Dear Parent,

 

Absolutely!  You can’t turn this whole experience into a treat, but there are many things you can do to make it easier for her.

 

The first thing you must do is never let her see your own anguish as she goes through these procedures.  If your expression and body language tells her “this is horrible and no one could bear it!” she will suffer more than if you are calm and matter of fact. 

 

Secondly, be as truthful with her as possible.  Explain why she needs to have these things done, in terms she can understand.  If she has to have a bone marrow tap done, for example, let her know that there’s no other way for her doctor to know what is happening in that space, so he can choose the right medicine for her.

 

Empower her.  Give her the job of concentrating on what her body needs to do and putting that part of her body to work, using an image that makes sense to her..  If her bone marrow isn’t making enough cells, for example, she could picture a huge factory making red and white blood cells.  If she is making too much of a certain type of cell, she could imagine a street sweeper cruising through her blood vessels and bones sweeping up the cells that don’t belong.  If she is fighting a chronic viral or bacterial infection, teach her about how white blood cells are the body’s soldiers that are supposed to fight the bad guys.  She can imagine these soldiers marching through her body searching for the bad guys and beating them.

 

Inform her.  Before any procedure that you know about, tell her exactly what is going to happen.  This requires that you find out this information yourself.  Some facilities may even have videos made for children telling then about the procedure.  Tell her truthfully whether it’s going to hurt, or whether she’s going to be asleep for the procedure but is going to be sore for awhile afterwards.  Tell her where the soreness is going to be, so she doesn’t think her whole body is going to hurt.  Try to give her specific words for the type and severity of the hurt, so she doesn’t imagine it to be worse than it is.  Use words like sting, pinch, ache when appropriate  Try to give her detail about when the pain will (and won’t) occur.  For example, a bone marrow tap can be broken down into the following steps: numbing the site (which involves a needle) takes about 30 seconds; the pressure from the bone marrow needle going into the bone takes about 5 seconds; pulling out the liquid from the bone marrow takes another 10 seconds.  The overall procedure might take 20 minutes or so, but real pain will probably only last for one or two minutes.^*  

 

Let her act out the procedure with a certain teddy bear or other stuffed animal, and give him a bandaid in the appropriate body part.  Let her take this comfort object with her.  Teach her how to get through painful tests by counting, deep breathing, or imagining being in a pleasant place.  For some procedures other distractions such as a video or cartoon may be appropriate.  Give her permission to cry if she needs, too, though.  Let her know that she may have to be held still to make it more likely that she only needs one poke; otherwise big strangers holding her down may be the worst part of the test.