A reader wrote to me:
If you ever do a post on handling anxiety or helping kids who freak out in medical/dental situations, I would be so interested in what other witches do.
Absolutely. Freakouts happen on such a sliding scale. My 10 year old son will start crying the instant he realizes a shot is imminent but unlike my brother, he never tried to escape the examining room in his underwear (my brother went on be a captain in the Army, so he eventually got his shit together.)
I asked witches whose kids need extra cajoling, mind games, bribery, bear hugs, whatever to get them through the appointment how they deal:
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“My almost 7-year-old kiddo is really freaked out by shots. For her first covid shot, in her school gym in front of tons of people, I had to put her in a full-on restraint. (I’m a social worker, so luckily, I had just been re-trained that week on therapeutic restraints.) What worked for later shots: dad brought her instead of me, since she’s more emotional with me (safe place, blah blah). Also, they luckily got an incredibly patient tech at the pharmacy who let her sit there for a few minutes and ‘think about it’ until she felt ready. Some things that didn’t work for us, but might for you: listening to favorite music on headphones during the shot, guided meditation, and bribery.
I think a good way to handle it is to talk to the child ahead of time ‘We’re going to go to the doctor for a shot. You really don’t like shots and you might feel scared or like you want to run away. We’re going to try lots of things to help you feel calm enough to sit still for the shot. Because the shot is super important to keep you healthy, if you can’t keep your body calm I’ll have to hold you tightly in a way that makes it so your arms and legs can’t move while the nurse gives you the shot. I don’t want to do that, and I don’t think you’ll like it either, so let’s work hard together to get the shot done without that. I’ll remind you when we’re there, and I’ll always let you know before holding you tightly.’ You can phase down the language for younger kids.”
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“My kid is only three but we just had a major win in this department and I’m happy to share what worked for us. For background, my kid has some intense medical anxiety, to the point that they see anyone wearing a vaguely medical-looking jacket and freak out. I attribute this, at least in part, to only having access to a doctor that treats children but doesn’t specialize in pediatrics (we live abroad and don’t have many options or alternatives for care) so all of her medical experiences have been unfriendly and clinical, not fun and accommodating. Recently we decided that she needed to see a dentist and we agreed to prioritize someone kid-friendly over other more convenient factors like location, etc. We asked for a bunch of recommendations and ended up choosing a dentist that is farther away and doesn’t speak English but has glowing recommendations from folks with kids, and I really think that it made a huge difference! She was freaked out at first but totally warmed up after a while because the dentist used a calm and friendly ‘kid voice’ and gave her a little stuffy to hold and let her sit on my lap, all things that our doctor wouldn’t do. This plus front loading WEEKS of imaginative practice play and watching the Daniel Tiger and Sesame Street episodes about going to the dentist meant that my kid had her teeth checked tear free which is an absolute miracle. Now we are using it as an example of how we can be nervous about things but do them anyway when they are important and feel really proud when they are done. I now have a warm fuzzy memory of the situation, despite holding myself in a plank position for 15 minutes while supporting my child like an otter. This is how I justify never working out!”
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“Neurodivergent dental stuff! First of all, if you can get on Medicaid, do so, because they’ll cover everything at 100%. If you don’t qualify financially, look into getting Supplemental Security Income from the SSA. If you even get $1.00 of benefits from them, you qualify for Medicaid. It’s a huge pain in the ass but worth it for the following reason: Both of my Autistic kids have to be put under for their exam and treatment. Fully sedated, with an anesthesiologist and everything. It’s incredibly stressful for me, but they seem to be fine.
We found our current providers by asking for recommendations in a local special needs parenting group and that has made all the difference. Our doctor really listens to them and will skip things that aren’t absolute requirements if they don’t need to be done. We also visit our dentist every six months instead of every year, and the mid-year visit is really just for a visual inspection. I think the regular exposure to the place makes it feel less scary to them.
When we go to an appointment, they get full unadulterated screen time, even in the car, which is strictly forbidden otherwise. We also get a treat right after. My son loves to get a donut after the dentist, which I’m sure his dentist would hate, but I don’t care! We wheel my son in in a stroller (he’s 6) which gives him a space where he feels safe. (Yes we do get looks from parents, yes other children have asked what’s wrong with him or if he can’t walk, no I don’t care!)
Basically we make them as comfortable as possible, muscle through it, then get them out and distract them with a treat. Anyone who gets in the way of that goal is politely ignored whether that means wheeling the stroller into a place I know it will fit despite being asked not to or not forcing my kids to sit on the exam table.”
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“My older son needs to feel in control of everything he can control. He needs time to collect himself and to give permission to be touched. I am very supportive of this even in front of scary overworked nurses who just want to stick the GD needle in his GD arm. My younger son wants to know what is happening, but not too far in advance. He can spiral if given information too early. So, I try to meet them where they are, but the 100% honest answer is SCREENS. Our pediatric dentist has tablets mounted above the kid heads and my kid was pushing the ‘skip credits’ button on ‘The Simpsons’ even when stoned out of his gourd. And I have calmed my younger son when waiting too long for a vaccination with videos of Red Pandas. Oh and giant frozen yogurts after everything.”
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“One thing I did (having learned this the hard way) was to specifically notify *in advance* the doctor and the dentist/ortho about the kid’s anxiety. You can judge how open to this convo they are but I think more practices are welcoming the info of only for their own needs and liability issues, etc. The second thing I would suggest is be willing to bail - out of an appointment, a throat culture, a braces fitting, anything. I felt like my kid was easier when he saw that I would listen to and follow through if he was having a very hard time. I asked him to trust me when he would need things that scared him, so I came to believe that he had to also trust that I would also be willing to speak up and end the appointment if I judged he was having too much anxiety to continue. Lots of hugs for the reader - this is a tough one and needs a lot of self-kindness.”
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“I have a kiddo with ADHD that went through some medical anxiety particularly around getting shots and dental work. I think that some of the freakout about shots kicked in once he started overthinking what was actually happening when they were injecting him with medicine. There is some advice out there that says to have the kid watch you get a shot first but that seemed to only freak him out more. We had one appointment when he was maybe 6 or 7 where we almost had to throw in the towel because he was so stressed out about getting the shot and wouldn’t sit still to do it. What seemed to eventually help somewhat is a distraction (typically screens) and them using a shot blocker. He is 11 and still insists on the distraction/shot blocker but it’s no longer as big of a deal.
He also had anxiety at the dentist and had one really bad visit when he had to get some cavities filled. They tried to give him laughing gas but he was so freaked out that he wasn’t really taking any of it in and then we just had to kind of power through and get it done and it was not great. His pediatric dentist said that the next time he needs something like that done we should give him some melatonin before the visit. Which we did and it did help. So it might be something worth asking a doctor/dentist about if you have a kiddo who is really freaking out. Now that he is a bit older he has done okay with just the laughing gas so it does seem like the anxiety about some of this stuff peaked and got a bit better with age.”
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“My kid is almost 4 and autistic, so the unknown is a biiiiiig deal in our house. The best thing we ever did is see a pediatric dentist. Those people are effing magical. They have tv on the ceiling to watch during cleanings, and their whole attitude is just super calm and reassuring. We also really push a good brushing/flossing routine so it’s just part of life for him now, which makes most of the process more familiar.
Our kid also responds really well to modeling and storytelling approaches, so we watch a lot of ‘go see the doctor’ episodes of his favorite shows, and we talk about what’s going to happen in as much detail as possible. I also try to include sensory details so they’re not a surprise: ‘the doctor is going to listen to your chest and then your back with their stethoscope, it’s going to press on you like this and it might feel cold!’ ‘The dentist is going to use a special tool to clean your teeth that spins, it’s very loud and it feels really tickly!’ All medications must first be administered to our stuffed Pikachu for testing. Pikachu is very brave. We had pinkeye awhile back and the drops were a challenge until mommy, daddy, and Pikachu had taken them enough times that it was no longer a big deal.”
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My daughter is very shot phobic and the longer we are in the waiting period for it to happen, the more anxious she gets. I've told our providers that they need to do it as quickly as possible and to not let her have time to "get ready" because she escalates up and not down with time.
But we've also talked with her about this outside the context of shots and she has agreed that we should hold her and get it done quickly, which feels important too -- she can't meaningfully give consent when she is in full fight or flight mode, so we make sure to check in with her after.
Pediatric dentists are magical. I was skeptical but one visit completely converted me. We've moved but have still gone back to the old office cause they are so good. Also seconding screens for shots and tons of pretend play. We had a traumatic dr visit at ~2yrs and then spent a lot of time before the next one with the dr kit examining his stuffed toys and giving them shots. lots of 'ow ow ow that hurt!' and then hugs. Helped a lot and now at 4 he got shot with no tears at all! He's still nervous but it was so much better.