Blood tests- how to?

[confustication]

My two year old. is now undergoing testing for autoimmune disease. (This poor guy, he seems to be the one who has more bumps in the road than any kid should!)

We ruled out most allergies as a reason for ongoing hives/dermographia and are not looking at autoimmune disorders (given my family history and my personal history- this is a strong possibility. We took a trip to the specialist yesterday for some testing, and we tried to do blood draws. They didn't go well at all- and only a micro vial was drawn for a cbc by the time both arms had the veins blown out completely. Since it was after 5pm at that time, we headed home (4 hours away from this hospital/provider) and will have to have the rest drawn at a closer lab.

I have drawn blood from kids this young, and while I know it is hard in general, my son is *by far* the worst I have ever seen. Even restrained by three people, we could not get a successful draw. Having worked in the medical field and done many draws myself, I have never see a child with such an overwhelming fear/panic reaction- it was not a reaction to the needle, it was a response to the restraint. He is preverbal- and has some global delay, so talking with him isn't going to help.

Suggestions? I am looking for btdt/ this worked for us ideas. Well, that, or a magic wand- maybe both.

[meg-momto2]

my DD(3yo) has a horrible doctor phobia. actually it more of a stranger phobia but since doctors have to touch her it's even worse. we had her blood drawn once when 18 months old for Alcat testing. i sat with her in my lap and wrapped my arm around her tightly and held her one arm down. the nurse was able to help hold her arm while getting the blood. it wasn't pretty but we got it done. i've considered using calms forte for kids or rescue remedy to help her stay calm but it probably would do much help. i'm not sure what to say about blowing the veins. i would do my best to find someone who has lots of experience with pediatric draws and can get it done right and quickly.

[confustication]

Originally Posted by meg-momto2

i would do my best to find someone who has lots of experience with pediatric draws and can get it done right and quickly.

Sadly, yesterday was our best shot at that. I did call the lab to ask what the best time would be after explaining the situation. The phlebotomist I spoke with sounded uneasy, but checked with his superior about the best time.

If it were something that could wait, we would, but we need to figure out what's going on with my son so we can better help him.

[sbgrace]

That sounds horrible. Poor guy and mommy too.

The best pediatric "drawers" in my experience have been ER at pediatric hospitals (best actually) and PICU people. They are used to little veins and panic I think. My son used to be an absolutely horrible stick as in lots of blown veins and "misses" and person after person before we would find someone who got it. In his case it was a lot his veins though. After a horrific hospitalization experience with that stuff we started requesting the above people at the outset. I don't know if that is possible for you? Short of that I wonder if they could do a mild sedative like versed? EMLA cream will help with pain but I don't think that's your main issue and you do have to use it carefully.

[confustication]

Originally Posted by sbgrace

That sounds horrible. Poor guy and mommy too.

The best pediatric "drawers" in my experience have been ER at pediatric hospitals (best actually) and PICU people. They are used to little veins and panic I think. My son used to be an absolutely horrible stick as in lots of blown veins and "misses" and person after person before we would find someone who got it. In his case it was a lot his veins though. After a horrific hospitalization experience with that stuff we started requesting the above people at the outset. I don't know if that is possible for you? Short of that I wonder if they could do a mild sedative like versed? EMLA cream will help with pain but I don't think that's your main issue and you do have to use it carefully.

Our nearest pediatric hospital is about 1000 miles away. When I delivered this child, the nursing staff had trouble finding *my* veins and, in fact, I gave up and did one stick on myself for them because I refused to tolerate any more failed attempts. (I have a great deal of clinical experience and a ton of IV starts/blood draws throughout my work history as well as being a cancer survivor, and knowing where the scar tissue is and isn't- it's less scary than it may sound initially when that is considered.)

I am going to call our doctor today to request an EMLA script- it won't solve the problem, but if it at least makes it a little less traumatic for him I will go with that. I have had to work really hard at getting him past a fear of hospital/clinical settings over the past few months so he could succeed in his OT/PT/Speech sessions without spending 30 minutes just getting over walking in the door- and I feel like I'm taking 10 steps back by subjecting him to all this.

[mrsfru]

I wouldn't be against requesting anti anxiety meds or light sedation (like gas, that's reverseable immediately) for a child for something that's traumatic for him. If it's really that necessary, then your doc can help find a med that will allow for the blood draw without so much trauma.

Does he like to wear headphones? If so, you might be able to provide him w/a "buffer" of kid's music, story on CD, or calming sounds before and during. Also, a heavy blanket to wrap him in from home might help him to feel more safe. I haven't used Rescue Remedy or flower essences w/my kids, but it would be worth a try. It always helped w/our dogs!

We just went through this w/my 4 yr old nephew. My child went first for a blood draw to show him what happens, and then my sil and I had to help hold him, as well as distract and reward him w/goodies (gum, candy, and a prize when he let them do the blood draw LOL).

Best wishes!!!

mrsfru

FWIW, I had recurring hives for ages and ages....had allergy workup and testing several times.....have had testing every year for 10 yrs for autoimmune disorders....and all that's been found is an allergy to dustmites, mold, and cats that don't usually cause me the hives and no positives on any of the autoimmune tests. Eventually, I figured out on my own that the hives (and severe breathing problems) always happen after or during exposure to new building materials containing formaldehyde, like new carpet, and some cleaning chemicals. Later, we discovered that I have an MTHFR mutation that means I can't convert folic acid to folate (and w/o folate, you can't break down chemicals very well).