Tips for Clinic Visits During Childhood Cancer

Listed below are some ideas for making treatment and medical procedures easier. These are based on the experience of other parents and are offered only as suggestions.

• Become involved in the health care of your child. Begin by informing yourself about your child's diagnosis and treatment. Your child's doctor or other members of the health care team can provide you with current information from books or pamphlets. Next, participate in decisions about your child's treatment. Remember, you and your child and the health professionals are partners in your child's health care. You may want to set up a meeting with the health care team, which may include nurses, doctors, social workers, nutritionists, and others, to discuss your concerns. Before that meeting, make a list of questions.

• Prepare your child for medical tests. You need to become informed about a test before explaining it to your child. Ask the doctor or other health care team members for information and how best to explain the test to your child. Your child may react with anger or fear, but knowing this information in advance helps to build a child's trust in adults. Using language that takes into account the child's age and understanding, you can tell what will be done and why. You may want to use dolls and puppets or other playthings. Be honest about the amount and type of pain the treatment will bring. Above all, listen to your child's questions and encourage your child to express feelings about what was just heard.

• Plan to stay with your child during a test or treatment. Your presence can do much to reassure and comfort your child and can make discussion afterward easier for you. Encourage your child to take part and make choices wherever possible. For example, your child may want to hold a gauze pad or watch for a signal. This helps children feel as if they have some control.

• Keep a daily log of your child's temperature, activity level, feelings, sleep patterns, amount of drugs given, and any reaction, among other information. Also, record the treatments and clinic visits. You and an older child may want to work together on keeping this log. Be sure to bring this log with you to your clinic visits. It will be helpful to your child's doctors.

• Bring a favorite toy or book to the clinic to comfort your child during the wait and the discomfort of treatment. Since waits are sometimes long and space is limited, reading, crafts, or quiet games can help pass the time. Teenagers may want to bring crafts, electronic games, playing cards, books, or magazines.

• Be discreet when talking with other parents or with patients in the waiting room. Don't discuss aspects of your child's illness that you haven't discussed with your child.

When To Call the Doctor

Ask when your child's physician should be called. Call when you have questions or if you are unsure whether something should be reported.

In general, you should let a physician or other team member know if your child has any of the following:

• A fever or other sign of infection of just doesn't "look well."
• Exposure to a contagious infection, especially chickenpox or measles, unless your child is known to be immune from prior exposure or develops a contagious infection.
• Persistent headaches, pain, or discomfort anywhere in the body.
• Difficulty in walking or bending.
• Pain during urination or bowel movements.
• Reddened or swollen areas.
• Vomiting, unless you have been told that your child might vomit after chemotherapy or radiation.
• Problems with eyesight such as blurred or double vision.
• Bleeding. In addition to obvious bleeding such as nosebleeds, signs of bleeding can be seen in the stools (red or black), in the urine (pink, red, or brown), in vomit (red or brown, like coffee grounds), or the presence of multiple bruises.
• Other troublesome side effects of treatment such as mouth sores, constipation (beyond 2 days), diarrhea, and easy bruising.
• Marked depression or a sudden change in behavior.

You should also check with your child's physician when your child is due to receive any kind of vaccination or any form of dental care.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.