Sewing Lessons

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“Come on sweetheart. Let the nice doctor take the stitches out!”

The four year old with dark curls was sobbing hysterically. Her mother was trying to soothe her. I was standing there awkwardly by the counter with the suture removal kit in hand…. still waiting.

“I can get some help with this….” I said quietly, trying to catch mom’s eye so I could mouth holding her down.

Mom shook her head no.

“I’ll buy you a toy if you let her,” Mom pleaded. “Anything you want…”

The kiddo pondered this. She held her arm out, warily. “Ok, ok. I’m ready.” 

She sniffed.

The wild look in her eye and the huge quantity of snot pouring from her nose told me otherwise.

I took one step forward with the forceps and little scissors and the sobbing and screaming started up again. We had tried this five times already. I was done, my patience worn thin.

I took a step back.

“How about if I leave and come back in a few minutes, let her calm down a bit?” I had three other patients already in rooms and two more still in the waiting room. I had already spent 30 minutes of a fifteen minute appointment (and they had shown up 12 minutes late to start with) explaining what I was going to do over and over again, even going so far as to let her hold and touch the scissors, all to no avail. 

“Yes, please!” Her mother sounded grateful.

Relieved, I left.

I knew from experience that with kiddos like this it was not going to work without restraining her. Once she realized after the first snip that this was going to be fine, she would relax and it would all be OK. It was clear that she had been tricked before. She knew not to trust adults, especially in this context. She was bound and determined that she was not going to be tricked again. She didn’t know me from Adam. All she knew was her past history. 

I couldn’t blame her.

I also knew that I could not do that restraining without parental permission. It was looking like I was not going to get that permission. 

Grumbling under my breath, I reviewed the next patient’s chart in the computer. I saw a couple of patients and then taking a deep breath, went back in.

“Are you ready to try again?” I smiled.

She nodded her head. Her puffy eyes and tear stained cheeks still said otherwise. Sure enough, as soon as I picked up the scissors, hysterics again ensued.

“Do you want me to get help?” I looked at mom. Please, please let me get help. She emphatically shook her head no, again.

“Sweetheart, do you want to come back again later?”she asked.

“Yes!” The water works stopped immediately and she hopped down off the table, smiling. She was at the door, hand on the knob, in half a second.

Of course she said yes.

I started assigning codes and printing the super bill. There was still going to have to be a charge for the visit. 

Her mother stared at me.

“She does not need those sutures left in indefinitely. That will increase scarring. Try to schedule in the next day or two…”

Her mother opened her mouth but hesitated like she wanted to say something.

“You want me to go ahead and grab some help?” I asked for her.

“Yes, can you? I really don’t want to pay another copay or spend another hour or two here again. Let’s just get it over with.” 

So I did. 

There was ear splitting screaming and that munchkin fought like a well trained ninja initially but she relaxed after the first suture was removed and stopped crying by the third. She was holding her hand out by herself for the last three. 

When we were done, she beamed proudly at what she had accomplished and literally skipped down the hall and out of the clinic afterwards, curls bouncing, chattering away happily, no worse for the wear.

It is terribly difficult for me to remember this with my own kids, that letting them experience something scary and overcoming it makes them stronger and happier and less anxious later in life. 

“Mommy I can DO it!” my son said as he started across by himself. All of the what if’s flew through my mind and my hand reached automatically for his. He swatted me away. “Let me do it!” He took one careful step after the other with me trailing close behind, but still letting him do it on his own, growing more confident with each movement forward, each step away from me.

Practice. That is what it is. Practice. And we all need it, early and often, though not necessarily in stitches…

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93 thoughts on “Sewing Lessons

  1. It is so hard to let them get that practice. That said, when you manage people, the same applies -= they have to be allowed to practice even when that means failure.

    Important post Victo – well done.

    Liked by 1 person

  2. The mother couldn’t hold the 4-year-old in her lap, in a bear hug? Speaking soothing words all the while? It always worked for me. I think it sends the message that yes, I know it will hurt, but it’s getting done no matter what, and I will be holding you all the time until it’s over – we will get through it together. Bribing the kid with toys doesn’t seem like a very good alternative.

    Liked by 2 people

    • This is a common theme I see constantly where parents don’t want the kid held by staff and do not want to do it themselves. Makes my job very difficult. You cannot ask a 4yo to be rational about this sort of thing. I love the way you handled it!

      Liked by 1 person

    • Not my kid. At age six, we had bad anxiety/Pandas attack, and needed to get strep test. She would not let us. . . Holding her down, the mother, the 250 lbs father, and nurse helping, it was still – almost impossible – the test was done so quickly and I do not think very accurately. Those kids can get super natural strength, you would not believe. Been through this too many times unfortunately….

      Liked by 2 people

      • Our local children’s hospital often had to use a “papoose” in the ER – a device which basically strapped the kid in and kept him/her motionless. I was glad that my child never needed that, but sometimes it was necessary for those patients who were already too terrified for the parents or anyone else to calm them. Terrified kids are strong kids, that’s for sure. How awful for the patient and the parents, but still better than going untreated.

        Liked by 1 person

  3. I agree with many of the comments above… however, it should be noted that Mom didn’t man up until cash was involved. Having said all that, I took my grandson last year to get his flu vax. Which was basically a saline dropper in the nose. Did he fight like a ninja? Yes ma’am… and so strongly that even I couldn’t hold the 5 year old in any sort of bear hug. He is either incredibly strong, or I’m a total wimp… but I lift 50 lb. grain sacks like they were nothing, so I’m rather thinking the former is the case. In the end, we had to abandon the appointment… Thank God for National Health, huh? To this day, I pity that nurse who sat there in despair, wielding a harmless pippette and looking for all the world like she would like to throttle one of us. Or both. Bless her NHS heart… xx MH

    Liked by 1 person

  4. Two of my kids are troopers about pain, and two can’t even. Sissy has had no choice, really (those liver biopsies for one). Although Moo is dramatic about aches and pains, she’s quite pragmatic about throat swabs and ‘getting her blood tooken’ lol etc. Sassy is the kind who feels faint at the sight of a bloody wound and is convinced she’ll die from having a hangnail cut off and needs to be talked down for needles of any sort! She’s not LITTLE, neither in age nor in size. My son was just like her, but I guess he does better now. He’s very good at avoiding anything that might injure him.
    I’ve had an experience like the above scene twice now, and I bet I’ll have a third. Both my eldest girls had to have the same loose tooth pulled, because it kept re-rooting. Both times, both the dentists assured me it’d be quick and not too painful, and both times they were wrong. *sigh* But you can bet that I’ll have them pulled, because I’m already there and I’m already paying.

    Liked by 1 person

  5. Great story. Hopefully mom learned a good lesson too. I have to admit I hover over my 2-yr-old grandson more than I did over my daughter. He seems fearless to me and so stubborn about doing things himself. He’d be slicing potatoes and hang-gliding if I let him. On the other hand, there are those things that he must do, even when he doesn’t like to, and the anticipation of often worse than the event itself. Then it’s time to buck up and learn a lesson that will serve us both over and over again. πŸ™‚

    Liked by 1 person

    • My son has no fear, either, so I am naturally a bit over protective in order to protect him from himself. He does not pay attention to cars or understand what they can do to you and he is so impulsive. But there are things I need to let him start trying, even if they scare the crap out of me.

      Liked by 1 person

  6. Oh this is a painful one for me. We abandoned blood draw at three different clinics, because could not make it work. We had done hold downs. I go through about 30 minutes of cries and frustrations just about trimming toe nails and fingernails. And keep praying – it is just the phase, she will grow out of it. . . I am the toughest person when it comes to pain handling, and just looking at some very stark differences among kids, makes me wonder why that is.

    Liked by 1 person

  7. I love taking my own stitches out πŸ™‚ Done it several times now. Last time the ER Doctor told me he wanted to see me in X many days to do a follow up (and take out the stitches. He was a young guy/ really liked his attitude. Anyway when he realized I was not coming back he gave me the little kit to take home. I like the way they tickle when they come out. ..back to your post…you work in such a pressure cooker environment! thought of you today when I read something about the new mandatory coding that’s coming. DM

    Liked by 1 person

  8. I remember reading about trauma induced reactions in people from doctors who restrained patients during procedures. But I do not know what else you could have done, which was brilliant . Money motivates doesn’t it. But poor baby. I imagine this is very difficult as a doctor but even worse as a mommy.
    I too took out my own stiches when I had surgery on my arm. Thought it was fascinating so the nurse let me do it. Reminded me of untrussing a turkey…… lololo

    Liked by 1 person

    • There is a loving way to restrain a child. I hate the papooses. I prefer having parents do it but if they are unable (sometimes it is just too hard for them) we can do it. Using kind words and gestures softens it some.

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  9. I’ve had stitches out a few times. Usually it’s not bad. But one time, I went back for removal after 10 days just like I was told to, and the skin had started to grow over some of the stitches on my thigh. It hurt like hell and took longer than usual. Fortunately I did not have to be restrained, but I did feel like skipping once it was over.

    Liked by 1 person

  10. Whew that reminds of me when LM was 3 and a papoose had to be used when he needed a tiny cavity filled. He was not having that mask with the gas put on him (forget the actual work), period. I feel awful about using the papoose to this day (that look of him thinking I wasn’t protecting him), but holding off wouldn’t have worked either. Probably didn’t take the dentist five minutes of work after that.

    Liked by 1 person

  11. The worst thing about treating children is absolutely the clueless-helpless parents…arghh… Sometimes I’ve wanted to tranquilize a couple of hysteric cases. Haloperidol and lorazepam, anyone? πŸ˜‰
    I always carried nice stickers etc with me in the ER to give to the children. But what could you give to the parents? Other than the tranc shot. A shot of medicinal ethanol? πŸ˜€

    Liked by 1 person

  12. I just had a flashback. I remember taking BOTH of my daughters through the car wash when they were babies. They looked out the window and screamed in terror. I felt awful. I still think about it every time I get the car washed. What a monster I was to do that.

    Liked by 1 person

  13. Parents are usually the problem, not the child. I know from experience that I was like a deer caught in the headlights with some scenarios (like my child being held down) and had to wait in another room while my husband was with our son and the doctor.

    Sometimes the child is a lot more resilient than their mother πŸ™‚

    Liked by 1 person

  14. Reblogged this on MULIEBRAL STUDIES and commented:
    I am happy to say our kids were troopers. They may have feared the pain as much as any other kid, but they held it in. There is something to be said about giving a child ‘space’ to come to grips with the inevitable.

    Like

  15. Your patience in this situatiion borders on heroic, Doc. Oh, if only we all could look outside the bubble and realize that our actions affect the world like a domino. This mom really needed to control the situatiion instead of letting her girl go amok. Next time better, you think? Lesson learned?

    Liked by 1 person

    • Hopefully there will not be another set of stitches but that will go more smoothly if it does, I have no doubt! I know I get better as I practice with my own children. Parenting just is not very easy or intuitive.

      Like

  16. Pingback: My Article Read (10-5-2015) | My Daily Musing

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