Basic guidelines for supporting psychological health of a sick 3-year-old?

Question

My 3-year-old son has become ill over the last few days - his white blood cell count is low and the diagnosis is immune thrombocytopenic purpura (ITP).

The prognosis is good - he should get better in a few weeks or months. He also feels good, but now we have to restrict his activities - no bicycle, no somersaults, no climbing, etc. At the same time, we have been seeing doctors, getting blood drawn, and discussing the topic as we learn about it. I would like to minimize psychological harm as a side effect - and, if possible, squeeze some positive educational opportunity out of it.

Considering the circumstances, he has been handling it very well. But he is starting to get worried - when we tell him he can't jump around he takes it very seriously.

How can we minimize negative psychological consequences of this situation? What should and should we not say to him? Maybe we should not discuss it at all in front of him? How should we discuss it?

This is making me realize the limits of my knowledge and abilities as a parent. For example, tomorrow we drive 2.5 hrs to see a doctor. To what degree should we avoid the topic? Should we go so far as to pretend that we are going to a park or museum with a quick stop at a doctor's office on the way?

Answer 1

It sounds as though he may be playing off of your reactions, to a degree. When kids have something serious happen to them, they take their cue from the adults around them-like when they fall... if you tell them to dust off (while checking to make sure everything's ok) and then have them go play they will react differently than if you say... be careful, don't do that.. or if you are more cautious with them the next time they are about to do the same thing.

I would say limit your talking about it to a minimum with them. It helps for them to understand what's going on-but then move on to other subjects-making sure to remind them that for right now, no jumping, etc...you'll be able to do that again soon. How about we do x, y, z instead... which means you have to come up with x, y, and z (play with trains, read, watch a movie/show, build with blocks, paint, be a turtle and follow each other around the house (gets movement, but slow and careful movement), etc). At 3 they need to be able to be a kid and not have an illness hanging over them 24/7-if at all possible. And I, personally, always blame the doctor for the limited activities... do you remember Dr. X said no jumping. I'm sorry, honey, but it could make you feel yucky/worse. If you need to talk about what's going on in more detail, than you need to do that with other adults-so that he doesn't feel like this is all there is in his world...

Having done the 2.5 hour drive or so to a doctor with younger kids-don't minimize the doctor... but "since we're here" why don't we go to this grocery store I never get to go to and pick out something as a treat and maybe get some things I can't find at home, too... or go to a restaurant for lunch/snack that isn't near our house as a special treat... so they don't dread the doctor's visits in the future.

Answer 2

I think you're right to discuss things and not avoid the topic. Just as with adults, children can find it easier to deal with situations if they understand what is happening and why. When my 2-year-old was throwing up and had to have an exam and x-rays, we explained that the doctor was going to help. We used age-appropriate explanations. During the exam and for the next few days, she repeated simple words like "help," "better," and "sick."

She also found it helpful to play doctor with her doll. She would use things like a toy stethoscope or a toy bottle and say things like "Baby sick, [something] help better".

The previously posted suggestions are helpful, such as quoting the doctor for the rules--you might even add "because Dr. X wants you to get better."