"Letting go" when your teenager won't help themselves (physical health issue)

[PangolinPie]

I'm finding this so hard. Dd is 17 and still hasn't started her period. She has undergone some investigations which have revealed she has undeveloped womb and ovaries. She's underweight (absolutely NO eating disorder involved) which has definitely contributed to this. She has an severe needle phobia which she's getting therapy for but the gynaecologist wants blood tests before they'll start oestrogen therapy. Anyway all this is background info to the fact she's basically buried her head in the sand. She's a closed book at the best of times. I can't say or do anything right, especially around this issue and feel incredibly powerless. How do you accept that they have to take responsibility for themselves? I've had all the talks with her about future health, fertility etc but she's not taking the advice about improving her diet, trying to gain weight or taking calcium/vitamin d regularly. I don't know what to do and all I can realistically control is how I react to her. Please advise if you can.

That sounds really difficult. I had read that genetics is biggest contributor to undeveloped womb/ovaries and so your list of gaining weight, taking vitamins wouldn’t really make a difference? So currently she’s getting therapy for needle phobia which will hopefully mean she can get the blood tests to start oestrogen therapy. I’m not sure what else she could realistically do that would have any impact at this point? So I would encourage her to keep up the therapy and get the blood tests done. I know it’s hard and you feel the need to do something, but I think this is more about accepting this is where she is and not trying to pressure her or push her into actions that really won’t make a difference imho.

The talks you mentioned about future health and fertility- I’d leave that for her to talk about with her therapist. It’s a bit much to put on her now, she may be shutting down due to being overwhelmed. She is only 17, a lot can happen between now and when she may decide if she does or does not want children.

I get what you're saying re: vitamins etc @Discovereads but this is what the gynaecologist has advised. One thing I haven't done is put pressure on her re: the therapy/needle phobia as I know that can't and shouldn’t be rushed. I wish the gynaecologist had that understanding because he put the fear of God into her.

I know she's only 17, and it's a lot for her to process. I agree I need to accept where she is now, this is what I'm struggling with I think. I just want to swoop in and make everything better for her.

I have one of these. Bloody nightmare. She’s 16.

I’ve had years of doctor refusal. She also buried her head in the sand. We’ve finally come to blows about an ASD assessment refusal.

I’d had enough, and instigated several severe threats to make her comply. She needs this for her future and l absolutely had to take a stand. I’m not at all a strict oarent, no real sanctions but l had to do it. I gave her loads of rewards after.

I felt terrible, because she’s a young g woman and should make her own decisions, but this was too important to override.

l think somehow you need to make a stand. Maybe a massive reward?

We always do want to swoop in and fix everything for our children as quickly as possible. It’s only natural you feel this way. I wouldn’t advise “coming to blows” or “making severe threats” though, as this could wreck your future relationship with her. I’d keep with gentle guidance imho. If you are deeply concerned if you get her permission, you can always meet with her therapist to talk ways in which you can support her. That way she can tell therapist what she’d like and therapist can communicate that to you. I know it sounds a bit odd, but teens often don’t feel comfortable asking or airing concerns direct out of fear of hurting your feelings. Having a go between who can mediate can often help massively.

@ArseInTheCoOpWindow why was it important to override, i'm not making a dig i'm just really curious about what having the assessment involved you having to make threats towards her

I know needle phobia well, I was terrified, my first pregnancy in my 20s I used to go an hour early to antenatal appointments for 'magic' cream! They wanted bloods to discharge me after my c section and if I wanted the cream I would have had to stay an extra night!! That was the thing that helped me, I wouldnt say cured but I just told the nurse to do it!! Its so hard as I knew myself how irrational my phobia was, I was scared the needle would snap in my arm if I moved, so made sure someone held my arm under my elbow while they did it. I have been held down screaming on many occasions while I was your dd age and many times they refused to do it. It wasn't just the snapping in my arm that I couldnt cope with, I dont know how to articulate it, the panic waiting for it does t help either if pervious appointments run over or so many variables.

I know it has probably been done but has emla cream been offered or the spray? Could she perhaps be seen by pediatric phlebotomy team as they are used to helping frightened patients? Maybe some gas and air along with the cream while its done?

Its so hard as she needs the bloods done and im sure she knows this but phobias are so hard to deal with. What kinds of things do they do in therapy for needle phobias? I only ask as I'm an 80s child and there was none of this on offer.

I really hope you find a solution that works x

Because she needs it for support at school. Because we need it as her anxiety and sensory issues are getting worse and causing arguments between Dh and l as we don’t know how to deal with it.
Because it’s absolutely exhausting and we need guidance on it.

l didn’t threaten to cut off her arm or anything. Just threatened to remove a special haircut and a new bag!! I’ve never done proper sanctions, they never worked with her. Rewards work better and tbh l wish I’d bribed her first. But it is what it is, but l was crying in relief when she backed down.

My sister had petite mal epilepsy. She didn’t know what it was at first but she refused to go to the doctor age 19. It was only because my mum literally dragged her that it was discovered what she had.

Lively headstrong women though they are, l just felt that as a parent l had to override everything for the sake of the entire family. My mum must have felt the same. They think they know everything but they don’t. Could you offer a tenner or something for every pound she gains?

Have you offered to do a stabilizing hold on her during the blood draw? At 17 this would be with her full consent. She would be able to withdraw it at any time. It’s part reassurance and part making sure she doesn’t jerk her arm away and hurt herself or cause injury to someone else.

I have had to do this for my phobic child for years and she has finally graduated to being able to hold herself still. She hasn’t had a non-sedated blood draw yet, but the time is coming soon and i suspect she will request the assistance. She is in charge at this point and she is good about expressing to me when her anxiety is taking over.

Emla cream doesn't work @Catclown it's not the pain she's scared of (she has multiple ear piercings and a nose piercing!) It's the whole idea of the needle going into her flesh for a medical reason. I know it will be hard for people to understand since she has piercings but she is genuinely terrified and often faints. The therapy is gradual exposure - building up from looking at picture of needles etc to a real one eventually and on from there. I haven't thought about whether they might be able to sedate her to take blood, I might ask the consultant about that. She's often said she just wants anaesthetised!

@Ponderingwindow we wouldn't even get to the point of her being in the room for a hold on her arm, she's scarpered out of several situations even for vaccines. She's never even attempted to have blood taken yet as that's "another level" in her mind and worse!
It might be something the consider once she's further along in the therapy though, thanks.

@ArseInTheCoOpWindow my dd is also asd actually so I know what it's like dealing with that, though she was happy to get help and support for that. You do have my total sympathy as I know how exhausting it can be when they're overwhelmed and shutting down.

I could try bribery! We bribed her for GSCEs 😬 it seemed to work OK and most teens want more money.

Aww I understand about the whole medical thing, although I get some people don't, a piercing is her choice so she is in total control of them a hospital visit is out of her control.

It must be so difficult for you as you know she needs them. I feel so guilty for what I out my parents through when I was younger. I used to run away and have bitten nurses to get them off me and the panic and fear is real. I dont know if they will sedate for bloods but gas and air can and should be offered, even to see if it helps slightly. Even getting her in the room, sitting on the chair etc all at a very slow pace. Even just getting into the room on one occasion with nothing happening on that visit?

I can still remember the terror and no amount of bribery or anything would have helped me, she will know she needs it and my be annoyed at herself for not being able to. I used to be so upset with myself afterwards thinking why could I just not do it.

I really hope you can get somewhere soon with it xx

Hi. Sorry I’m coming to this thread very late but have you thought of hypnotherapy? It worked for a family member who was absolutely terrified for years. He still doesn't like getting blood tests etc but he can actually get them done now.

Hard though it is you need to strike a balance between stepping away and trying to take over.

She is still more a young girl than a woman, and you are her parent, it’s still your job to do all you can to make sure she gets the treatment she needs, because right now you understand the impact of not getting it better than her.

Hefty use of bribes and creation of momentum might be better than trying to talk to her. It may just feel embarrassing to talk about. Research a counsellor so the option is there if she wants it, don’t force it. Threats can be good in combination with bribes! But try just the bribes first.

I totally agree. In my experience, in a similar situation, teens actually blame you afterwards if you don't insist that they do something that you are 100% sure will benefit them long term. Yes, I know, it is completely illogical when they have avoided, protested, shouted, cried, and made everyone's lives miserable at the thought they might have to to the thing they don't want to do. After putting up with all of the opposition and protestations, and after trying every tactic you can think of and then trying again, you finally give in. And low and behold, three or four years later, we the parents are blamed for "not making them do it". And when I say "you didn't want to do it and refused every single suggestion we made to make it easier for you" the reply comes back ,"well you were the adult and I was just a child". Just one of the joys of parenting!

Have you had any luck with this @PangolinPie?

I couldn't believe it when I read your post and genuinely thought that I had posted about my dd and forgotten!

We are in the exact same situation. My 17 year old dd hasn't started her periods and is needle phobic (despite multiple self piercings!!) Only difference is we don't know what is causing it, so there are several possible causes worrying my mind! She just won't engage about it at all. Head in sand, very closed off as a person. It's so hard to see her self sabotage in this way.

Hi @Nordstrom sorry I've just seen your message! Wow that's pretty amazing (perhaps not the right phase but ykwim) that our dds situations are so similar. I wish I had some words of wisdom to impart but I don't to be honest. Is your dd getting any help with her phobia? Although my dd is very head in sand, she did at least agree to therapy which is a step in the right direction. I have been through the full gamut of emotions about this, from over-involved control-freakery trying to manage everything about it, to withdrawing completely and very depressed about it. My dd is also ASD which I think is playing a fairly large part in things. I've tried very much to change my tack in the last week or so as I know I was getting too over emotional about it which made her withdraw even more. I had an extremely calm chat with her (which took some effort on my part as I'm a natural over-reactor - not great I know) which she's reacted better to and although she's struggling to eat more still, she's so far being better at taking her medication/vitamins. Have you thought about contacting your GP yourself to get some advice? Although the problem is at this age, the GP won't talk to you about your dd specifically.

But really, I do genuinely think that once you've done your best to calmly offer potential solutions and support to try them, it's a case of stepping back. It's INCREDIBLY hard and upsetting because they are still very very immature as this age and more often than not, a parent is not the person they want to talk to, especially when they tend to bury their own emotions. I think it's just about being a calm constant in their life, which is something which is extremely hard for me to master. I'm going to try and get help for myself in managing my own emotions in this, based on the idea that you can't help someone who is drowning if you are also drowning yourself. Feel free to DM me if you want to chat more. I've felt very alone while this has all been going on and completely understand your worry and frustration.

FWIW DD2 also has delayed puberty and is now on oestrogen. I think the things they say about improving diet etc can be helpful, but really don't make a massive difference. Unless there's a serious eating disorder then it's mostly just genetic and will resolve in time (with possible help from a course of oestrogen). We did try at one point to persuade DD2 to eat more, and to have protein shakes, but she wasn't keen, and she has plenty of energy so it didn't seem like it was worth forcing things.

Have you tried asking the gynaecologist exactly what they need to check for with the blood test, and what the possible adverse effects would be of your DD starting oestrogen without the test if her needle phobia is going to make the test impossible?

@PangolinPie and how does she think she will be anaesthetised. Intravenous induction via a cannula generally!

@Bramshott was your dd also underweight? And can I ask how old she was when her periods finally started?

Yes I am planning to speak to the gynaecologist about why he's insisting on waiting until blood tests have been done.

@Gassylady it was something she said in desperation and hadn't thought through the mechanics of how it would happen. Have you got anything useful to add?

My Autistic DS had to be anaesthetised for minor surgery, they gave him something he breathed in from a mask first. No needles till he was out.

OP have you spoken to her therapist at all about this? I know it's a lot more problematic at this age, my DC are little so I get told what goes on in therapy sessions. I know they can't tell you what she's said or anything like that, but they may be able to provide some general advice on things you can do to support her. Also whether it would be worth bringing up the idea of taking medication to help her through the blood tests when she's ready. Benzodiazepines like valium are sometimes used in these situations.

@PangolinPie she is very small and slight. She's younger than your DD (not 16 until the New Year) and no periods yet despite oestrogen since earlier this year. We think she'll probably just get to that stage in her own time and try to keep relaxed about it (easier said than done I know).

OP this is so hard! I have been slowly overcoming a needle phobia myself.
I couldn't even touch my own arm in the same place as a blood test as it made me shiver. It's not the solution for your daughter but the only way I've been able to overcome mine is exposure as I needed IVF so had no choice but to have lots of bloods and injections.
I've gone from using numbing cream and having someone cover my eyes while I sobbed, to now having regular blood tests through pregnancy with nerves but no creams or crying.
I do think the longer you go without doing it, the worse it builds up in your head. Very difficult for your daughter though as avoidance is the obvious choice for her whether she needs the tests or not

@PangolinPie a gas induction is less likely to be offered for someone of her age compared to a very young child (risk benefit ratio changes) Generally we can offer heavy dose of reassurance, hypnotic language and sometimes “gas and air” to get the cannula in. I have taken blood samples after anaesthesia before but in the context of severe learning disabilities or dementia usually and where the anaesthetic was required for another procedure. If she can cope with piercings etc could she try some visualisation exercises to try and reframe this as the needle being part of a similar process and the cotton wool ball left at the end as the resulting adornment.