Ryan has had issues with nose bleeds for a while. I've even blogged about it (see Scary post). He would go through spells when he'd get about 1 or more nose bleeds per day for weeks at a time. You may be thinking that it's not a big deal, and really, in the grand scheme, it's totally not, but it was a big inconvenience. For most people, you can just grab a tissue and try to pinch the nose to make the bleeding stop. But with Ryan, based on the way he likes to move his hands and arms, it wasn't so simple. He would smear blood all over his sleeves, cheeks, hands, mouth, etc. He isn't able to understand simple commands like "put your hands down" or "don't touch" so he makes a mess of the blood. If you can get him to stop moving for a second to grab a tissue, the blood drips out all over his shirt, his pants, the chair in which he's sitting, the floor, etc. and by the time you have a tissue in your hand, blood would be everywhere. I watch some crime shows and I would always think, if someone were to come to our house and take the black light and see where all this blood has been cleaned up, they would think something sinister is going on. Nope - just nose bleeds! Lots of them. And it wasn't just at home. We'd get notes home from school constantly letting us know that he had {another} nose bleed and he'd be in his extra change of clothes. It was getting to the point when it was too much.
Another thing about it was that it didn't take much to get it going. If he got upset, even in the slightest bit, and started crying, his nose would bleed. I'm not talking about a real cry or getting super upset; even just a wimper, or a teeny, tiny cry - that's all it took. It would immediately start gushing. Huge drops just coming right out. There was no "light" nose bleed. It would come on strong.
I brought it up at the boys 5 year old well check at the pediatrician last fall and was told again not to worry about it. The main point that was made was that as long as the bleeding stops within 15 minutes, there's no need for further examination or concern. And it's very true that his nose bleeds did not last that long. I wasn't necessarily worried about him losing too much blood and being in danger from it, but it did seem like a lot of blood for a little guy.
We'd been given the suggestion to put Aquafor in his nose - did it. We were also told to try the kids version of saline nasal spray. Just knowing Ryan and how he is, I knew this would not go well. When he doesn't like something, it will get him upset and he will start crying. When he cries, of course, his nose will bleed. It felt like we were stuck in a vicious cycle.
I had to make another pediatrician appointment for Ryan this winter for pink eye and at that appointment, I once again brought up the nose bleeds, as it was during a time frame when the nose bleeds were numerous and frequent.* I tried to explain how easily they start and how fast they flow when they do start. I'm sure his doctors and people I talked to about it just thought I was over-reacting and blowing it out of proportion. Ryan actually got upset at the pink eye appointment and his nose started bleeding (just barely) but it was enough for the pediatrician to understand what little provocation it took to get it started. I didn't want to be the squeaky wheel, but I did feel like we needed to get some help and to quit ignoring it. She agreed to create a referral to an ENT for him.
*Pictures of him before his pink eye appointment are below. They are gross so I didn't want to put them at the top of the post. While I was trying to get a pic of his eyes to show the doctor at the appointment later, his nose started bleeding. You can kind of get a glimpse of how it goes from 0 to 60 in a matter of seconds. It can be somewhat gruesome.
Fast forward a few weeks to when we got this referral appointment scheduled and Thomas and I went to the ENT (Ear Nose Throat) Dr with Ryan. I made Thomas come to this appointment because I know that Ryan doesn't like things in his nose (or ears, or hair, and so on) and I thought he might get upset, have a nose bleed, possibly vomit. I wanted some reinforcement there with me. I brought a change of clothes for both Ryan and me, just in case!!! When we got in to see the doctor, I only felt right that I should warn him of such and I think he had his reservations about whether we would actually be able to do anything at the appointment.
The thought was that Ryan had blood vessel(s) close to the surface of his skin inside his nose, and that anytime there was any irritation, the blood vessels at the surface would create the bleeding until a clot formed. If/when the clot came off, it would start bleeding again. Getting upset and crying causes your heart rate to go up and your blood pumps faster and that was all factoring in to the nose bleed situation and why him getting upset made the nose bleeds start and/or get worse. The ENT said he wanted to cauterize one side of his nose and it could be done in his office that day. They only do one side at a time to prevent complications and I knew that his left side had been bleeding most recently so that's what we focused on. First the doctor had to numb Ryan's nose. This consisted of putting some sort of numbing substance on a small piece of cotton and putting inside his nose for about 15 minutes to numb it. I was concerned how this would go. The doctor was clear that if he didn't do well with the numbing we were NOT going to try to cauterize and instead we could make an appointment in the OR to include anesthesia. That was obviously not the preference so I was trying to stay positive that we could get this done in his office on that day. In all honesty, I thought this numbing would go over like a lead balloon. But I was hopeful and ready to try to distract Ryan so that he wouldn't mind as much. Y'all. Ryan was a CHAMP. He fussed just a little when they put the cotton in, but that was it! He kinda sorta forget about it being in there. I had to keep his hands busy, so that he wouldn't rub his nose and make the cotton come out so I held his hands and we walked around the room as a distraction. When the numbing process was complete, the doctor and the nurse came back in and were as pleasantly surprised as Thomas and I were. The doctor was able to cauterize and all we had to do was hold Ryan's hands to keep them from going rogue and getting in the doctor's way. Ryan was cool, calm and collected. Mind you, he didn't love it, but he was really, really calm and very good. We made it through the whole thing with no tears, no nose bleeds, no vomit. SUCCESS. The doctor told us to keep the Aquafor on his nose (easy enough) and then to start with the saline spray (ugghh).
The doctor warned us that Ryan's nose may bleed a little while healing from the cauterization but that the bleeds should be fewer and lighter. It's been a while between the appointment and when I'm finally writing this post, so I could be off a little, but if I remember correctly, I think his nose has only bled two times since then. It really did the trick! Not having to deal with the nose bleeds has made our lives easier. I think his teachers at school are probably really thankful too.
We did end up doing the saline spray for a while, per the ENT's request. As predicted, he did not like it. He got to the point that he would tolerate it, and I would do it as fast as I could, but he would still cry, at least a little, right when I put the sprayer in his nose. I've backed off of the saline as time has passed and now I don't bother doing it anymore.
*Pink eye pictures WITH nose bleed are below. You may not want to look if you get squeamish. I was just trying to take a pic of his eyes before I cleaned them out so I could show the doctor when we went to our appointment. As I was taking the picture, his nose started to bleed and it got messy.
Another thing about it was that it didn't take much to get it going. If he got upset, even in the slightest bit, and started crying, his nose would bleed. I'm not talking about a real cry or getting super upset; even just a wimper, or a teeny, tiny cry - that's all it took. It would immediately start gushing. Huge drops just coming right out. There was no "light" nose bleed. It would come on strong.
I brought it up at the boys 5 year old well check at the pediatrician last fall and was told again not to worry about it. The main point that was made was that as long as the bleeding stops within 15 minutes, there's no need for further examination or concern. And it's very true that his nose bleeds did not last that long. I wasn't necessarily worried about him losing too much blood and being in danger from it, but it did seem like a lot of blood for a little guy.
We'd been given the suggestion to put Aquafor in his nose - did it. We were also told to try the kids version of saline nasal spray. Just knowing Ryan and how he is, I knew this would not go well. When he doesn't like something, it will get him upset and he will start crying. When he cries, of course, his nose will bleed. It felt like we were stuck in a vicious cycle.
I had to make another pediatrician appointment for Ryan this winter for pink eye and at that appointment, I once again brought up the nose bleeds, as it was during a time frame when the nose bleeds were numerous and frequent.* I tried to explain how easily they start and how fast they flow when they do start. I'm sure his doctors and people I talked to about it just thought I was over-reacting and blowing it out of proportion. Ryan actually got upset at the pink eye appointment and his nose started bleeding (just barely) but it was enough for the pediatrician to understand what little provocation it took to get it started. I didn't want to be the squeaky wheel, but I did feel like we needed to get some help and to quit ignoring it. She agreed to create a referral to an ENT for him.
*Pictures of him before his pink eye appointment are below. They are gross so I didn't want to put them at the top of the post. While I was trying to get a pic of his eyes to show the doctor at the appointment later, his nose started bleeding. You can kind of get a glimpse of how it goes from 0 to 60 in a matter of seconds. It can be somewhat gruesome.
Fast forward a few weeks to when we got this referral appointment scheduled and Thomas and I went to the ENT (Ear Nose Throat) Dr with Ryan. I made Thomas come to this appointment because I know that Ryan doesn't like things in his nose (or ears, or hair, and so on) and I thought he might get upset, have a nose bleed, possibly vomit. I wanted some reinforcement there with me. I brought a change of clothes for both Ryan and me, just in case!!! When we got in to see the doctor, I only felt right that I should warn him of such and I think he had his reservations about whether we would actually be able to do anything at the appointment.
The thought was that Ryan had blood vessel(s) close to the surface of his skin inside his nose, and that anytime there was any irritation, the blood vessels at the surface would create the bleeding until a clot formed. If/when the clot came off, it would start bleeding again. Getting upset and crying causes your heart rate to go up and your blood pumps faster and that was all factoring in to the nose bleed situation and why him getting upset made the nose bleeds start and/or get worse. The ENT said he wanted to cauterize one side of his nose and it could be done in his office that day. They only do one side at a time to prevent complications and I knew that his left side had been bleeding most recently so that's what we focused on. First the doctor had to numb Ryan's nose. This consisted of putting some sort of numbing substance on a small piece of cotton and putting inside his nose for about 15 minutes to numb it. I was concerned how this would go. The doctor was clear that if he didn't do well with the numbing we were NOT going to try to cauterize and instead we could make an appointment in the OR to include anesthesia. That was obviously not the preference so I was trying to stay positive that we could get this done in his office on that day. In all honesty, I thought this numbing would go over like a lead balloon. But I was hopeful and ready to try to distract Ryan so that he wouldn't mind as much. Y'all. Ryan was a CHAMP. He fussed just a little when they put the cotton in, but that was it! He kinda sorta forget about it being in there. I had to keep his hands busy, so that he wouldn't rub his nose and make the cotton come out so I held his hands and we walked around the room as a distraction. When the numbing process was complete, the doctor and the nurse came back in and were as pleasantly surprised as Thomas and I were. The doctor was able to cauterize and all we had to do was hold Ryan's hands to keep them from going rogue and getting in the doctor's way. Ryan was cool, calm and collected. Mind you, he didn't love it, but he was really, really calm and very good. We made it through the whole thing with no tears, no nose bleeds, no vomit. SUCCESS. The doctor told us to keep the Aquafor on his nose (easy enough) and then to start with the saline spray (ugghh).
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| Post-appointment - happy boy and happy Dada |
The doctor warned us that Ryan's nose may bleed a little while healing from the cauterization but that the bleeds should be fewer and lighter. It's been a while between the appointment and when I'm finally writing this post, so I could be off a little, but if I remember correctly, I think his nose has only bled two times since then. It really did the trick! Not having to deal with the nose bleeds has made our lives easier. I think his teachers at school are probably really thankful too.
We did end up doing the saline spray for a while, per the ENT's request. As predicted, he did not like it. He got to the point that he would tolerate it, and I would do it as fast as I could, but he would still cry, at least a little, right when I put the sprayer in his nose. I've backed off of the saline as time has passed and now I don't bother doing it anymore.
*Pink eye pictures WITH nose bleed are below. You may not want to look if you get squeamish. I was just trying to take a pic of his eyes before I cleaned them out so I could show the doctor when we went to our appointment. As I was taking the picture, his nose started to bleed and it got messy.
