Having a child with medical or other special needs can be overwhelming and expensive. Not knowing where to find resources is a common reason children and parents don’t get the support they require. I wish I could transfer everything I’ve learned over the past few years to you. My book is a great resource, but even it doesn’t cover everything exhaustively. Trying to address every challenge all in one place would have made it so vast and unwieldy it would’ve been unreadable.
No one likes having their blood drawn. Trying to explain to most children why someone absolutely must poke them with a needle isn’t realistic. It comes down to “no ouchies” which, frankly, is an argument I have a difficult time winning. With kids, you can’t exactly have a thorough discussion on the merits of whether or not these specific tests will provide adequate insight into their current medical problem.
I’m going to share what has worked for us. I hope it works for you. There’s no judgement if it doesn’t. Every kid is different! First, infants and toddlers under two. You really can’t do much for them except hold them down firmly with cuddles to minimize the stress and discomfort. Your focus will be more on the nurse. Ask yourself:
- Does the nurse have all of their supplies ready and accessible, while still having them outside of your child’s reach?
- Is the needle your nurse has pulled uncomplicated? It should look like a sewing needle, except it’ll be hollow.
- Are the test vials present? Sometimes nurses pull blood by syringe. That’s also fine as long as the syringe is ready to go.
- A second nurse will usually be present. While you hold your child down, the second nurse will either perform the blood draw or ensure the site they’re using stays completely still. I recommend highly to ask for a second nurse if there isn’t a plan for one to assist. It’s worth the wait.
First, congratulations deciding you’re willing and able to take on a vacation. I personally find the idea of going to some other place foreign to our toddler and trying to stay there for more than just a few hours terrifying. Staying the night is quite an undertaking. We’re planning to do it for the first time this summer. Anyway, the whole process is scary enough without forgetting something so here’s some helpful information on how to pack for your adventure.
If you touch it on a normal day for your child it needs to go with you. Find a way to mark items with brightly colored tape or maybe placing them in a certain place. The last use of the day means the item gets packed up. This does make packing an all-day process, however, it makes you much less likely to forget things. When I pack myself I do it a few days before we leave. That way I don’t forget anything I need to be comfortable in the process of making sure my son has everything he needs to eat and stay healthy.
It’s pretty common to see parents of kids who vomit frequently in the car armed with a bottle or canister of scent removal spray. After all, we spend so much time cleaning everything else it’s sometimes tough to justify spending a whole lot of time cleaning one of the places we spend the least amount of time. You spray the right product and the smell goes away. Everyone’s happy!
Every once in a while, it’s good to get in there and really clean up all of the things that didn’t quite get clean when you wiped them down with a rag right after the vomit episode. There are also ways to protect your vehicle and make it so most of the mess can be drug out of the car and banished with a hose. Let’s talk about those first because, frankly, preventing a tough mess in the first place is really the only way things are going to stay somewhat clean.
- Auto Seat Protector – This handy device will sit under the car seat and make sure any vomit which overflows from the car seat’s undercarriage won’t lie around and keep the seat underneath wet. Yes, some of them will claim to completely protect your car’s interior. For most children this is probably true. Our son overflows ours from time to time.
- Rubber Floor Mats – These are a must have for many, many situations. We have the heavy-duty grooved rubber mats which cover a wider area than your traditional cloth mats. We use them to pile soiled clothes, diapers, and rags until we can get home. This keeps the soiled cloth from seeping out into the vehicle’s upholstery.
- Car Seat with a Machine Washable Liner – Not all car seats have this feature. I consider it a must have since children make messes regardless of whether or not there are medical reasons involved. Our He machine does an excellent job of scrubbing our seat’s liner as long as it’s pressed down into the bottom so the water will cover it. You’ll need to wash after you’re in for the day. I’ve yet to find a car seat liner which permits machine drying.
There are a lot of kids who vomit in the car and it’s mostly an annoyance. For our son with Noonan’s Syndrome every bit of food counts. He has difficulty gaining weight under normal circumstances and getting car sick makes it that much worse. If you find yourself thinking, “It’s not that big of a deal,” please remember it is a big deal for our son.
One of the first things we were told to do with our son to soothe him was to toss him in a car seat and drive him around. Our first pediatrician even recommended sleeping in a car seat as a way to lessen the discomfort of his reflux. We did try these things before writing them off but they weren’t helpful for us. The angle of the car seat seemed to guarantee our son would puke all over himself, in the car or out of it.
If you’ve dealt with getting a prescription filled at a pharmacy you may have come across this term at some point. When something requires prior authorization it means the insurance company must approve coverage for it before it can be purchased. Many children with feeding tubes run into this for acid reflux medications but there are other types of medications which also have these sorts of restrictions.
The mechanics for prior authorization can be extremely confusing because policies between insurance companies differ significantly. One company may approve a brand without any objection while it might be nearly impossible to get approval for anything else. If you switched insurance companies you might well find that one brand which was preferred before is almost impossible to get approval for once companies change.
This week the case for our son’s feeding supplies and his formula was approved by the insurance company. We changed companies the first of the year and I began working to get the case set up with the new insurance company prior to the swap. Approval came almost exactly three months to the day after beginning the process.
Why did it take three months? Many, as in more than four or five, well-intentioned people thought they knew how to take care of the case and it turns out they were wrong. How could so many people be wrong? Some were new and simply didn’t know the answer. Most had been at their job for a while but things had changed and no one bothered to inform them. Everyone I spoke to was trying their best to help.
If you’ve never gone through this process before it may come as a surprise. Three months is actually not that bad to get everything in place if you’re changing insurance companies. Having a child with medical needs which require case management approval makes changing insurance companies complicated. Now that we’ve gotten through the process I feel comfortable sharing some tips on managing insurance companies, case management companies, supply companies, and frankly any large organization.
The process of transitioning from one formula to another should be done under the guidance of your child’s pediatrician.
There are many reasons you might change your child’s formula. Some of them aren’t medical at all. The price may simply go up on the one you’re using and you decide to switch to a less expensive brand. For the purpose of this discussion, I’m going to focus on the medical reasons. I’ve listed some common medical reasons below.
- Gas / Fussiness
- Mucousy stool
- Bloody stool
- Vomiting / Poor weight gain
This is never fun for anyone but it can be especially difficult for medically complex children. Instead of a doctor’s office or two, there’s a medical supply company, the pediatrician, and all of their specialists. Prior authorizations have to be submitted to the correct insurance, so you may need to update insurance information with doctors you haven’t even seen yet!
Tip #1 – Call the new insurance company. They won’t be able to tell you much until the insurance activates, however, you can request a case manager be assigned before the transition. This gives you an advocate on the inside that already knows your situation before the paperwork starts flowing.
Tip #2 – Call and update insurance info with all of the doctors who write a perscription for your child. That way if there are any issues at the pharmacy which require additional paperwork from the doctor’s office the responses get sent to the correct location.
I highly recommend anyone with a child who has complex medical issues or special needs purchase a basic medical ID. There are a lot of different kinds available. There are adjustable ones with velcro and watch bands. For the fashion forward there are adorable combinations of pink and blue bracelets. You can choose to engrave the details on a plate. Some have a pocket where there’s a little piece of paper you write on. Whatever method you choose, children with special needs and complex medical issues NEED a Medical ID.
Why? You might be incapacitated by the same thing that injured your child or your child might not be with you. Then…
- Drug allergies will not be discovered until the drug is administered.
- If your child has an implanted device, such as a shunt, no one will know to check right away if it’s been damaged.
- They may offer your child who silently aspirates food or drink.