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Breathing
Easily
Dina Lemus came to Bellevue Hospital
Center from Argentina because she was very ill. The 9-year-old
has idiopathic thrombocytopenia, a condition that among other
things, causes her to feel very tired and week. To Dina,
the worst thing about her illness was not how bad she felt
- it was all the blood tests that monitored the progress of
her treatment.
For
the first three months after she was diagnosed, Dina had to
have blood drawn twice every week. Astrid Rios, a Child Life
Specialist who is part of the pediatric department's Pain Management
Team, worked closely with Dina and her mother, Isabel Garcia,
to help them manage Dina's fears about the difficult treatment.
When the tests began, Dina was so frightened
she could only lie rigid on a treatment table with her fists
clenched. When a child is so stressed and tense, Astrid said,
the blood doesn't flow easily and this makes drawing the sample
even more difficult. Dina, her mother and Astrid tried many
different techniques to help Dina gain control of her emotions.
Before the procedure, the doctor applied a cream, called Emla,
that eliminates some of the pain. But it doesn't always work.
They tried blowing bubbles to distract Dina and clenching
a ball tightly in her hand.
The technique that has worked the best for
Dina is to concentrate on slow, regular breathing. She and
her mother practice her breathing at home before coming for
a blood test. "We rehearse," said Ms. Garcia, "we
make believe." She is especially satisfied because she
knows how to help Dina manage her fears when Astrid or another
Child Life Specialist can't be present for a blood test.
Now Dina sits comfortably in a chair with
her arm outstretched when she needs to have blood drawn for
her twice monthly check ups. She closes her eyes and her mother
sits closely coaching her as she breathes. The procedure is
over in no time. The tests show that Dina's treatment is working.
Her mother reports that she is able to keep up with the other
children at play now and is even riding a bicycle.
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