Everything possible to minimize a child's pain

Tommy Buisman (12) and child life specialist Erin Sinnema.

Tommy Buisman of Gilbert wasn’t expecting to be in the hospital that day. It was fall break, after all, and  and he should have been out doing something fun.

But 12-year-old Tommy has diabetes. And sometimes, despite everyone’s determined efforts to keep it under control, it gets the better of him.

Erin stands at the entrance to a private room at the hospital. The mural, a cityscape of Atlanta, and the home-like entrance are all part of a planned approach to reducing anxiety when children must be hospitalized.

We met Tommy and his mom, Cristina, toward the end of a two-hour video shoot at Cardon Children’s Medical Center. Multimedia journalist Vicki Balint and I were there to learn about pain management techniques available to blunt the physical and emotional backwash that can follow a painful medical procedure. We interviewed child life specialist Erin Sinnema, who talked about the longterm effects of a bad experience with pain. We talked to nurse practitioner Teri Reyburn-Orne, RN, MSN, CPNP-AC, who explained some of the techniques the hospital uses to mitigate pain. Teri demonstrated the J-Tip, a fairly new device (it’s been available only a year and a half or so) that allows medical staff to inject topical anesthetic without a needle so that the procedure to follow — a venipuncture (blood draw), for example — is not painful to the child.

Teri shared a story about her own, now-grown son, who vividly remembers the trauma he experienced as he was taken into surgery as a young child.

“It’s a myth that children forget pain,” Erin told us. She explained that untreated or undertreated pain causes permanent changes in the pathways that interpret pain, making the body more sensitive to pain. The body forms a permanent memory that changes forever how it responds to future painful experiences.

As Vicki was interviewing Teri, I met some people in the hallway who were there for a completely different video shoot. David Curran, M.D., is a pediatrician with East Valley Children’s Center in Tempe and chair of the pediatrics department at Cardon Children’s. He and his wife Tina are co-chairing “Stars of the Season,” an inaugural event to benefit the hospital’s Integrative Pain Management Program, on Friday, Dec. 3. They were at the hospital that day to be interviewed for a video about the event. Chester Bennington, lead singer of Linkin Park, was with them. His wife volunteers at the hospital as a dog therapist.

The Currans have three children of their own, ages 3, 7 and 9. They have wholeheartedly embraced the hospital’s commitment to offering cutting-edge pain-management therapies, even those that cut across traditional boundaries.

Each room at Cardon Children's has a whiteboard chart that includes sad or smiley faces that help children indicate how much pain they are experiencing.

When pain can be managed successfully, “children get better quicker,” says Dr. Currran.  So he is open to anything that works, and is leading efforts at the hospital to integrate alternative therapies — including acupuncture, massage, music, meditation, hypnosis, aroma and pet therapies — with high-tech contemporary medical approaches.

When he came into his position as department chair, Dr. Curran says, he asked the staff at Cardon to “give me three things you need. Number one on the list was an integrative approach to pain management.”

Unfortunately, alternative therapies provided by specially trained practitioners are not reimbursed by health care insurance. The fundraiser will raise money to ensure that children and families who could benefit from alternative pain management techniques are not denied access to them because they are unable to pay out-of-pocket.

So back to Tommy, who was a terrific sport about welcoming strangers with cameras into his treatment room at the Emergency Department. Though still woozy from the effects of his diabetic incident, Tommy managed to smile and patiently answer some questions. Tommy was hooked up to an IV, which meant he’d undergone a needle stick just moments before we entered his room.

Erin chatted with Tommy for awhile, asking him what grade he was in and quickly establishing a rapport. Gradually she got around to asking him what he’d felt like when the IV was administered.

“Was it scary?” she asked gently.

“No,” he said quietly. “It was comfortable.”

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