Child with GAD and immunizations. Help!

[Neesy228]

My DS12 has generalized anxiety disorder, but he copes pretty well with a lot of pre-planning and discussion...the only area where this consistently fails is with doctors/dentists. I have had horrible horrible HORRIBLE experiences with him in medical offices.

He is due for his next round of vaccines in a few weeks and I have been trying for nearly two months to help him come up with a coping plan, but nothing seems to be working...he is panic stricken over the thought of these three vaccines.

When I tried to take him in October for a flu shot, we ended up leaving without getting one because he completely unraveled...

Does anyone have any coping techniques I could try? Or other suggestions? I'm desperate! He needs to get these vaccines...so it's not optional, but I really don't want the entire medical staff holding him down either. thanks.

ETA: I just realized I posted this in the wrong area...mods, feel free to move to the disabilities community board! Sorry!

 

[clanmcculloch]

What about the vaccines is he anxious about? Is it the pain, the idea of something going in his arm, something else? If it's the pain then maybe he'll do better if you get some numbing cream for the injection site?

I know it should seem obvious what's causing the anxiety but you'd be surprised. My 15yo used to freak out over blood draws. I finally figured out it was the rubber band that went around her arm that was freaking her out, not the needle. She had this notion in her head that the rubber band was cutting off circulation out of her hand which would make blood collect causing her hand to explode. It didn't occur to her that blood flow couldn't be cut off if the blood was getting to her hand but you never know what kinds of fears can pop into a child's head. The point of this story is to say that it doesn't hurt to sit down with him to go over with him all the steps of getting a vaccine to see if you can figure just what part of it is causing his anxiety so you can confront the specific fear rather than trying to deal with general anxiety.

 

[StitchesGr8Fan]

I went through that with my allergy shots and my anxiety. I would pitch a fit and not want to go. There was no particular reason behind the anxiety. Before the anxiety got bad, and after we got it under control I had no problem with needles. With GAD there doesn't have to be a reason or rationale to the anxiety.

I'm going to get flack for this, but one option is medication. A small dose of Xanax 30 minutes before his appointment would probably calm him enough to get through it. After a few hours it would wear off. Of course the doctor would have to agree it is safe and prescribe a few pills. Its a way to win the battle while you are still working on winning the war against GAD.

Maybe he can vocalize why he is afraid, but with GAD you are scared and you just don't know why. Good luck OP. I'm sure your son feels awful about pitching fits like that, but he just can't help it.

 

[clanmcculloch]

Just to be clear, DD15 never said what she was afraid of. I figured out her trigger based on conversations and observations. There may not be a specific trigger(s) but it's worth the effort to at least try to step through the process verbally to see if any triggers can be figured out.

 

[Neesy228]

Just to be clear, DD15 never said what she was afraid of. I figured out her trigger based on conversations and observations. There may not be a specific trigger(s) but it's worth the effort to at least try to step through the process verbally to see if any triggers can be figured out.

We have talked about this backwards and forwards...I have yet to pinpoint exactly what the panic is from. It seems to be fear of the unknown (much like most of his anxiety)...he wants to know exactly how big the needle is, how far it will go into his arm, how much it will hurt, where it will go in, how fast they will administer all of the shots etc. I can't tell him those things exactly and he doesn't want to go look at the needles or talk to a nurse because he think it will make him sick (ugh!)....

To the previous poster who mentioned meds...I have considered getting him some Xanax, but I hate to use medication. He's able to handle most things with great success, so I almost feel like I'm telling him that he can't handle this...maybe it's a bad way to think about it and I should just give him meds to help him cope with this? Tough call. :/

I appreciate your feedback!

 

[StitchesGr8Fan]

We have talked about this backwards and forwards...I have yet to pinpoint exactly what the panic is from. It seems to be fear of the unknown (much like most of his anxiety)...he wants to know exactly how big the needle is, how far it will go into his arm, how much it will hurt, where it will go in, how fast they will administer all of the shots etc. I can't tell him those things exactly and he doesn't want to go look at the needles or talk to a nurse because he think it will make him sick (ugh!)....

To the previous poster who mentioned meds...I have considered getting him some Xanax, but I hate to use medication. He's able to handle most things with great success, so I almost feel like I'm telling him that he can't handle this...maybe it's a bad way to think about it and I should just give him meds to help him cope with this? Tough call. :/

I appreciate your feedback!

It is a tough call. I know medication isn't for everyone. I felt like a failure or weirdo as a teenager because I had to take meds for my anxiety. But I also felt like a failure and a weirdo because I had anxiety and would have these freak outs. My mom put me on the meds because she didn't want my GAD to spiral into something worse.

And she finally explained something to me: if I had seizures or a heart condition and a medication would help me live a more normal life, I wouldn't think twice about taking a pill. Why would I not take a pill to help me live more normal life just because my condition isn't something you can see on an MRI or CAT scan and society put a stigma on meds for mental illness? No one needs to know he occasionally has to take a Xanax unless you or he tell them.

Now as an adult, I've accepted that I have an imbalance in my brain that will always be there. I can handle life without meds (Im doing it right now because I'm pregnant) but it is exhausting. I focus so much energy on keeping my anxiety in check that I don't have the energy to enjoy life. I have accepted that I will be on meds the rest of my life, and there is nothing wrong with that.

Not trying to talk you in to giving him the Xanax for this appointment. I just want you (and him) to know that it is ok if he needs a little help. No one is saying he can't handle it. You are just trying to make it easier on him.

You may even want to talk to him about it. It may be less embarrassing to him to take a pill versus causing a scene at the doctors office and having to be restrained to get his vaccines.

 

[clanmcculloch]

I see the lesson being taught that it's important to know when you need help and to reach out to get it. Everybody needs help with one thing or another. This is just something he needs help with.

Something I learned with my DSD who has OCD is that sometimes the medication is needed just to lessen the anxiety so that the person is able to be in a position to even try learning and practicing the coping skills needed to get through the worst of the anxiety.

It really is a tough choice. At 12, maybe he's old enough to have some say in the decision?

 

[Mama Who]

To the previous poster who mentioned meds...I have considered getting him some Xanax, but I hate to use medication. He's able to handle most things with great success, so I almost feel like I'm telling him that he can't handle this...maybe it's a bad way to think about it and I should just give him meds to help him cope with this? Tough call. :/

I appreciate your feedback!

I understand your reluctance, but... he *can't* handle it. You had to leave without him getting the shot he needed. I take my klonopin very infrequently, but the moments I need it, I really need it. I would focus more on there being no shame associated with needing the meds and let go of not needing the meds. Does that make sense?

 

[Gantu]

I dont know if this helps, but I use to have the doctor (Dentist even once) and nurse come out to the car. If my son stayed in the car he was fine.

He's 21 now in the Navy with a great job.

Here's a hug to you too!

 

[Christen99]

I know this generally doesn't work as well for vaccines, but works really well with blood draws. We've used EMLA cream for a blood draw in the past. My son has autism, and a major fear of needles. He had to have a procedure done that included a blood draw prior, and it took 5 of us to hold him down, and then he passed out and puked when he woke up. Fun times. Our doctor suggested EMLA for an additional blood test and although he flipped out, he didn't realize he'd had his blood drawn during the brouhaha.

The difference with a vaccine, is that the medication entering the muscle stings. I wonder if te EMLA will give him enough of a confidence booster (you won't feel the initial pinch), and help reel in the anxiety.

 

[Gracie09]

This won't help with other vaccines but would he take the flu mist instead of shot? You could practice with a saline spray so he gets what it will feel like.

 

[Neesy228]

I dont know if this helps, but I use to have the doctor (Dentist even once) and nurse come out to the car. If my son stayed in the car he was fine.

He's 21 now in the Navy with a great job.

Here's a hug to you too!

Thanks for this...I so often wonder what the future holds for him and your post gave me some hope.

 

[Neesy228]

I know this generally doesn't work as well for vaccines, but works really well with blood draws. We've used EMLA cream for a blood draw in the past. My son has autism, and a major fear of needles. He had to have a procedure done that included a blood draw prior, and it took 5 of us to hold him down, and then he passed out and puked when he woke up. Fun times. Our doctor suggested EMLA for an additional blood test and although he flipped out, he didn't realize he'd had his blood drawn during the brouhaha.

The difference with a vaccine, is that the medication entering the muscle stings. I wonder if te EMLA will give him enough of a confidence booster (you won't feel the initial pinch), and help reel in the anxiety.

Thank you for your advice. i have wondered the same, but I'm not sure if they could get close enough to him to give EMLA. I really really really (did I say really?) want him to get through this without flipping out...last time it took seven full grown adults to restrain him and it was so awful. Neither of us want to experience that again.

 

[lost*in*cyberspace]

Is he currently in any type of therapy? There are a number of types to help people with fears or phobias.

 

[Freesia123]

I think you need to negotiate with him a bit. Three at a time might be too much for him. How about one? Then when he sees its no big deal he can opt to either continue or come back. Give him some control over the situation. I was freaked out beyond belief of needs when I was his age (I bit the dr giving it to me!!) but after it was done I admitted it wasn't too bad. I also have GAD and when I know something unpleasant is coming I cope by trying to control it a bit. Give him a bit if power, I think it will work.

 

[EastYorkDisneyFan]

Just a couple of questions is is your DS12 only afraid if the nurse does the shots, what about if the Doctor does it? I know from my own experience that I really didn't like going to the dentist and having a dental hygienist do the work instead of the dentist, for my appointments my mom would note that I wanted the dentist to work with me rather than a hygienist. He was really nice and gave me time if i needed it.

 

[SueM in MN]

It is a tough call. I know medication isn't for everyone. I felt like a failure or weirdo as a teenager because I had to take meds for my anxiety. But I also felt like a failure and a weirdo because I had anxiety and would have these freak outs. My mom put me on the meds because she didn't want my GAD to spiral into something worse.

And she finally explained something to me: if I had seizures or a heart condition and a medication would help me live a more normal life, I wouldn't think twice about taking a pill. Why would I not take a pill to help me live more normal life just because my condition isn't something you can see on an MRI or CAT scan and society put a stigma on meds for mental illness? No one needs to know he occasionally has to take a Xanax unless you or he tell them.

Now as an adult, I've accepted that I have an imbalance in my brain that will always be there. I can handle life without meds (Im doing it right now because I'm pregnant) but it is exhausting. I focus so much energy on keeping my anxiety in check that I don't have the energy to enjoy life. I have accepted that I will be on meds the rest of my life, and there is nothing wrong with that.

Not trying to talk you in to giving him the Xanax for this appointment. I just want you (and him) to know that it is ok if he needs a little help. No one is saying he can't handle it. You are just trying to make it easier on him.

You may even want to talk to him about it. It may be less embarrassing to him to take a pill versus causing a scene at the doctors office and having to be restrained to get his vaccines.

Very good ways of looking at things.

I see the lesson being taught that it's important to know when you need help and to reach out to get it. Everybody needs help with one thing or another. This is just something he needs help with.

Something I learned with my DSD who has OCD is that sometimes the medication is needed just to lessen the anxiety so that the person is able to be in a position to even try learning and practicing the coping skills needed to get through the worst of the anxiety.

It really is a tough choice. At 12, maybe he's old enough to have some say in the decision?

I think you need to negotiate with him a bit. Three at a time might be too much for him. How about one? Then when he sees its no big deal he can opt to either continue or come back. Give him some control over the situation. I was freaked out beyond belief of needs when I was his age (I bit the dr giving it to me!!) but after it was done I admitted it wasn't too bad. I also have GAD and when I know something unpleasant is coming I cope by trying to control it a bit. Give him a bit if power, I think it will work.

In a past job, I was a Public Health Nurse and gave a LOT of vaccines.
Some kids really needed some ability to control things - like which arm it was going into.
Some did want to know a lot about the shot, like how big the needle is, how far it would go in, whether it would hurt. So, in that way, he is no different than many kids who do not have GAD.
He just has a higher 'background' level of anxiety than they did, so the added anxiety of the shots is enough to send him over the edge into not being able to cope.

Thank you for your advice. i have wondered the same, but I'm not sure if they could get close enough to him to give EMLA. I really really really (did I say really?) want him to get through this without flipping out...last time it took seven full grown adults to restrain him and it was so awful. Neither of us want to experience that again.

EMLA cream will not help with the shot IF the solution stings, but not all shots sting. Some are worse than others and using EMLA cream may take enough sensation away that he is able to cope with the rest of the procedure, even if there is some stinging from the solution, as Christen99 suggested.

They may be able to work something out so that HE is more in control of the application of the EMLA cream.
The other thing that came to mind to me is that if this is the same place where it took 7 adults to restrain him, they may come in like a SWAT Team. The possibility of that in itself would increase his anxiety.

Just a couple of questions is is your DS12 only afraid if the nurse does the shots, what about if the Doctor does it? I know from my own experience that I really didn't like going to the dentist and having a dental hygienist do the work instead of the dentist, for my appointments my mom would note that I wanted the dentist to work with me rather than a hygienist. He was really nice and gave me time if i needed it.

That could backfire with shots. Chances are that the nurse has a lot of experience doing shots, but the doctor, not so much.
If the doctor is anxious about giving the shots, that will fuel the child's anxiety.

 

[Neesy228]

Just a couple of questions is is your DS12 only afraid if the nurse does the shots, what about if the Doctor does it? I know from my own experience that I really didn't like going to the dentist and having a dental hygienist do the work instead of the dentist, for my appointments my mom would note that I wanted the dentist to work with me rather than a hygienist. He was really nice and gave me time if i needed it.

No, it won't matter who does it...but thank you for your thoughts!

 

[Neesy228]

Very good ways of looking at things.



In a past job, I was a Public Health Nurse and gave a LOT of vaccines.
Some kids really needed some ability to control things - like which arm it was going into.
Some did want to know a lot about the shot, like how big the needle is, how far it would go in, whether it would hurt. So, in that way, he is no different than many kids who do not have GAD.
He just has a higher 'background' level of anxiety than they did, so the added anxiety of the shots is enough to send him over the edge into not being able to cope.

EMLA cream will not help with the shot IF the solution stings, but not all shots sting. Some are worse than others and using EMLA cream may take enough sensation away that he is able to cope with the rest of the procedure, even if there is some stinging from the solution, as Christen99 suggested.

They may be able to work something out so that HE is more in control of the application of the EMLA cream.
The other thing that came to mind to me is that if this is the same place where it took 7 adults to restrain him, they may come in like a SWAT Team. The possibility of that in itself would increase his anxiety.

That could backfire with shots. Chances are that the nurse has a lot of experience doing shots, but the doctor, not so much.
If the doctor is anxious about giving the shots, that will fuel the child's anxiety.

Thank you for your thoughts! You are correct about his background level of anxiety...I've already talked to the office about not coming in like a SWAT team, but it may end up that way anyway.

 

[Neesy228]

I think you need to negotiate with him a bit. Three at a time might be too much for him. How about one? Then when he sees its no big deal he can opt to either continue or come back. Give him some control over the situation. I was freaked out beyond belief of needs when I was his age (I bit the dr giving it to me!!) but after it was done I admitted it wasn't too bad. I also have GAD and when I know something unpleasant is coming I cope by trying to control it a bit. Give him a bit if power, I think it will work.

I have tried this and he says he wants to get them over with while he's there so he doesn't have to go back for a long time...it doesn't seem to be that he feels a lack of control, just more of a general overwhelming fear of the unknown added to a fear of pain. Ugh. Thank you for your thoughts though!