When emotions are high, for parents or the child, it is very helpful to have a solid idea of what works, rather than trying many many things. Procedural anxiety is anxiety around hospital procedures such as having blood taken, having a cannula inserted, going for a scan, or something like a wash out. So, with that in mind…
“At first the title of this post was meant to be “struggling with enemas”. But while I was writing it and doing research I realised its not going to be about the struggle but about solutions to it. So here are some TRICKS
For last few weeks we are struggling with enemas. To be exact its S. who struggle, but its all on us as parents. It got worse since an accident in A&E, every time we are about to start S. is running away, screaming and crying she doesn’t wanna do it. Its proper hysteria and my heart is breaking seeing her like this. Once the wash out is started she is OK while sitting on the toilet. We are colouring, reading books, doing nails, etc. just to make the time go faster (she has to sit about 30 minutes).
But the trouble is – she doesn’t like the cone that goes into her bum, and the feel of water running through her guts. Hard to blame her. I keep telling her I understand, its natural she doesn’t like it, no one would! and we as parents don’t like to do it to her (even thou we know its FOR her not TO her) but we still have to do it. She knows why we are doing it – to keep her clean, so she wont be pooping all day while in play school (she used to hate being pulled out of playing just to change her nappy) and so her belly wouldn’t hurt. Recently she had some blockage in her bowel- and ended up taking some laxatives to clear it out- that wasn’t nice either- as she had awful cramps.
We tried every possible trick- from bribing her with sweets to new toys, up to threatening (hate this part and ashamed of doing it) that we will have to go to hospital if she wont do it… when we are desperate. Nothing works. Shes missing playschool (cant send her knowing she will be leaking ad having a dirty nappy every 30 minutes) and I’m loosing my mind. For last few days its so bad each of us cry in own room while she fights, and I know that if its so stressful and traumatic to me- its way worse for S.
I start to realise having to do enema every day (and whole drama and fight about it) is starting to cause psychological issues. So I looked for psychological advice. Met with lovely Dr Kim and she gave us few tips (THANK YOU!) Turned out the first one we come up with ourselves and second one helped us. So Id like to share them with you, and hopefully they will help someone.
1. TOY BOX
Box of toys that are always in the bathroom and they are use ONLY on the toilet. Our box we gathered with S. and it contains:
- Story books (to be read by parents),
- stickers books,
- small toys such as dolls and their cars and pony’s,
- and our latest hit- colouring by numbers with a big box of crayons (my personal favourite – love colouring with S. – super relaxing)
2. SAND TIMER
First when I heard of it I was like: Why and how that’s suppose to help? It sure does!
First of all its graphic way to show child how long it takes for the unliked procedure – in this case inserting cone and flushing water into bowel- but it can be use for ANYTHING like taking bloods on injections, etc. Child watching sand going down, focus on it. It makes it VISUAL and PREDICTABLE. Child will know every time that it will be over when the sand is gone. It helps reduce the negotiations – “we are only doing IT until sand is gone – so watch the sand”. And what works for us – the child is IN CHARGE of it.
So we start and finish when S. say so. So we have the washout bag ready, and when she say START we can start but then when sand is down, she says STOP and we have to stop. Word of advice – do a dry run first- time how long you need before you introduce sand timer to child. We made mistake and when tested -didn’t realise that sometimes it takes longer because of blockage. Lucky for us our sand timer has 3 tubes 1,2 and 3 minutes – with different colours. So if the black sand is gone (1 minute), sometimes we ask S. if we can go by the orange sand (2 minutes).
You can also use a timer in the phone – get child to press start and listen for the beep when it ends, but personally I found sand timer works magic. Especially if you introduce it with excitement 🙂 “from now on YOU are in charge and tell us what to do ” 😀 This are two tricks we are using and they are working well so far. I wont lie to you sometimes we also use bribery like ice cream/ snacks etc
There is few other tricks to be use- we haven’t try yet as the timer works great for us- but worth to know them:
3. SCHEDULE with ICONS
Basically make a chart where you stick on Velcro or blue tag pictures of whats going to happen for example: washout, toilet, then toys, treat. And as things happen, child take a picture off the chart so child can see whats left to do. Icons make kids feel they are in charge. It can be helpful because we can reduce the language. Its also great way to introduce the feelings. Making it consistent and predictable which helps when people are anxious.
Choice A or B
Toilet OR potty
* bit of advice – don’t make our mistake and don’t ask if child wants to do it before or after dinner/ treat etc. most likely will choose AFTER as they can postpone it…its not a helpful option for parents 😉
Use a thing that child usually don’t get like ice cream, screen time or other AS A TREAT
6. TOKEN SYSTEM
Token system to earn time to do things – what child wants to do – playing video game, screen time etc.
Hope this will help someone.
If you know any other “tricks” that can help kids and parents, please share with us.