My 8 year old absolutely refuses to do the incentive spirometer

Specialties Pediatric

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My 8 year old daughter had an open heart surgery, and this is her 2nd day post op. She absolutely refuses to do the incentive spirometer. We tried alternatives, such as blowing balloons, balloon and straw races, straw painting, kazoos, pinwheel, party blowers, blowing up plastic gloves, (than she gets to decorate them) but that didn't help. She will blow bubbles, but she will not do it slow. We tell her she needs to blow the bubbles slowly, but she refuses. I even paused the DVD until she decided to deep breathe slowly, so the DVD was paused for an hour while I kept prompting her, until I decided to give up (after an hour). While the DVD was paused, I only told her twice that I will play the DVD once she blows the bubbles slowly and coughs. She does receive pain medication, and we know this is behavioral. Previously I and my husband offered to buy her the toy she really wanted and we tried reward charts, and behavior therapists, which all didn't work. Prior to the surgery we met with a physiotherapist who was supposed to teach us the breathing exercises she would need to do. She refused to practice or talk to the therapist, (they even gave us another therapist after 2 1/2 hours of not cooperating) and a play therapist came in (didn't help either), so after 5 hours we quit. She is doing well in most other areas. What do I do about this issue?

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Specializes in hospice.

Stop giving in. Seriously. Giving up after an hour is still giving up, and you've taught her that if she holds out long enough, you cave.

This isn't a baby, it's an 8 year old. She should know by now to obey or there are consequences. If her parents have taught her, that is.

However, are there developmental or mental health issues you haven't specified in this post? I can't imagine being an 8 year old who needs open heart surgery is easy. Is she chronically ill? Could she depressed and deciding to give up? I have a pretty spunky 7 year old who definitely knows her own mind and can be very stubborn, but I'm sure if she was in a serious medical crisis and I told her this was necessary to get better, she'd do it. So I'm just wondering what's making your child not take her recovery seriously.

I'm sorry your family has to cope with this. Can't imagine having to deal with such a thing.

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Specializes in Nursing Professional Development.

Have you asked her why? She's 8. She should be able to tell you why unless there is some development issues you haven't told us about.

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Stop giving in. Seriously. Giving up after an hour is still giving up, and you've taught her that if she holds out long enough, you cave.

This isn't a baby, it's an 8 year old. She should know by now to obey or there are consequences. If her parents have taught her, that is.

However, are there developmental or mental health issues you haven't specified in this post? I can't imagine being an 8 year old who needs open heart surgery is easy. Is she chronically ill? Could she depressed and deciding to give up? I have a pretty spunky 7 year old who definitely knows her own mind and can be very stubborn, but I'm sure if she was in a serious medical crisis and I told her this was necessary to get better, she'd do it. So I'm just wondering what's making your child not take her recovery seriously.

I'm sorry your family has to cope with this. Can't imagine having to deal with such a thing.

Well the longest we have waited after she refused to cooperate with an unrelated physical therapy was 10 hours. We did all we could to make it fun, she just wouldn't budge. We just know she wouldn't budge this time no matter how long we presisted, so we just gave up.

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Well I just asked her why she refuses to do it and she says "I want to do what I want". Than I told her the health consequences of this, but I'm not sure she understands. She has no developmental issues.

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Specializes in hospice.
Well the longest we have waited after she refused to cooperate with an unrelated physical therapy was 10 hours. We did all we could to make it fun, she just wouldn't budge. We just know she wouldn't budge this time no matter how long we presisted, so we just gave up.

Do you generally have discipline problems with her? I don't get the "making it fun" thing. There are things you have to do in life that suck, and one of the ways people gain maturity and character is by realizing that and just getting them done. My kids hate their chores, but they do them because they know they'll lose privileges and their favorite devices if they don't.

You said no developmental issues but mentioned physical therapy unrelated to this surgery. Is she chronically ill? If she is, I reiterate that depression could be an issue here.

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Specializes in Nephrology, Cardiology, ER, ICU.

We wish you well but suggest that since we do not know all the details of the surgery and post op issues, we ask that you discuss very frankly the issues with your daughter's surgeon.

Please take care.

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