There will be blood

October 11, 2012 by in Anxiety, Autism, SPD with 9 Comments

As part of my son’s four-year wellness check last Monday, the doctor issued orders for blood work. My husband and I both dreaded this news. We remembered the last time that we took Philip for a blood test. The phlebotomist became quite stern with me. “You can’t let him move,” he chided me. In the end, Peter ended up holding a crying, squirming Philip as the blood was drawn. I think Peter had been as traumatized by the experience as Philip.

Despite our feelings, we couldn’t put off the testing since the preschool requires it as part of an overall report from the pediatrician. The wellness report is mandatory in order for Philip to attend.

Having both moved and changed insurance providers since that blood draw, it was necessary for us to determine a new place to take Philip for the testing. Many years ago, my mom developed a blood clot in her leg following surgery. Since that time, she has had a couple of other clots. As a result, she will stay on blood thinners for the rest of her life. This requires that her clotting factor be frequently monitored. I asked my mom where she goes. When I found out she goes to one of those laboratory chains, I verified that this place was covered by insurance. Then I set about trying to make sure that the visit went as smoothly as possible.

I started by calling the local facility. I explained that I had a four-year-old with autism. Was there a technician who was skilled with children?

The woman who answered the phone suggested that I try a different branch of the company in a nearby town. She stated that they have two workers instead of one.

When I called the other facility, I got voice mail. When I called again and explained my situation, the student who answered told me she would have to check and call me back. When she phoned, I learned that, yes, they sometimes have two staff members working. This is because the office has an extremely large volume of clients. Yes, I could schedule an appointment and reduce my wait time. However, I was told the only way to do this was online. The woman informed me of their off-peak hours. Not surprisingly, these conflicted with either Philip’s school or my work.

I decided that, rather than upping the anxiety (both mine and Philip’s) by driving thirty minutes to a busy facility whose location I would need a map to find, I would schedule my appointment at the local branch. It is located across the road from our grocery store, only five minutes’ drive from home. I booked the appointment using the online system, selecting a time that wouldn’t conflict with Philip’s school.

****
Many children didn’t have school since today is Columbus Day. Philip’s preschool held its annual Grandparents Day instead. The schedule for the day was altered. Students were to arrive later than usual with their grandparents or special guests and stay for only ninety minutes. During this time, there would be a potluck meal in the cafeteria.

Before picking Philip up this morning, my mom went to get her blood work done. Remembering my questions about where I could take Philip for his testing, she asked the phlebotomist if they accepted children.

The technician answered that, yes, children come to the lab. In fact, she had drawn the blood of a child just that morning. It was a boy who didn’t talk.

The small talk continued. Mom told the technician that she was getting ready to go to Grandparents Day.

What a coincidence, the technician remarked. Just that morning, the woman who had been in with the child had mentioned he was going to Grandparents Day, too.

My mom puts two and two together.

“Was that boy’s name Philip by any chance?”

****
I scheduled the appointment for this morning since Philip would not be going to school until later. I told Peter that he didn’t have to join us. He finds it hard to stand by while our son cries, knowing that there is little he can do comfort him. “You can stay home and be the hero,” I assured him as we headed out the door.

The appointment was at 8:00 am. We thought this would be a good time since it would give Philip a chance to wake up, but not make me too late for work. Of course, no one consulted with Philip who woke up at 4:48 am, fell back asleep around 6:00 am and tried to remain so until I persuaded him to wake up again just after 7:00 am.

As soon as I got Philip ready, we drove to the facility. Even though I had an appointment, I thought they might be able to take us earlier if it was too crowded.

The only car in the lot when we arrived probably belonged to the staff member.

We were able to walk in, sign in and go straight to the room. Philip balked a bit. I think the room reminded him of a doctor’s office, but had enough differences that he was willing to enter. The staff member took our orders and insurance card and began inputting our information into a computer. I took off Philip’s coat and got out a toy. He played with this while rocking side to side.

When the paperwork was complete, we moved to the chair. I could tell Philip was nervous, but he didn’t start to cry until she put on the tourniquet. Once she found a vein, she removed the tourniquet while she assembled the materials for collection.

I explained that Philip was non-verbal, so there was not much I could do to prepare him. The technician assured me that, in her opinion, there really isn’t much one can do to prepare any child.

I thought about this as I watched the procedure. I thought about how it feels to have a tourniquet pinch your skin. I thought about having a stranger sitting so close, alternately thumping and stroking your arm to find a vein. I thought about the wet coolness of an alcohol wipe cleaning the site. I thought about the sharp pinch as the needle breaks the skin. I thought about that funny feeling I get in my stomach as the needle hangs in my vein. I thought about how I start to think about what would happen if I twist my arm at the wrong time or if the needle goes in too far. If I, a neurotypical adult, experience such a wide variety of discomfort and anxiety, why wouldn’t my child? All I can do is murmur, “I know, sweetie, I know.”

The phlebotomist worked calmly and efficiently. She,too, spoke soothingly to Philip, but focused on collecting his blood as quickly as possible. He cried. He cried until he gagged, but I was able to hold his arm straight.

When the needle was removed and gauze put over the needle site, I folded Philip in my arms. His crying was slowing. There was a temporary increase when the bandage was applied, but it subsided into snuffles by the time Philip’s coat was back on and we were headed to the car.

I gave Philip milk on the ride home. His eyes were read, but he saw something that made him giggled. He was subdued when we got home and didn’t like the sight of the gauze and bandage, but quickly returned to good spirits. I had to rush off to work.

***
I called my mom during my lunch break. I wanted to find out how Grandparents Day went. She told me about the morning and said that she took pictures.

It was during this phone conversation that Mom told me about her visit to the lab this morning. She told me that the technician thought Philip did really well. She also complimented him on his long eyelashes.

Before Philip and I had left, I half-jokingly remarked that Philip would never let me take him anywhere again. The technician said, “You’d be surprised how quickly they forget.”

We shall see.

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About cynkingfeeling

I am working mother who is trying to see the glass as half full. My stay-at-home spouse and I are raising a four-year-old autistic son. The three of us are developing a sensory life with our dog, Roscoe, in Ohio. I blog about my son over at "that cynking feeling" (http://cynk.wordpress.com/).

    Comments

  • Jennie B


    This sounds like progress to me! Great idea going early and being able to walk right in. Waiting rooms are really hard for my son, who has a hard time sitting still or knowing how to wait appropriately and not destroy the room.

    My son is also non-verbal, and things like shots and blood draws are really hard. He doesn’t mind the actual needle so much, but we have to hold him (restrain him, really) so that he doesn’t move around or grab the needle. But it sounds like you all did the right thing, keeping things calm and hooray for the technician who let you handle your child and took care of her job quickly and efficiently.

    • cynkingfeeling


      Jennie:
      It feels wrong to be restraining one’s child, but what else can we do?
      I’m hoping since this is a small place but we will luck out and get the same technician when we return.

  • Reinventing Mommy


    I cringe every time my son’s GI orders a blood draw. He always tries to send us to the lab downstairs, but they never seem to handle my boy well. The local children’s hospital is across the street from his office, so I’ve started taking him there. They do a much better job and make the whole process very quick. He cries and squirms, but their nurses handle it so that I don’t have to be the bad guy.

    Just a thought if you have access to a children’s hospital close by…but at least it’s over for this go-around, right?

    • cynkingfeeling


      After that appointment, we got a postcard in the mail saying that one of the children’s hospitals in the state has opened a branch in the next city over. Going there would have added to the time involved, so I think we ended up at the right place.
      I’ll know again in four weeks because, unfortunately, it’s not over for now. The results came in with an elevated lead level, so we’ll be monitoring him for at least six months.

  • Jess


    So glad to hear that it went better this time! Angel hasn’t had to have blood drawn, so I’ve been spared going through that so far.

  • Heather Finnegan


    When my little guy first had to have blood drawn, to test for lead (we live in a 120 year old house) we went to a local chain too. Our doctor put on a numbing cream and it might have helped, but I could still hear him scream. I sent dad in, and I cried feeling bad I didn’t go back with him too. Our new doctor has a machine “in house” and just does a tiny finger stick and it’s so much easier.

    When my guy got hurt this summer and required emergency care we went to the Children’s Hospital downtown, and it was a great experience (except for the reason we were there). It was worth the 40 minute drive!

    • cynkingfeeling


      As I mentioned in my comment above, the results came back with an elevated lead level. I was told it was good it had been a venous draw rather than a finger prick since the former is more accurate. Still, we’ll be going back for more testing every four weeks or so until the levels are reduced.
      This was definitely not the news I wanted to hear.

  • S.


    Oh, geez. That sounds awful. I can remember those times, being that young. Honestly, getting blood drawn still bothers me a bit. But back then…I can remember having to be held still a few times. Mainly I was expected to “suck it up”, though. He’s lucky to have such understanding parents. Hmm…not exactly the same, but the last time we all had flu shots one of my younger siblings screamed until her nose started to gush blood. …none of us have gotten flu shots since then. The Ordeal no longer seems worth it.

    • cynkingfeeling


      It’s as you said: all I have to do is think of how I feel getting blood drawn to understand how uncomfortable and frightening it must be for my son.
      Sorry to hear about your sibling’s experience with a flu shot.

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