How can transfusion dependent children get used to needles?

Do transfusion dependent children ever get used to the scary needles?

It's heartening to see little children born with blood disorders or those who unfortunately are diagnosed with leukemia to be tested repeatedly through blood tests.

The blood tests have to be conducted through blood drawn through the veins in the arms or through the veins on the hands.

When babies have to be tested, the worse part is that their veins are too tiny to be easily visible and so finding the right 'spot' to prick the child with the needle becomes a tricky part. Often the needle is pricked and the nurse or doctor has no choice but to move the needle left, right and centre so that the blood starts coming into the vile or tube.

The needle can become such a traumatic sight for the child that some children develop a fear of needles for a very long time, some times even when the prick does not hurt that much. On the other hand there are children who become so used to the prick of the needle that they hardly even wince when they are pricked. This later case is a relief for parents who have to see little children aged less than 6 years of age, go through repeated blood transfusions or phlebotomies for blood samples being drawn for tests etc.

The best thing for parents to do would be to let the child feel safe in their arms while the needle is being pricked. Hold the child tight so that the child does not move. Any untoward movement will very likely mean that the child might need to be pricked twice.

A local anesthetic cream for children called EMLA is very effective too. It helps to numb the area where the child is to be pricked. However studies have shown that long term and prolonged use of EMLA is harmful for the veins of the child, so use it only when you know that the spot that's going to be pricked is an especially sensitive spot (such as the inner wrist, foot, scalp etc. which can be very painful spots for children to have needles inserted in).

Getting used to needles is something that happens so gradually that even the child does not notice that he or she is getting accustomed to the pain. But this happens only with thalassemia or blood disorder patients. Leukemia child patients who may develop the disease after the age of 6 remember the pricking sensation of the needle very vividly and usually find it hardest to adjust to the prick of the needle.

At this point, doctors usually suggest a Central Venus Line to be inserted in the chest of the child patient. A CVL is a tube dangling from the chest of the patient which has to be inserted into the body normally through an incision in the neck and it is inserted into a main vein close to the heart. This vein then comes out of the chest and hangs there with a clip attached at it's end to open and close the valve of the tube.

Once inserted a CVL is an extremely useful device to give the child iv medicines, transfusions of packed cells (Red Blood Cells), platelets and even a bone marrow transplant.

A child becomes much more relaxed and the best part is that the CVL can be used daily for drawing blood samples for testing too.

In cases where a child becomes very difficult or scared of being pricked, doctors sometimes suggest (if they are convinced that the child will be pricked repeatedy in the future too) to get the child a CVL. A CVL can function without any major problems for ypto 6 months. After which time a fresh CVL will need to be srgically inserted under general anesthesia.

One of the biggest risks of having a CVL inserted apart from the risks involved in surgery, is that the tube can be a HUGE source of infections. So though the CVL will help the child through a lot of pain, an infected tube, especially where blood counts are (probably) already not normal, can become a cause of death.

I've written a small explanation of some key terms that I feel parents who have blood transfusion dependent children should know. If any one would like to add to the thoughts expressed above then I would be very happy to hear. My daughter has had around 100 transfusions, several before and some after her bone marrow transplant.

My daughter did become used to the needles at one point but when she had a break from the pain for a few months, it was a whole new dilemma. I'm writing about my experiences with my daughter in my memoir. hope it helps other parents and many doctors who have to deal with child patients in such predicaments.

Until we meet again!

Stay positive for the children!