Both girls have their CF appointments tomorrow. Kelsie routinely goes for her CF checkups every 3 months. Mackenzie went every month for the first 3 months but is now being seen every 2 months. So the timing works out this time for them to both be seen together again. And pretty soon, they will both be seen every 3 months and will typically have clinic visits together.
This will be our 2nd double visit and I am praying it goes better than the last.
One of the reasons the last visit was so memorable was because of the absolute horrific experience we had with Kelsie as the nurse tried to obtain her sputum culture. This is a simple throat swab and not particularly painful, just uncomfortable. It’s basically the same thing as getting your throat swabbed for strep throat, except they take the sample from a specific area in order to try to get a sample of sputum. (They do this to check for any bacteria that might be growing conspicuously down in her airways.) She has had this test at every visit since birth so she expects it, but she has also developed a great fear of it and dreads having it done. Now, this is a child who is not anxious about much of anything. She is secure, confident and independent. She looks forward to going to clinic, loves the staff, giggles during the blood pressure, pulmonary function tests, and physical exam. She is always chatty and happy to be there. She is also a kid who will sit and watch them stick her with a needle, draw her blood, and not flinch – all because they put on the EMLA, aka, “magic cream”. Like all kids at this age, the anxiety is way worse than the actual insult of pain.
I believe in preparing kids for what’s going to happen, although I realize that may not work for all children or all circumstances. But in general, I think its a good idea. I have always been honest with Kelsie. When she has to have a shot, I tell her that it is going to hurt a little but that the pain will go away quickly, kind of like stubbing your toe. I tell her that it is okay to cry afterwards if it hurts but I ask her not to cry or kick and scream before because she is scared. And I tell her that it will go faster and hurt less if she is still.
She has been fighting this test since she was old enough to fight it and I have always had to hold her down. The last time we went in, we had talked about the throat culture several times leading up to it. I really thought she was ready and that it had finally sunk in that if she just sat still and opened her mouth voluntarily, that it would be over in seconds. She said she was going to be brave and I really felt positive that it was going to go better. But wow!
It was TERRIBLE! Teeth clinched, hands over her mouth, head twisting, legs kicking and flailing, throwing her head back, sweating, hair matted to her face…for 45 MINUTES! It took 3 of us to hold her down and they eventually made me leave and told her I couldn’t come back in until she did it (which really made me mad if I’m honest, but it worked). I’m telling you, I did not even recognize this child! It was so heartbreaking and infuriating at that same time! We were all so emotionally drained after that experience and still had to continue with Mackenzie’s visit afterwards. We didn’t get out of there until after dark and everyone else in the clinic had left. I will not go on about this any longer, but it was easily one of the worst visits we’ve had and I want to avoid it from ever happening like that again!
So for tomorrow, I am trying something new. I talked to Kelsie about a “magic lollipop” before the last visit but she seemed so confident about doing it without crying that I didn’t even pull it out first thing. I tried giving it to her middle of the way but it did nothing. She took a few licks and immediately put her hands back over her mouth. But this time I am doing things differently. First of all, I found this great little lollipop that just looks magical! Right!?
A colorful butterfly! And secondly, I am going to give it to the nurses to bring in which will make it look more official. I thought this was a smart idea and then Kelsie confirmed it when she asked me tonight, “Mommy, I want to try a magic lollipop, but not YOUR lollipop…your lollipops don’t work, I want it the nurse to give me a magic lollipop.” (She doesn’t even know I have this thing!) She is remembering how the nurse offered magic cream for her last blood draw and that actually worked! So she trusts those nurses! Now, the “magic cream” isn’t actually magic…it is a medicated cream that numbs the skin. But this sucker, of course, is nothing but candy! Besides easing the anxiety enough to make her open her mouth, it’s not going to do a hill of beans to decrease the pain and discomfort. But I’m not too worried about it because the test isn’t that painful to begin with. So when it doesn’t hurt as bad as she thinks its going to, she may actually think the sucker did something. And if it does hurt, it extremely short lived and at least she didn’t have to endure being held down and tortured for 45 minutes, which is WAY worse. So we’ll see how it goes! I’ll let you know tomorrow if it works!
So beyond the lollipop, there are other things I do to prepare for these visits. I know they can take a while and I plan on being there at least 3-4 hours. So just imagine you are going on a 3-4 hour road trip with your kids. That’s kind of how I prepare. I pack a bag with snacks and activities to keep her occupied (soon “them”, but for now, Mackenzie is pretty easy to occupy). I often buy some new things like coloring books, puzzles, stickers, pens, activity pads etc. to keep her entertained. Here are a few $0.97 things I picked up on the Valentine aisle at Walmart today. Sometimes drawing and stickers is all it takes to occupy her.
I really never know how long we will have to wait, and I don’t always even need all of these things but it does help to have them on hand. When I am opposite my role as the mom, and sitting on the other side of the chair wearing my NP hat, I often see kids acting out and misbehaving. I recognize that more often than not, they act that way because they are bored and tired. Kids have a short attention span so you can’t expect much from their behavior when they are sitting for a prolonged amount of time in a doctor’s office.
So I try to have some things that are new and interesting for Kelsie and that will make the time go by faster. It also makes a day at the doctor fun for her. I don’t typically take the iPad or use my phone because I think it makes a kid frustrated when you suddenly have to take them out of the trance of the game or show they are into and make them cooperate for the exam. I also like for Kelsie to be a part of her visit. If she is lost in the screen world, she doesn’t even pay attention to what is going on around her most of the time. I like for her to answer questions about what she is eating and how she is feeling. I like for her to have a chance to tell her doctor all the new things she is doing and what makes her happy and if there is anything bothering her. And I think it is important that she hears what kind of questions the doctor asks me and how I answer them. So I try to have things for her to do while we are waiting but when the doctor is in the room, she is always very much a part of the history taking and story telling.
Tomorrow, I am also taking a piece of bribery with me! I will tell you I try not to practice bribery often. I do not believe in consistently bribing kids to get them to comply with what you ask of them. It actually drives me nuts when used as a method of behavior modification (won’t get on that soap box now!) But, I do believe using a reward to motivate a child can be a good thing at times. And in this case, I will try almost anything to prevent what happened last time and to get my child over this fear. So I put that unicorn and box of sour patch kids (her favorite “animal” and her favorite candy) from the picture above into a bag and sealed it up with an important message…”BE BRAVE”. She will get to open it after her throat test IF she is brave and doesn’t fight it like last time. Ok, so my husband told me I will probably let her open it either way and I can’t promise that I won’t. But she will at least have to wait until AFTER the test! And the curiosity of what’s inside that pretty pink bag will surely be motivation for my child to just open her mouth and get the test over with.
Another thing I try to do before our visits is be positive. We have been talking for a week about going to see Dr. Dellon and Kelsie is really excited. She even asked me the other night if I had her phone number so I could call her and tell her about all the new foods she is eating. I assured her we would tell her in person when we saw her this week and even made a list of the foods so we wouldn’t forget. (More on how I have gotten my picky eater to like these foods later!)
Her doctor really such a wonderful person and I think the world of her. I couldn’t imagine a doctor being a more perfect fit for my girls and for our family. We are really so thankful for her. So when we talk about going to the doctor, I talk about going to see our “friends”. The staff all know us well, are so kind to us, and we enjoy catching up with how everyone is doing. Kelsie even made a Valentine card for Dr. Dellon today and she said she wanted to write “I love you, Dr. Dellon”. It really warms my heart that she has such a great connection with her already. We also picked her some red velvet muffins for the staff today and Kelsie said she wanted to give Dr. Dellon TWO valentines…a muffin and a beautiful dance. 😉 Then she proceeded to show me this ballet dance in the middle of Harris Teeter.
So tomorrow is going to be a long day! Bags are already packed so I’m not running around crazy in the morning before trying to get Kelsie off to school. We start with PJ and pancake day at preschool in the morning followed by the clinic visit at 1:00. I don’t like doing clinic visits in the afternoons because we get out so late, but I also don’t like for it to interrupt Kelsie’s life more than it has to. She enjoys preschool so much and tomorrow’s “PJ and Pancakes” day is one of their favorite events so I hate for her to miss. Nathan took off work tomorrow so we will go to the PJ/Pancake morning at her school, have lunch together after school, and then go to clinic. Kelsie also has dance in the afternoon if she gets out in time. I don’t know how Mackenzie will get any sleep tomorrow but we will figure it out. It should be a fun but exhausting day, for sure. Thankfully, a very sweet and thoughtful friend from church offered to bring us dinner tomorrow so I don’t have to worry with what we are going to eat afterwards, which will help immensely after such a long day. Feeling so grateful for all those who support us! Family, friends, church, and the clinic staff.