There will be blood

As part of Philip’s four-year wellness check last Monday, the doctor issued orders for blood work. Peter and I both dreaded this news. We remembered the last time that we took Philip for a blood test. The phlebotomist became quite stern with me. “You can’t let him move,” he chided me. In the end, Peter ended up holding a crying, squirming Philip as the blood was drawn. I think Peter had been as traumatized by the experience as Philip.

Despite our feelings, we couldn’t put off the testing since the preschool requires it as part of an overall report from the pediatrician. The wellness report is mandatory in order for Philip to attend.

Having both moved and changed insurance providers since that blood draw, it was necessary for us to determine a new place to take Philip for the testing. Many years ago, my mom developed a blood clot in her leg following surgery. Since that time, she has had a couple of other clots. As a result, she will stay on blood thinners for the rest of her life. This requires that her clotting factor be frequently monitored. I asked my mom where she goes. When I found out she goes to one of those laboratory chains, I verified that this place was covered by insurance. Then I set about trying to make sure that the visit went as smoothly as possible.

I started by calling the local facility. I explained that I had a four-year-old with autism. Was there a technician who was skilled with children?

The woman who answered the phone suggested that I try a different branch of the company in a nearby town. She stated that they have two workers instead of one.

When I called the other facility, I got voice mail. When I called again and explained my situation, the student who answered told me she would have to check and call me back. When she phoned, I learned that, yes, they sometimes have two staff members working. This is because the office has an extremely large volume of clients. Yes, I could schedule an appointment and reduce my wait time. However, I was told the only way to do this was online. The woman informed me of their off-peak hours. Not surprisingly, these conflicted with either Philip’s school or my work.

I decided that, rather than upping the anxiety (both mine and Philip’s) by driving thirty minutes to a busy facility whose location I would need a map to find, I would schedule my appointment at the local branch. It is located across the road from our grocery store, only five minutes’ drive from home. I booked the appointment using the online system, selecting a time that wouldn’t conflict with Philip’s school.

Many children didn’t have school since today is Columbus Day. Philip’s preschool held its annual Grandparents Day instead. The schedule for the day was altered. Students were to arrive later than usual with their grandparents or special guests and stay for only ninety minutes. During this time, there would be a potluck meal in the cafeteria.

Before picking Philip up this morning, my mom went to get her blood work done. Remembering my questions about where I could take Philip for his testing, she asked the phlebotomist if they accepted children.

The technician answered that, yes, children come to the lab. In fact, she had drawn the blood of a child just that morning. It was a boy who didn’t talk.

The small talk continued. Mom told the technician that she was getting ready to go to Grandparents Day.

What a coincidence, the technician remarked. Just that morning, the woman who had been in with the child had mentioned he was going to Grandparents Day, too.

My mom puts two and two together.

“Was that boy’s name Philip by any chance?”

I scheduled the appointment for this morning since Philip would not be going to school until later. I told Peter that he didn’t have to join us. He finds it hard to stand by while our son cries, knowing that there is little he can do comfort him. “You can stay home and be the hero,” I assured him as we headed out the door.

The appointment was at 8:00 am. We thought this would be a good time since it would give Philip a chance to wake up, but not make me too late for work. Of course, no one consulted with Philip who woke up at 4:48 am, fell back asleep around 6:00 am and tried to remain so until I persuaded him to wake up again just after 7:00 am.

As soon as I got Philip ready, we drove to the facility. Even though I had an appointment, I thought they might be able to take us earlier if it was too crowded.

The only car in the lot when we arrived probably belonged to the staff member.

We were able to walk in, sign in and go straight to the room. Philip balked a bit. I think the room reminded him of a doctor’s office, but had enough differences that he was willing to enter. The staff member took our orders and insurance card and began inputting our information into a computer. I took off Philip’s coat and got out a toy. He played with this while rocking side to side.

When the paperwork was complete, we moved to the chair. I could tell Philip was nervous, but he didn’t start to cry until she put on the tourniquet. Once she found a vein, she removed the tourniquet while she assembled the materials for collection.

I explained that Philip was non-verbal, so there was not much I could do to prepare him. The technician assured me that, in her opinion, there really isn’t much one can do to prepare any child.

I thought about this as I watched the procedure. I thought about how it feels to have a tourniquet pinch your skin. I thought about having a stranger sitting so close, alternately thumping and stroking your arm to find a vein. I thought about the wet coolness of an alcohol wipe cleaning the site. I thought about the sharp pinch as the needle breaks the skin. I thought about that funny feeling I get in my stomach as the needle hangs in my vein. I thought about how I start to think about what would happen if I twist my arm at the wrong time or if the needle goes in too far. If I, a neurotypical adult, experience such a wide variety of discomfort and anxiety, why wouldn’t my child? All I can do is murmur, “I know, sweetie, I know.”

The phlebotomist worked calmly and efficiently. She,too, spoke soothingly to Philip, but focused on collecting his blood as quickly as possible. He cried. He cried until he gagged, but I was able to hold his arm straight.

When the needle was removed and gauze put over the needle site, I folded Philip in my arms. His crying was slowing. There was a temporary increase when the bandage was applied, but it subsided into snuffles by the time Philip’s coat was back on and we were headed to the car.

I gave Philip milk on the ride home. His eyes were read, but he saw something that made him giggled. He was subdued when we got home and didn’t like the sight of the gauze and bandage, but quickly returned to good spirits. I had to rush off to work.

I called my mom during my lunch break. I wanted to find out how Grandparents Day went. She told me about the morning and said that she took pictures.

It was during this phone conversation that Mom told me about her visit to the lab this morning. She told me that the technician thought Philip did really well. She also complimented him on his long eyelashes.

Before Philip and I had left, I half-jokingly remarked that Philip would never let me take him anywhere again. The technician said,  “You’d be surprised how quickly they forget.”

We shall see.

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