Getting Ready for Round Two of Botox

Cassie at McMaster Children's Hospital 2Q Clinic coming for an appointment to meet Tara her Child Life Worker.

The Botox appointment was moved to June 8, 2009 which was fine with me as it gives Cassie a little bit more preparation time with her child life worker Tara

The plan is to receive 4 needles (300 units). The muscles that will be injected are the gastrocs, add. hall, add. poll, pronator meres. I am not sure if I have the names exactly right but I am going to get an anatomy book and look them up. I am worried about the lack of physiotherapy available after the June 8 injections. Cassie's therapist at the after school clinic went off on maternity leave and one of the cost containment measures at CDRP was to not replace the therapist. This was one of the most valuable physiotherapy clinics Cassie ever participated in and I am extremely disappointed to not have access to it. Although it was only one hour a week it was the best program for Cassie. She loved working in the gym with the other children. She was motivated and loved the program. I wrote a letter asking them to reconsider but have not heard anything. I decided on my own to try to learn the muscles being injected with Botox and then I will ask the therapist to show me some exercises that will help these muscles strengthen. Cassie already has exercise equipment in our basement. I may try to find a physio student or a kinesology student and see if they wan to work on some of our home exercise programs with a very cute little girl.Cassie took Sarah doll in to see Tara today. They started an IV and gave Sarah blue and green sleepy medicine. Cassie has walked through the entire procedure of having an IV start. We have come up with lots of strategies for the big day. Here are the few most important ones.
1. Ativan the night before to help her sleep
2. Ativan the morning of the appointment
3. Don't mention the appointment until we head out in the car.
4. Emla patch on 45 minutes before the poke.
5. Bring Walkman with Hannah Montana Music for a listening distraction
6. Sit on Mommy's lap during the IV start with Tara "Safe person in the hospital standing by to tell the nurses all Cassie's strategies.
7. Look away during the poke. Mommy to do the imagery breathing techniques learned with Cassie.
8. Mommy has a special never before heard story as a distraction during the rough periods.
9. Next visit to hospital Tara to take Cassie to the clinic room to look around
10. Cassie to have access to her own special girl band aids.
11. Wake up time. Nice drink and TV to watch with roommate.
12. Internist will consider need for oral Medazolam that helps erase memory but this may not be necessary this time we will see.

Stay tuned to see how the strategies empowered Cassie and help to decrease her fears and assist her to deal with a painful sensation. I am confident the plan will make things easier on her.