At Simone’s appointment last week, her blood pressure was very high. Pediatric blood pressure is confusing, to me, but for those of you who know about these things, it was 114 over 67, otherwise known as HOLY SHIT over MEH. It has been getting progressively higher over the past several months, and as high blood pressure is the complication her nephrologist warned us to look for, this was Trouble. Trouble with a capital T that rhymes with P that stands for Pediatric Renal Failure. Or something.
It has been impressed upon me that getting an accurate blood pressure reading from a toddler is difficult, and so of course it could be a fluke. But they whisked Simone away a few days later for a renal ultrasound, with the possibility of an echocardiogram later in the week. Why an echocardiogram, you ask? So did I. Apparently it is one way to tell whether she’s really having high blood pressure, because persistent hypertension will cause thickening of the heart.
I blinked rapidly when the pediatrician explained this because…excuse me? Thickening of the WHAT, now? It is my understanding—and you medical types feel free to correct me if I am mistaken—that the heart is among the more important organs. So, I would prefer if it not “thicken,” or do anything at all except pump blood with the vim and vigor of one of those chipper women on commercials for cleaning supplies or washer/dryer sets.
Anyhow, they did the renal ultrasound, which was fairly useless, and now they have decided to skip the echo and do some labs and a renogram next Friday, since Simone’s nephrologist wanted her to have one in the spring regardless. Her pediatrician gave me a brief run down of the procedure, and after he mentioned the urinary catheter that would be in place, I said “Oh, so she’ll be sedated?” and he replied that actually…no.
Now. He is the pediatrician, but it is my opinion—though I am by no means an expert—that 20-month-olds should ALWAYS be sedated, and not just for medical procedures. Anytime they are in a public place, in fact, I feel sedation is appropriate, if not for them, then for their Handlers. But like I said, I’m no pediatrician, so I tried to be open-minded. And then I read the informational handout provided for parents whose children are undergoing renograms (I’m skipping around, to highlight the best parts):
What is a renogram?
A radioisotope (a clear liquid that allows us to see only the function of the organ we are looking at) is given into your child’s vein. It travels through the bloodstream to the kidneys. The camera detects gamma rays (invisible radiation) (INVISIBLE RADIATION? IN MY CHILD? Do we really want to risk giving her some sort of superpower, or god forbid, making her stronger?) coming from the radioisotope and creates the images (pictures). (Thanks for that. Because “images” is such a complicated concept. Not like, say, “radiation.”)
How is the test done?
A technologist will bring you and your child into an exam room and explain the test to you both. (Ha!) The technologist will start an IV in a vein, usually in the arm or hand. It should not bother your child once it is taped down. (HA!) Your child will lie (HaHA!) on the imaging bed. It will take about 30 minutes for the camera to make the images. (“Make the images?” Who wrote this? A time-traveler from the past?) Many children watch a movie, listen to a story read by a parent, or simply rest. (HaHaHAHaHAAA!)
Before the appointment, you and your child can:
• practice lying down and being “as still as a statue.” (At this point, I started laughing so hard that Simone—always eager to be in on the joke—joined in. Once we’d worn ourselves out, we continued reading.)
• practice relaxing. (Again, with the tandem hysterics.)
Be sure to share your child’s wishes with the staff once you are here. (Oh, I’m pretty sure Simone will do an EXCELLENT job of “sharing her wishes” with the staff, all on her own.)
During the test:
• Praise your child often during the test. Be specific to behaviors, such as “You’re holding still. (Uh-huh.) or “You’re doing just what we asked you to do!” (Spit-take!)
• Ask open-ended questions that encourage conversation rather than those that require just a yes or no answer. For example, “Tell me what you’d like to do when we go to the pool” works better than, “We’re going to have a great time when we go swimming, aren’t we?” ( “Why is mama making the water with her eyes?” works better than “DO YOU SEE WHAT YOU’VE DONE TO ME, DEVIL CHILD?”)
• Read the books you brought, hold a toy so your child can see and play with it, play “Can you guess?” ( “Can you guess how much gin mama will require when this is over?”) and give clues about people and pets you know, things you see in the room. (“I see a pediatric radiology technician who is considering a career change!”)
Don’t you feel prepared, now? This is going to be so much fun!
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oh my god. i can’t even BEGIN to imagine. what are they thinking???
I always like reading instructions involving children in which it is clear that the author has none. INSANITY. Sending good wishes and vodka your way.
Hmmm. Strange. They don’t seem to mention the STURDY ROPE they obviously use as an integral adjunct to their Achieving Calm 101 class for Toddlers.
They gave you the wrong age-group leaflet, right? Right?
Practice this mantra before you go: “I will not punch the tech. I will not punch the tech. I will not punch the tech.”
Because no matter how sweet and proficient the tech is, by the time this is over you will. want. to. punch. the. tech.
I’m sorry. I hope it goes…. as, um, well as can be hoped for.
Oh that picture is just too much. “They” have no idea what they’re in for.
Hank joins in on my laughter (usually directed at him) often as well.
I should find it cute, but instead it cringingly reminds me of when I was in middle school and would laugh at sex-jokes I didn’t understand, always eager (read: terrified) to appear as if I *did* understand.
Don’t you hate replaying past embarrassments over and over in your head? Dude, it’s almost 20 years later and I *totally know* what a blow job is now. And who knows if anybody even caught on…but I still wince, thinking about how I laughed a little too late, and little too long, a little too loud.
Um, I think sedation is definitely required.
For you, if not for Simone.
Also, I’m crossing my fingers AND toes (despite the distinct unpleasantness I find in that act) for you and Simone, both in the immediate laughable escapade that will be “playing statue” and in the long term all-organs-accounted-for-and-working-fine area.
I felt guilty at how much this made me laugh. ;-)
And am reminded of a well-meaning radiologist performing a rare kind of x-ray on me, circa 1989, who actually uttered the words, “And when the pain becomes so unbearable that you need me to stop, blink twice.” Um, check please?
Good luck. You’ll get through it somehow.
Ohh–I feel for you. I really do. But I was snorting with laughter as I read this.
I particularly love the suggestions from their handout on “preparing” for and “relaxing” during the test. I am trying to recall the last time my two-year-old held still while awake for more than 0.03 seconds and I’d say it was right around, oh, NEVER.
Good luck–and have a bucket of gin ready for when you get home!
Why not just get both of you sedated and be done with it?
You think I’m kidding?
I had this exact procedure done when I was around 9 or 10. It was mildly uncomfortable for short spurts of time, and only really bad when I had to hold all that water in my bladder while they processed the X-Rays to make sure they got the right image (so they wouldn’t have to recatheter (?) me.)
I imagine it’s faster now. That said, as long as it doesn’t interfere with the test — DEMAND that Simone be given something to make her a little sleepy, if nothing else. Or, if you have a proven track record with Benadryl, I say go for it. I think that will be much less “traumatic” than having to be held down by several hospital support personnel while Mommy sips discretely from her “Starbucks”.
Seriously? No sedating? WTF are they thinking? I cannot IMAGINE trying to get my son to sit still for 5 minutes let alone 30. I guess it is just one of those things you get through and later you’ll look back and think how did I manage. I recommend lots of gin.
And lest I sound like I get random urges to physically attack medical personnel, it was when my five-month-old was strapped in THIS thing
http://www.xraymdm.com/pediatricimmobilizers.htm
that I nearly lost it.
Isn’t it astounding that they haven’t come up with a more humane, gentle way to keep babies still for x-rays than the delightfully named Pigg-O-Stat? (Let me assure you, the calm ‘Hey check it out, I’m trapped in a tube’ attitude of the toddler pictured is not typical, and a little baby looks WAY MORE pitiful strapped in there.) But it turns out they get a better chest x-ray image if the infant is crying vigorously. It also turns out that the whole procedure makes you want to deck the technician and sprint off into the night with your sobbing child.
I hope Simone gives them what-for, while acing the exam. So to speak.
Doesn’t it suck when what’s best for your child doesn’t feel like its the best?
We’ve done unsedated echocardiograms, several urinary caths, renal ultrasounds, head xrays, chest xrays, hundreds of blood draws, hundreds of NG tube insertions BY MYSELF, gtube changes, etc…
It sucks, but you’ll both get over it. You don’t really have a choice.
You make an excellent case for breaching the minimum age restriction for ph.energan.
Surely a sympathetic anaesthetist can slip you some Midazolam? Oh, and for Simone, too.
Good luck.
g
I’m so sorry. This just sucks.
They have to be able to give her something. Otherwise, do they expect you to lay on top of her and force her to stay on the table?
1) You are so awesome for making this funny instead of just posting a picture of Munch’s “The Scream”, and 2) STILL AS A STATUE, OH MY GOD.
Vaya con Dios, my friend. I hope it’s . . . well. I hope there’s gin afterwards.
I can’t get my 24-month-old daughter to lie down so they can look in her ears, much less do a renogram! The ENT told me next time we go in they’ll sedate her if she won’t stop screaming and fighting to get free. Why yes, we have thought of reading her a book on going to the doctor and bribing her with candy for sitting still, as people have helpfully suggested (and really are just being nice). But she’s two, and sadly just not as logical as one might hope.
I can’t even imagine the renogram. Good, good luck, and make your husband go with you for moral support! Hope the test turns up nothing to worry about!
I don’t understand how they can possibly expect a child that age to lie still because you told her to do it. (While you’re at it, you can tell her to fly, to shoot lasers from her eyeballs, to achieve world peace.) Surely she can be sedated. Can you get a second opinion from another doctor about the sedation?
Hugs to you. I’m sending many virtual sidecars your way.
Hey, I’m a nuclear medicine tech, which will be the person doing this type of exam. For pediatric patients we ALWAYS sedate them as the results are useless if the patient moves during the exam. I suggest you call the nuclear medicine department directly to speak to them about sedation, and having a Peds nurse start the iv (if you’re not in a childrens hospital). Also? The amount of radiation she will be given is MINUTE. Considerably less than an x-ray or CT. Good luck!
Been there, done this test when my son was 8 months old. He then had it repeated annually until he was four and I said enough. It isn’t fun but you will get through it. You know that medicine they give you when you have a bladder infection? The one that makes you pee orange? Ask for a pediatric dose of it to have just in case.
Ohmygod. This dude clearly has never spawned. Can you dose her heavily (like not too much so she doesn’t ever wake again, but just enough to keep her out cold for 12 hours or so) with Benadryl?
I was injected with a radioisotope just last week. And had to sit at awkard angles for about 30 minutes while they took pictures of my insides. However, I’m 32 years old, so I was really good at the sitting still. They can’t truly believe that a toddler would sit still for that process.
Gah. Also, ugh!
I recently had to have an MRI, and I absolutely lost my shit in that tiny little tube and asked if it was possible to be sedated for the procedure–something much, much stronger than valium that would render me unconscious. My doctor wasn’t sure if such a thing was possible, but his whole rationale in believing that it was (as indeed it was) was that kids need procedures like this all the time and they can’t possibly be trusted to sit still for that long. So, my assvice it to get thee to a doctor whose a little more willing to work with, you know, reality.
You have a remarkable ability to make anything funny. I await the recap (and hope this all somehow goes really well.)
Teki is right. There are lots of pediatric hospitals that do sedation and get great results and the child has no trauma and no problems later with fear of medical types. PTSD can occur in babies and kids. And sedation or painkiller or whatever is no big whoop. Quite easy to do. I suggest you call around to your Ped or to the patient rep on staff at the hospital and start asking some pointed questions.
Do you know how they get this result and nice pictures at my evil local children’s hospital? By making you hold them down while the child screams and panics in agony. They insist that any sedation is dangerous.
The other closest pediatric hospital sedates all the time, gets better pictures because the child is pain free and calm and has never had a problem with sedation causing any dangerous effects or illness. None.
If you need anything, like studies to back you up, email me, I’ll send you whatever I can find ASAP.
My son had this done on his kidneys at about 1 – some sedation but no urinary catheter – now he is three he wont even lie still for a scan so I am glad they havent repeated the nuclear med est recently..
seriously? this wouldn’t even work for a seven year old, much less a toddler. insane.
My son had a renogram when he was around 10 months. Or something like that age. (He also has a kidney that has to go to the movies by itself.) They strapped his little body down with about 4 velcro straps. The velcro straps were by far the worst part- as far as I could tell. Worse than the IV, or the catheter, because he was already purple mad about the straps. I will say, the medical people were fast, and it was all over quickly. I expected subsequent moodiness or crankiness at the indignity of it all, but as soon as the straps were off, all memory of it seemed erased. I don’t know if at 20 months your experience will be similar, but I hope it is as “easy”. Easy being a relative term in life.
Oh my! I hope they have more than just one tech. Last Thanksgiving I took my then 18 month old to urgent care due to a week of off and on fever and raging crankiness. I thought he must have an ear infection because a child that cranky must be in some kind of pain. After checking his ears (perfectly clear) the on duty doc decided he might have a urinary tract infection. It took three adults to hold one toddler down just long enough to put the catheter in for a few drops of urine for the test. (Also came back fine.)
After all that we went home. He ate a full Thanksgiving dinner and played all afternoon like he had never been sick at all.
I’m so sorry you have to go through this. I do hope it is all for naught and Simone turns out to be just as healthy as can be.
I had this done in high school (I can tell you the day: 1/28.86, and I’ll get back to that in a second) because I had a few asymptomatic urinary tract infections. (All was well, though apparently my kidneys are not so much kidney shaped, but they told me actually a lot aren’t but most people don’t know because they don’t get imaging. Huh.) Which begs the question: THEY HAVEN’T CHANGED THE TECHNOLOGY IN 23 YEARS? Really?! This is still the best way to do this? For a toddler? This does not do wonders for my already really shoddy attitude about medical imaging technology. (I did get to watch the whole thing on a tv, which I thought was cool, but Simone will likely not find it entertaining in the slightest.)
So, I’m lying there, being “still,” thinking of the beach or whatever, and suddenly everyone is running around talking in really hushed tones about *something.* Something bad. I thought a plane or helicopter must have crashed locally the way they were whispering and mumbling. I went out in the waiting room afterwards to find everyone starting at the tv: The space shuttle had exploded.
Ergo: That’s what I remember, not the procedure. She’ll forget it too, even without a catastrophe to mark the day.
Hang tough mommy.
HA HA HA HA HAHA HAH!!
Is it just me, or is Simone looking more and more like Elvis Costello?
When they strapped Millbarge into that contraption that Helen linked to, she just blinked a couple of times. The xray tech was actually ANNOYED that she wasn’t crying, because apparently the crying makes it possible to get a better chest xray.
ON THE OTHER HAND, holding her down to get a urinary catheter put in was deeply horrible, and I don’t think I will ever consent to have that done to her again without something to take the edge off of it for both of us, and I am not kidding.
Basically, while I completely understand, on an intellectual level, that what we were doing was safe and medically appropriate and that everybody involved had the very best intentions and was trying to help her, I could not get past the reality: I was helping hold her down while strangers held her legs apart and did very painful things to her genitals.
Yes, white coats and scrubs and medical degrees were involved, but I don’t think that really made the experience any more palatable for Millbarge.
Oh my goodness! Your comments (in bold) left me in hysterics… the funniest thing I’ve read all day!!!
On another (more somber) note… I’m so sorry that you (and Simone) have to go through this. I’ll be thinking of you BOTH.
Dear God. May I ask if this is at a Children’s hospital? If not, I highly recommend you ask for a referral to one. For children of that age, they should understand the importance of not causing pain and the complete inability to get them to lie still. General sedation, while not great, beats the alternative. I know some great people here in Toronto, but not so much in your area.
Best of luck. I know how difficult and scary and traumatising for all concerned it is dealing with serious or potentially serious medical issues in a little one. My daughter is now 16 (and was the WORLD’S MOST INDEPENDENT TODDLER) and we have come a terrifically long way – it will get easier/better.
Hey there, I am so sorry for what you’re facing, and I really love all the advice you’re getting about asking more questions and doing some research on this. I literally cannot imagine having my 3 year old catheterized while he’s unsedated, so I am stashing away all the advice for a rainy day, myself.
I laughed hard at your post, despite being horrified that Simone would have to go through it. That’s how well you write!
Lurking pediatrician here.
Simone should absolutely have some (light) sedation for this. The chances that anything that might be going on would get significantly WORSE in the days/weeks it’d take to schedule the renogram with sedation are MINUSCULE, so I would definitely push for sedation, for everyone’s sake.
OMG. My daughter is 18 months old and won’t keep a band-aid on…I can’t imagine trying to get her to hold still and let them catheterize her, give her an IV AND expect her to hold still for any length of time….
I can’t imagine a doctor that ever deals with kids would think that it would work without a little sauce for the kiddo….
Seems like it would be easier for EVERYONE involved.
I am sorry that underlying this post is something possibly quite serious and I sincerely hope that the tests show only the banal. That said, your attempts to alleviate the potential seriousness worked brilliantly — I nearly wet my pants and woke my sleeping baby (with my laughter, not the wet pants). Good luck with the test. I am sure both you and Simone will take it in stride. Well, maybe a few strides, and yours might be wobbly after the gin . . . but there is nothing wrong with that.
My first reaction was FUCK THAT. But then Sonya was much more eloquent and reasonable. Listen to her, pls, not me. Second opinion, children’s hospital, etc. I had to hold down my 6mo for a catheterization and NEVER EVER AGAIN. sorry for the shouting. but it deserves it.
I was in similar hysterics when my dentist suggested I bring my 2.5 yr old to my next appointment so she could see the process before her first exam. “She could sit next to you and color the rest of the time” was the comment that made me laugh.
We will be thinking of you on Friday.
Good luck to both of you, I hope you are both under some form of sedation for the procedure. And I am hoping the tests show the best possible results.
And you are an amazing writer.
holy eff, your baby’s awesome.
and i hope everything goes well, as always.
S
The picture makes this post for me, Simone looks like she is about to kick some medical booty. Have those people never MET a child? Good Lord.
I think I just wet myself laughing. Like really, I’m laughing so hard. I might have tears. I’ve got no idea what drugs the doctors are on, but I think I want some.
NO WAY KNOWN would I be able to get my daughter to follow those instructions and she’s 3. I wouldn’t have been able to at 20 months either.
I’m sure you’ll be back to tell us all about it afterwards though?
I am now planning for my son to undergo a rigorous training regimen in “Lying still as a statue” just as soon as he improves at “phrasing all requests wit deep bows and humble politeness”
Like you always do, you will get through it… somehow. You may not be quite sure at this moment how that can possibly happen, but history has shown that you have the tools to deal with whatever hand life deals you.
Oh and by the way…you have the cleanest bookshelves i have ever seen!!
Good God.
She needs sedation. (Or at least the fun stuff that that guy had, the guy who wrote the brochure. That stuff sounds awesome.) My husband treats children too (but more the, uh, upper parts) and goes absolutely batshit crazy when he hears about procedures done to kids without appropriate sedation. CRAZY, I tell you. Sedatives are so safe these days, there’s no reason to subject little kids (and their parents) to such torture.
I wish you luck getting yourself heard. And I’m so sorry you have to go through this at all. You must be worried sick. Sending you a huge virtual hug and an even huger drink.
I am so sorry you guys have to go through this procedure–but I so loved your post–I was laughing right there with you. Willow is 1 1/2 and there is NOTHING you can do with her that would make her still for 30 mins…except giving her some of that good ole sedation!
Good luck! I think they may have to give you both a HUGE lollipop after that!
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