Helping Your Child Cope with Painful Medical Procedures

Helping a child through unpleasant medical procedures is a difficult
task that parents of children born with EA/TEF must face. By preparing
yourself, you can better prepare your child to cope with invasive
medical procedures.
Improve your child's Understanding:

• Obtain information and explanations from medical staff to increase your own understanding of the expected procedure.
  
• In explaining the content of the procedure, relay factual information (use demonstrations, booklets, etc.)
  
• Suggest coping strategies. ("You can squeeze my hand until it's over.")
  
• Provide opportunities for active involvement rather than
  allowing your child to become a "passive victim". ("You can hold the
  band aid until we need it.")
  
• Give a brief explanation of why a procedure is necessary.
  This dispels any fantasies about medical treatments being viewed a s
  punishment.
  

In providing explanations, use vivid descriptions and simple comparisons:

1. colors ("The medicine will be thick and white.")
   
2. sounds ("The machine will make a loud sound like a vacuum cleaner.")
   
3. feelings and sensations ("It will feel cold.")
   
4. size and shape ("The electrodes are about the size of a dime.")
   

Create Positive Expectations:

• Avoid words children don't understand such as medical terms or
  jargon. Define a medical word the first time it is introduced to your
  child. ("Surgery is another word for operation." "A surgeon is a doctor
  who does surgery.")
  
• Avoid words with dual meanings such as: shot; deaden; put to sleep; stretcher; stool; dye
  

Avoid emotionally charged words. Say:

• "The needle will slide gently under your skin" rather than "the needle will stick to you".
  
• "After the surgery, your leg will feel uncomfortable " rather than "it will hurt".
  
• "When the IV is removed, the nurse will ease the needle out" rather than "...pull it out".
  
• "The surgeon will make an opening" rather than "cut".
  

Remember positive words act as indirect positive suggestions. Try to
convey a positive, rather than a scary attitude by setting up positive
expectations toward the procedure. Avoid inadvertent negative
suggestions. Things that sound innocent enough such as "You look like
such a brave boy. I know you're going to do such a good job" can
instead convey in your child's mind, "This is going to be awful!"
It is important to always be open and honest with your child
concerning their illness and treatment. Ensure that your child is free
to approach you concerning any fears or questions he may have.
Reduce Anxiety

• Often children's expressed discomfort is derived more from anxiety than from the actual procedure itself.
  
• Offer your child emotional support by being present during
  the procedure. However, if you are anxious, that anxiety can be
  perceived by your child.
  
• Having a role to play, such as holding your child's hand, can counteract your own sense of helplessness.
  

Encourage relaxation through breathing techniques your child can
practice. Relaxation takes place on the exhale phase of a breath, so
promote "blowing" exercises to be used later at the time of stress.
Your child can make noise through his lips or teeth; blow a pinwheel or
soap bubbles; pretend to blow out birthday candles (use your fingers as
candles and fold them down once he blows).

• Have your child tense then relax his muscles ("Make your arm tight and stiff; then let it loose ...Ahhh!")
  
• Help your child to focus attention by limiting his
  perception. Too many people talking all at once can be confusing and
  heighten anxiety. Designate only one person to talk directly to your
  child. If your child wants to focus on the procedure, allow it to
  happen rather than trying to direct his attention away from it.
  Otherwise, encourage your child to look at one thing, to hear one thing
  or to think about one thing. Relaxation comes from narrowing attention.
  
• Use imagery to focus your child's attention on something far
  away from where you are. Using your imagination, take your child to a
  favorite place. Stimulate his senses by asking him specific questions
  and guide him through the recreated experience. Don't just ask about
  it, visualize it in detail.
  
• Distraction can narrow attention and help your child focus
  on one thing. Use external distractions such as posters, counting holes
  in the ceiling tiles or petals on a flower, or internal distractions
  such as counting breaths or saying the alphabet.
  
• Positive self-talk enables a child to be in control. Remind
  your child when a procedure has already been experienced. Your child
  can then say, "I've had this before. It only lasts about five minutes."
  

What you as a parent do with your voice is important. Volume and
pitch often increase during stressful situations, but if your goal is
to relax your child, reduce the volume and level your pitch. Talk in a
monotone voice. Speak lower, quieter and slower. Use words that carry a
relaxed feeling: Heavy; Relaxed; Warm; Limp; Tired; Quiet
Provide your child with genuine choices that re-establish some sense
of control. ("Do you want to lie down or sit up?" or "Which finger do
you want your blood test in?") Refrain from giving an apparent choice
when there really isn't one. )"Are you ready to have your I.V.?")
Teach coping mechanisms ahead of time to help your child feel "in
charge". ("You can say 'ouch' real loud and squeeze my hand tightly.")
When you are familiar with the procedure, you can coach your child
through the entire treatment. Request information from the medical
staff as needed.

Source: Eatef.org