Childhood Cancer

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Your Child in the Hospital

Psychological method

There is no fear greater than fear of the unknown. If children understand what is going to happen, where it will happen, who will be there, and what it will feel like, they will be better able to cope. Before any painful procedure, you can ask the hospital’s child life specialist, psychologist, or nurse to discuss the upcoming procedure with your child.

• Explain each step in the procedure. Even if you think your child understands, ask him to tell you what he thinks will happen. Many parents are very surprised by their child’s misconceptions.

• If possible, meet the person who will perform the procedure and let your child ask questions.

• Tour the room where the procedure will take place.

• See the instruments that will be used.

• Allow small children to play the procedure with dolls.

• Let older children observe a demonstration on a doll.

• Show adolescents videos that describe the procedure.

• Encourage discussion and answer all questions.

Seven-year-old Tayler needed frequent blood draws to monitor the level of Dilantin® given for seizures. Before the first blood draw, we bought a new doll and poked her with needles. Then we went to the lab and met Barb—the technician. She told Tayler about her dogs (their pictures were on the walls). Barb and Taylor really connected. Barb showed her the needles and let Tayler watch some people have their blood drawn. Barb reassured her that, “I am very good and very fast at this.” Tayler felt much better after the visit.

There’s no substitute for good preparation to help your child get through a medical procedure. But you may also be able to use psychological techniques to lessen your child’s pain during the procedure.

Imagery is an effective way to manage discomfort, but it requires practice before the procedure. Your child will visually focus on one object in the room, hold your hand, breathe deeply, and imagine a tranquil scene.

I discovered my special place when I was 12, during a relaxation session. My place is surrounded by sand and tall, fanning palm trees are everywhere. The sky is always clear; the sun shines bright. Each time I come to this place, I lie down to feel the gritty sand beneath me. Once in a while I get up and go looking for seashells. I feel the breeze going right through me, and I can smell the salt water. Whenever I feel sad or alone, or if I am in pain, I usually go jump in the water because it is a soothing place for me. I like to float in the water because it gives me a refreshing feeling that nobody can hurt me there.

You can use distraction techniques with children of all ages, but they should not be used as a substitute for preparation before the procedure or medication during the procedure (if needed). Colorful, moving objects will distract babies. Parents can distract preschoolers by showing picture books or videos, telling stories, singing songs, or blowing bubbles. Hugging a favorite stuffed animal comforts many youngsters. School-age children and teens can watch television or listen to music. Several institutions use interactive videos to help distract children or teens.

Our son has a chronic illness that requires daily shots. He is in charge of the process (which he often changes). Right now, the special Band-Aid® that looks like a tattoo needs to be open on the table; the appropriate site (left or right thigh) agreed upon, pinched, and alcohol-swabbed; a sibling holding one hand and he pinching an ear with the other; on the count of three the QUICK injection, followed as nearly instantaneously as possible by the Band-Aid®. No fear and no tears.

In some hospitals, music therapists help decrease discomfort during procedures by using guided imagery or progressive muscle relaxation exercises while the children listen to music. Other therapies that are sometimes used to help deal with discomfort during medical treatments are relaxation, biofeedback, massage, and acupuncture.

Chapter 9: Pain ManagementPreventing pain during procedures

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