Wednesday, February 16, 2011

Looking for Ideas about Chronic Pain in Kids with Attachment Issues.

Okay Internet peeps, I need your help and your experience to deal with Calvin.

To make a long story short we still have no answers about Calvin's fluid in his hip joint and as we get passed from department to department in the hospital we need to deal with the pain. The hospital has told us that we can give him Tylenol and Advil alone or together as needed.

My struggle is in judging his pain and what the best course of action because I do not know if:

- the is the amount of pain he says he is in is as bad as he says it is even though he at times says he is in pain but then seems to be moving ok or putting weight on the affected leg.
- or he is saying he is in more pain because he does not want to be at school
- or he is looking for attention
- or really does hurt a lot and it has for a long time and he has not been admitting that to anyone because he rarely complains about feeling unwell.
- or when we were at the hospital yesterday he said it was not hurting when it was because he was afraid of what might happen if he said it hurt.
- or any combination of  the above things. 
- or something else that I am missing or not thinking of.

I have observed him moving when he does not know that I am watching with mixed results and I have spoken to him about what I see him doing and what he is telling me are not always the same. I imagine that the pain does come and go depending up on his movements. I know that movement makes it worse and that resting makes it better and that after he has been quiet for awhile there is little pain. What I do not know is if  I should push him to do more so we can have a better sense of what is going on or just to let him be. I also do not know whether it is a better idea to keep him on the pain killers every 4 hours or to give them to when he asks. I asked yesterday and they said give them to him for the pain which is not helpful, before the pain, during the pain... they just said when he needs it. The problem is that he is not so good at judging what is going on because he is a 10 year old boy and he waits until the pain in really bad before he asks for Advil and then sometimes says it helps and other times says it does not.

He is exhausted and not really eating much and says it hurts and it is making me stressed because I do not know what to do for him. Nor am I completely sure that this is all about the pain is his hip and that some of it is not about the pain in his heart that is healing but it is a long and slow process.

Suggestions, ideas, solutions, magic bullets....

5 comments:

C Dawn's bucket said...

This is just my gut and not based in anything other than mommy intuition. I think I would give him the Ibuprofen every 6 hours and then if he complains of pain give a dose of Tylenol.

Maybe try that for a couple of days and then reassess if it is working.

Kim (from the Rhinebeck barn) said...

Pain management is difficult. Here's what we DO know about pain...it's easier to manage and takes less meds to manage it, if you take the meds on a regular basis. Maybe try giving him advil or tylenol...whichever one works best...every 4 or 5 hours. (but don't wake him up to take it...let him sleep through the night if he can. Sleep helps pain.) Try that for a few days to see if it manages the pain.

You could also try things that allow for more human contact and see if that helps. I've had a lot of good luck with Arnica gel or Traumeel (holistic med with arnica). Rub it where it hurts, as needed.

Another strategy that they use at Sick Kids is video games. They've found that if kids are given a handheld game or the TV version to play with, their brains are distracted from the pain and they tend to need less medication. It's about distraction and misdirection. So, in the case of someone you're trying to bond with, it might mean playing the game with C., or playing a board game with him.

So these are the methods I've found work to help with pain management. Hope it helps a little. You're not alone.

Sheri said...

My son had stomach issues a couple years ago and has lowered pain receptors so we were not sure what we were seeing in regardw to the pain. At first we thought that if he was complaining, it must be really bad. What I think ended up happening was attention/habit. We medicated every 4 hours with tylenol (ibuprofen tends to havea bounce back effects if it builds up and can actually cause more irritability) for several days.

When he complained we would simply say, "Im sorry, I bet it hurts, but the medicine will help. I can give you a hug." Then we tapered it off to every 6 hours.

Within about a week or so the complaining tapered off and he was okay again.

May not be the case with you, but worth a shot.

Claire said...

I find that pain meditation can help. When it is really bad ask him to visualise it.

What colour is the pain?
What shape is it?
Does the shape and colour stay the same or move?
Now shrink it in your mind imagine the shape getting smaller and paler and slower, if it's moving. Now imagine it disappearing all together.

If there's time or he's still able to concentrate finish with some slow breathing. Breathe in for a count of 4 slowly and out for 8. As you breathe in imagine cool calm and comfortable air going out and when you breathe out imagine all the pain and discomfort leaving too.

When he's done this with you a few times he should be able to do it on his own if needed. It should help with sleeping too.

You might want to try a bit of neurolinguistic programming too. This has been proved to reduce the length of illnesses and recovery times.

Get him to say out loud to himself things like "My leg will feel better soon." or "My leg will stop hurting." This sounds strange, but does actually work and you can use it to re-enforce any positive behaviours or change e.g. "I am learning to be calm" or "I can control my anger" or "I am choosing healthy fruit because I want a healthy body"

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