Thursday, February 9, 2012

The blood draw saga continues...

Despite having a couple of successful blood draws, unfortunately the trend did not continue with C’s next TEDDY visit. The 27 month visit started off with a big struggle putting the EMLA cream on at home. He had calmed down by the time we arrived at the TEDDY clinic, but he was still hesitant to come into the building, and when we got to the clinic room, he wasn’t his usual cheerful self but was very clingy and didn’t want to play with the toys. He wouldn’t even smile for the picture!

Eventually he settled down while we were going over the questionnaires, and he did great with height and weight, but when it came time to do the nasal swab, he got very upset again. Throughout the winter he has been sick a lot, so has had to go to the doctor when he’s tired, sick and cranky. At his most recent doctor visit, they did their own nasal swab to check for flu, but the way it was done was much more invasive than the TEDDY nasal swabs. I think that C remembered how painful it was, and he wasn’t happy to have to go through that again. He continued to cry throughout the blood draw, and couldn’t be soothed, even with a sucker, until it was time to leave.

Needless to say, I was frustrated that it didn’t go well, and I began to wonder if we should stop the study or take a break for awhile. I talked to some of the TEDDY clinic staff members about it and they recommended trying another no-ouch visit with some role-playing next time. It was possible that taking a long break would make it even harder when we did come back, and having another no-ouch visit would be a chance to show C that it doesn’t have to be painful to come to TEDDY. The role-playing would give C a chance to be in control (a big thing for 2 year olds!) and also demonstrate that the nasal swab and blood draw don’t have to be painful.

When we left the house for C’s 30 month visit, he said, “NO TEDDY!”, but he says NO to pretty much everything these days anyway, so I wasn’t too worried. This time there was no EMLA, so he was pretty happy when we got there and started playing with the toys right away. He actually wanted to do height and weight several times—I think he liked pushing the buttons on the scales. Instead of doing a blood draw, TEDDY staff member B demonstrated the blood draw on a teddy bear, and then C got to draw the teddy bear’s blood. He really liked “drawing” the blood, and putting the band-aids on the bear. C also gave nasal swabs to the bear, B, and me. However, he wouldn’t give a nasal swab to himself. I think it’s the nasal swab that he dislikes the most.

We took the pretend blood draw kit home with us, and plan to practice with stuffed animals at home before the 33 month visit. I’m really glad to have learned about this technique to help with the TEDDY visit and I can’t wait to see how it goes next time.