Olivia Curtis hates the injections and infusions she receives for her severe arthritis, so hospital staff on one recent morning gave her a virtual reality headset that allowed her to look at a pristine, sandy beach instead of the IV line they were prepping on her arm.
Soon, the 13-year-old was smiling. Even the bitter taste of saline from the IV line didn’t seem so bad when someone reminded her that the ocean is salty, too.
“It’s just me on the beach,” she said, describing her view. “Maybe I’m rich and I own it.”
Keeping patients relaxed and amused is part of a new offering at Gillette Children’s Specialty Healthcare, a St. Paul hospital that provides patients with virtual reality headsets before they receive injections, infusions or other procedures that make them tense or squeamish.
Fear of injections can have a cascading effect on children, who can come to loathe their entire hospital visits, said Dr. Todd Dalberg, Gillette’s director of integrative medicine. Some even require medications to overcome their anxiety,
“For some of them, as soon as they take the exit off [Interstate] 35 or 94 [to the hospital], that’s when the fast breathing starts or the nausea starts or the vomiting starts,” he said. “If you can just erase the anxiety and the associated symptoms … it will be night and day.”
Needle sticks and infusions offered an easy place for Gillette to start its grant-funded VR program. A 2012 Canadian study found that two in three children fear needles. Worse, one in 12 didn’t get vaccinations because of that fear.
Meanwhile, a group of American and Italian researchers reported last month that virtual reality distractions can reduce pain and discomfort for everything from wound care to chemotherapy.
Gillette’s Child Life department also provides games, putty and fidget spinners to occupy patients’ minds during injections, but Dalberg said today’s children appreciate high-tech distractions.
The VR headsets offer everything from views of a farm or beach or Machu Picchu to visually controlled games.
Gillette researchers have applied for funding to study whether the headsets help young cerebral palsy patients endure Botox injections and if they reduce the need for pain medications, including opioids, in children after surgeries.
“We want to know that it works,” said Chantel Barney, who evaluates new technologies for Gillette. “It’s not perfect. There can be side effects. Some people can get a little bit nauseous.”
The headsets might also offer cost savings, such as preventing the need for extra nurses to calm or restrain children during injections. Barney recalled a recent case in which a child used a VR headset to get through the painful changing of a wound dressing without the need for heavy anesthesia in an operating room.
Pizza didn’t work
Curtis is no stranger to needles. Diagnosed with juvenile idiopathic arthritis, she first received naproxen pills to address her joint pain but eventually needed at-home injections of methotrexate from her mother, Jennifer Walton. It was a nightmare.
Curtis would curse at her mother for the pain of the injections. Eventually they tried bringing in other relatives to comfort her and having pizza on injection nights. Instead of relaxing for shots, Curtis learned to hate pizza.
“We ruined pizza and Davanni’s for her,” Walton said. “Pizza became this terrible, awful thing.”
Eventually, the at-home injections became less effective, and Curtis required trips to the hospital for infusions of Remicade, a potent and expensive anti-inflammatory drug.
An eighth-grader at the Laura Jeffrey Academy in St. Paul, Curtis isn’t slowed down by her disease. She plays volleyball and will soon appear as adult Simba in her school’s production of “The Lion King.” She gets periodic and painful flare-ups, though, and has come to terms with her need for drug infusions every few weeks.
“I’m used to it,” she said. “Even if I wasn’t, it’s still something I have to do.”
Curtis typically watches the insertion of needles in her skin because it gives her a measure of control, but her mother said the virtual reality beforehand is a distraction that prevents fear from building.
“That really helps cut the anxiety,” Walton said, “even though she wants to see it at the actual moment.”