Advice needed for blood draw / 2nd appointment with psychiatrist

Discussion in 'General Parenting' started by Jules71, Oct 13, 2010.

  1. Jules71

    Jules71 Warrior Mom since 2007

    My difficult child (8 yr M, ADHD/ODD) has never had to have blood drawn. Our new psychiatrist ordered a blood panel. Does anyone have any advice for making this as easy as possible? I am pretty sure my difficult child will freak out, say he's not doing it, refuse, etc. I can just envision him hitting someone or knocking things over and running out of there. Maybe I can bribe him with something he wants - but right now all he wants is an airsoft gun and I don't think that is a good idea!!

    2nd appointment with psychiatrist today. I think he was ready to prescribe an antidepressant and I may have swayed him into thinking maybe we should try an increase in his Concerta first, so that is what we are doing. In all fairness, we haven't ever tried going up on his Concerta (we have with other stims in the past). His pediatrician-doctor thinks we never got to a high enough dose to manage the ADHD symptoms and although we were seeing increased irritation/aggression and some insomnia, she thinks it may not actually have been a side effect - but possibly just what was going on with him anyway. Ughh - we will see how this goes. I think psychiatrist thinks difficult child is depressed and that is where the irritation/aggression is coming from. Does anyone have a depression rating questionnaire they can share? I can't find anything online that you don't have to pay for and/or get from your doctor. I am surprised the psychiatrist didn't give us one.
     
  2. smallworld

    smallworld Moderator

    There is a prescription cream called Emla that you can put on the insides of the arms about 45 minutes before the blood draw to numb the area and make it less painful for the needle stick. That works very well for my daughters. Unfortunately, my son was so needle-phobic that we needed Ativan to calm him down, and even that didn't always do the trick.
     
  3. jal

    jal Member

    My difficult child started blood draws around age 4, as a result of exhibiting a symptom of leukemia (luckily, that was not the diagnosis). Since then he's been going due to medications...it's never been an issue, he hops up and throws out an arm and he's good to go. They do have numbing creams that can be applied before the needle (this is how his first one was done). You can ask the lab ahead of time if they offer it, or you may be able to get a rx from your dr.

    My difficult child is diagnosis'd ADHD & Mood. He never did well on ANY stims...we trialed them ALL. The psychiatrist would want to go up, we would try it and the aggression and anger were unbelievable. We had a great breakthrough using Prozac. Our difficult child also did not exhibit signs of depression. He's not perfect, but he's A LOT better.

    Good luck.
     
  4. Josie

    Josie Active Member

    My daughter uses the Emla cream also. I had to get a doctor to write a prescription for it.

    In the beginning, I also had to offer a pretty big bribe. Now, she is used to it and as long as we have the numbing cream, she is ok with it.
     
  5. Jules71

    Jules71 Warrior Mom since 2007

    Thanks - I will call his doctor to see if we can get the cream. Should I talk to him ahead of time about it, or just take him there? Arrghh.

    Jal,
    I don't really know for sure if my difficult child is depressed but the psychiatrist said depression in children can present as irritability/anger/aggression. Are your child's ADHD symptoms helped with the medications he is taking? I am afraid the increased dose will make things worse, but we haven't tried it and I guess we should before trying something else. It just sucks we have to go through this. I want a NORMAL life!! :anxious:
     
  6. Josie

    Josie Active Member

    If you use the cream, you will have to tell him because it needs 30 - 60 minutes to work. I was told put a lot of the cream on, not to rub it in, and cover it with a bandage to let it absorb.

    Before, if my daughter knew she needed a blood test too much in advance, she would obsess over it until it was done. This might be all weekend if the timing wasn't right. Until you know how he is going to take it, I wouldn't tell him too much in advance.
     
  7. smallworld

    smallworld Moderator

    I agree with Hope. We usually tell our kids a little in advance, but not too much in advance so they don't obsess about it.

    In terms of Emla cream, we coat the insides of both arms because you're never sure which the nurse will choose for the blood draw and then cover with Saran wrap. Works like a charm.
     
  8. KTMom91

    KTMom91 Well-Known Member

    Miss KT is still needle phobic, and cries and throws a huge fit anytime she needs bloodwork. I was amazed that she actually donated blood last week...but she said she cried the entire time. I'll tell her about that cream.
     
  9. shellyd67

    shellyd67 Active Member

    difficult child had bloodwork prior to him starting his medications just to make sure his liver was functioning properly and he had no heart problems. He also had an EKG ... He flat out refused to have both tests done when husband and I told him. We talked about the tests for a few days prior and told him stories of when we were young and had test done and how frightened we were. We assured him we would stay right by his side and when the day came he was a real trouper. It also made a huge difference that I clued in the phlebotomist and EKG tech before hand and they were both wonderful. I wish you LOTS and LOTS of luck !
     
  10. Josie

    Josie Active Member

    The saran wrap is a great idea.
     
  11. Jules71

    Jules71 Warrior Mom since 2007

    Oh my gosh, I am WAY stressed out about this - of course I will hide it and not let on that I am stressed. I am thinking maybe I should call the lab ahead of time, ask if certain days/time are better as far as who is on staff and trained to deal with this type of situation. Oh, and guess what came in the mail today??? A blood test kit for my husband to go have blood drawn (for a study he is participating in). How is that for timing? Maybe if difficult child sees dad do it and everything is ok, then he won't feel so scared. They have to fill many tubes though. Of course, Dad is a major baby when it comes to needles so that might not be good. I don't know. Maybe it would just be better if someone else takes him, like my Mom, or just Dad.
     
  12. jal

    jal Member

    Jules71,

    I want a normal life too. I never counted on this one. Honestly, the ADHD portion for my child is not helped by the medications he's on. He's very active from the moment the sun rises until it sets. He sleeps like a log though and is in bed by 8:30 every night. He still bounces and is chatty, but it's not a mania...and he never crashes, depression wise - but crashes in the sense of a 2 hour Sat nap occasionally. The Prozac struck something in him two years ago that made him finally open to work and learn at school. Once we started it he just blossomed in school (this kid only has missed 1 day of school since the first day of K). But he is in a therapeutic setting since 1st grade (he's there for behavior, rage issue, but functions 1.5 years ahead of his grade level).

    At home things have been better. The rages have lessened since he's become older (8). The threatening behavior is few and far between, but he is physical, in moving his body around, but not attacking us. There was a period of time years ago that he was. He's come along way, but we've had help. Behaviorists in home (starting at age 3). psychiatrists, Tdocs, neuropsychologist, reg psychiatric evaluation, 1 hospitalization age 6, in home voluntary services, school district excellent assistance, IEP since first month of K, para, summer para, therapeutic horseback...you get the idea. husband and I have been at it for 5 years...I lost a job of 9.5 yrs because of difficult child. All that said I just had to speak to him for jumping on our bed...but he's been hyper since he came home and today entailed school, playing in yard with-dad after school, therapist appointment and after that soccer practice. So no, I'm sorry in the ADHD respect it doesn't, but for my difficult child it seemed to help ease the triggers that caused the rages. Again I can't say that its the medications or combo of medications and services we've been able to access that have helped.
     
  13. Wiped Out

    Wiped Out Well-Known Member Staff Member

    Jules,
    I had never heard of the cream but they use to give difficult child some sort of a gel pack to numb his arm when he had his blood drawn. He had one terrible experience with a blood draw when he was younger and I thought he would always hate it. However, he now gets his blood drawn weekly with no issues (he even used to ask for the biggest needle).
     
  14. idohope

    idohope Member

    No advice, just empathy. I dont know what I would do if a psychiatrist wanted a blood test on difficult child. I would make sure she got it done but it would certainly be a draining experience for me! To figure out how to get her there, to get her there and to get her to stay there through it.

    Let us know how it goes.
     
  15. Jules71

    Jules71 Warrior Mom since 2007

    Thanks everyone - we'll see how it goes. I think I am going to have my Mom take him. Do you think that is terrible for me not to go? I just think she will be able to calm him more and his defiance will not be as bad with her.

    Jal,
    Can I ask you what dose of prozac your difficult child takes? What was the starting dose? Any negative side effects from it?
    Thanks,
    Jules
     
  16. smallworld

    smallworld Moderator

    I think whatever works is what you should do.

    Hang in there, Jules.
     
  17. DammitJanet

    DammitJanet Well-Known Member Staff Member

    You may want to ask for the IV specialist because they are the best of the bunch for blood draws. After I was in the hospital so long with the meningitis my veins started collapsing left and right and they just couldnt get blood out of me all the time the way they needed to every day. They were sticking me so many times. I finally put my foot down and said I wasnt taking it anymore and would only allow the IV team in to do blood draws anymore. They got witchy with me but it was my arms they were hurting. They were actually black and blue.

    The cream is good if the doctor will rx it. They try to tell me they dont have it. Hah...I know better. I tell them we can sit here for hours and argue the point...lol. I have gotten much better now though.

    One thing you can do is even after you get all that stuff on that will make him numb is to distract him from watching what is going on. Get on the side that they arent drawing and show him a video on your cell phone...or a new toy or something that he needs to watch on the opposite side from the needle. My phone shows tv so I would put disney on tv and put it over on the opposite side. Or bring an Ipod that shows videos and let him watch one on there.
     
  18. rainyseason

    rainyseason Guest

    What you need is a good phlebotomist. difficult child has liver function tests every three months with his epilepsy medications. They started very young and we quickly learned that some of the phlebotomists are NOT great with kids (IE: hurry up I got other kids after you! sit down already...your getting on my nerves!). Anyway, we found one who is a Godsend. Uses the smallest size he's got and laughs and jokes with him beforehand. Now whenever we go, he asks for Eric to draw his blood. He won't let anyone else do it. I even call ahead to make sure that Eric is on duty before I take him in. There may be trial an error at first. But once you find a good one, stick with them:) It makes life a whole lot easier!
     
  19. jal

    jal Member

    Hi Jules71,

    difficult child started on and only has taken 20mg 1Xday in the am for the past 2.5 years. No side effects. We only saw it as a positive when he started because he began to excel in school. It was more for anxiety than depression. We are going to start titrating down tomorrow per psychiatrist as we want him on the least medications possible. So tomorrow he will start 10mg 1Xday.

    My difficult child is also on a low dose of Seroquel. 100mg am, 50mg afternoon and 25mg early pm. THAT'S the one medication I want gone as I think the Prozac (Fluoxetine) has been beneficial. Like I said before not perfect, but A LOT better.

    One AD he was on was Nortriptyline (Pamelor) after a hospitalization. That had awful side effects...drooling and tics...got him off of that ASAP.
     
  20. Jules71

    Jules71 Warrior Mom since 2007

    I know your pain DJ! I have very tiny veins and they have to use the smallest needle. I always get stuck at least twice any time they need my blood. I've even been stuck in my feet. I was stuck 18 times to try to get an IV in when I was in the hospital to deliver my youngest son. They had everyone in the place trying to do it! It was ridiculous. There is one guy at my OB's office that can do it every time. I had bad experiences when I was a kid too having to get blood taken. One really crazy guy wouldn't let my mom try to distract me, he made me look at it and watch him doing it. I have never forgotten that. I am pretty ok with it now, but I don't like it and it causes me some anxiety because i know they will have a hard time. I feel so bad because I want to be there for him and I want to be able to comfort him - I just don't know if it will make it worse or not. Can you tell my anxiety is rising?
     
Loading...