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Scary Medical Visits Cut Down to Pint-Size

Several hospitals provide special teams whose duty is to put their young patients at ease. Videos, murals and music are among their tools.

June 27, 2004|Holly Ramer | Associated Press Writer

LEBANON, N.H. — When her 6-month-old son had surgery, lawyer Kathryn Babin argued her way into being allowed to hold him beforehand, but was denied permission to wait for him in the recovery room.

Baby Roger shrieked as an intravenous tube was inserted in his arm and was crying again when she finally was allowed to pick him up later.

"This is crazy," Babin thought. "Isn't there some other way?"

Now nearly 3, Roger has undergone several more medical procedures, but thanks to an innovative program at Children's Hospital at Dartmouth, both he and his parents are much more relaxed. Instead of being held down and poked with a needle, he played in the hospital's "Comfort Corner," surrounded by ocean-themed murals and colorful kites, then snuggled with his mother while a mask delivered anesthesia.

"This last time, he told me, 'I'm ready to go to sleep now,' " Babin said.

The medical community appears to have heeded the American Academy of Pediatrics' policy statement on childhood pain. Issued in 2001, the policy urges doctors to relieve needless suffering by better anticipating and assessing pain, creating soothing environments in their offices and getting parents more involved.

The Pain Center at Akron Children's Hospital in Ohio uses everything from acupuncture to aromatherapy to soothe children undergoing medical procedures or recovering from surgery. The Children's Hospital and Research Center in Oakland, Calif., has a "Child Life" team dedicated to making hospital stays as comfortable as possible. And at Texas Children's Hospital, relaxation and distraction techniques used by pediatric anesthesiologists include blowing bubbles and letting children ride tricycles to the operating room.

Staff members at Dartmouth's Pain-Free Program still see plenty of tears, but the reason is different: Patients don't want to leave because they're having so much fun. Whether they're performing scary diagnostic tests or repeated treatments, the program's team of specialists uses technology and creativity to reduce the pain and stress of medical procedures.

"The hardest thing to do is relinquish your child to someone else," Babin said. "When they're doing something to them and you can't be there, it's very hard and nerve-racking.... The way the Pain-Free clinic approaches it is so much more of a relaxed environment."

A generation ago, many healthcare providers bought into the misconception that children don't feel pain as adults do. But youngsters deserve -- and parents now expect -- better, said Dr. Joe Cravero, an anesthesiologist and medical director of the program.

"There's no reason a kid needs to be crying and screaming in the hospital," he said. "If you or I come in for an appendectomy, we get the anesthesia we need. It comes down to how interested you are in doing this right."

Although many hospitals offer clinics to help children deal with chronic pain, the Dartmouth program works with all children, even those undergoing routine -- but still sometimes frightening -- procedures.

The pain-free team consults with parents and offers tips to prepare children for their appointments. By the time the children arrive, staff members know how to put them at ease, such as asking about their pets by name or having their favorite movies cued on individual DVD players.

One of the first patients when the program started two years ago was a teenage girl with severe developmental disabilities who hadn't received needed medical care -- just being approached by a doctor traumatized her. But when the pain-free team discovered that she loved to dance, it arranged to have music playing when she walked through the door.

"We were all dancing and she jumped right in," said team member Kristen King, a child life specialist. Moments later, the girl was calm enough to be sedated.

"She has not fallen asleep in my arms since she was a baby," the girl's tearful father told King.

At the Pain-Free Program, stocking up on the latest animated movies is just as important as keeping up with the latest medical advances. Some techniques are complicated, such as figuring out the correct dose of fast-acting, short-term anesthesia. Others are as simple as letting children wear their own clothes and sit on their parents' laps during sedation.

Older children who can stay still long enough for 45-minute MRI brain scans are helped by visualizing a trip into outer space -- hospital workers count down to blastoff and explain the thumps and bumps they hear as passing planets. To practice at home, some parents are told to have their child lie underneath a blanket-draped coffee table to get a feel for the machine's enclosed space.

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