was soak his foot twice a day for 20 minutes (I’d like to say in a foot spa but it was just a mop bucket) hot water and loads of Epsom salts. Then 3 or 4 times a day I used something called GEHWOL fluid it’s about £7 off amazon for ingrown toenails. Put some on and it softens everything up and in about 2 weeks it had completely resolved!

Thank you so much, I'll have a look at that fluid now - fingers crossed it works! So glad you managed to sort it for your son too!

I’ve just added some pics of ds toenail from last time, I treated this at home as I mentioned above, I just checked back on my photos as I remember taking them, this is the one podiatry couldn’t do anything with as he wouldn’t let her touch his foot.

Have ordered the fluid and Epsom salts, hopefully this will do the trick. Thanks for your suggestions :)

@Ollivander It's so difficult. My son manages the dentist but ran out of appointment for his flu jab and I can't even get him into an opticians as he hates anyone messing with his face and eyes.
We do our best. As a nurse I would be advising you to keep an eye on the redness and swelling. Also watch out for signs of the infection worsening (cellulitis, sepsis).
Would it be possible for him to have an anaesthetic if things get to that stage?

Thanks Niffler - when I first tried to get him to the podiatrist he was convinced that the injection would put him to sleep, that was his biggest fear. Have tried to explain that if he doesn't get it done now it will end up needing a general anaesthetic, which he understands but panics him more and he starts spiralling. Dr said they're not doing anything like that atm though due to covid, so it's not even an option.

I am really worried about sepsis though, as his toes are a real mess. Need to google cellulitis, sorry I don't know what that is. His toes bleed daily and stick to his socks. At least now he's off school they can get fresh air and he won't be on his feet as much through the day.

Am keeping an eye on his temperature and any more swelling, but he doesn't even like me looking at them, I get shouted at and names called for trying to check, especially when I had to take photos for the doctor!

@Ollivander Cellulitis is essentially an infection in the deeper tissues. Watch out for redness spreading, increased swelling and pain.
Maybe some numbing gel to the skin around the toes would make the local anaesthetic injections more comfortable.
Could the podiatrist just offer an appointment to talk about what will happen without doing anything with the toes at that time?

Thank you :)

After the NHS podiatrist I've tried a lovely local podiatrist who spent two hours on two occasions talking to DS explaining everything. She was really calm and I had forewarned her that if he gets stressed he sometimes swears, but he was ok throughout the appointment just couldn't go through with it. That was as close as we got. We did try Emla cream as well the second time, but the problem is in his head with him overthinking it. If we could switch off the negative thoughts we'd be ok!

I've booked DS in for therapy previously but his walls go up and he becomes aggressive, even though it was (on the face of it) calm and non-threatening, I think it must be his anxiety. He clicks with certain people but it's hard to know what traits he likes to know which professionals are best to go with.

Thanks for the advice, I'll be keeping an eye on the toes more closely for redness and swelling. Have ordered him a special foot bowl, as he's so picky about using a normal basin and it not being clean!

@Ollivander Hope everything goes ok and those toes heal up! Take care! 😊