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Janet WoottonJanet Wootton is the Chair of ERIC’s PAC (Professional Advisory Committee) and Deputy Clinical Nurse Specialist – Paediatric Bladder Services at the Evelina Children’s Hospital in London (Guy’s and St Thomas’ NHS Foundation Trust). In this blog Janet shares how Jasmine, a five year old girl who attended a clinic for an assessment was helped by play therapist Michelle Saunders and a simple song.

Jasmine came in to our clinic at the Evelina Children’s Hospital for a Bladder Function Assessment with her mum a few weeks ago. A bladder function assessment is a non-invasive assessment in which the child is asked to drink regularly to fill the bladder and when they feel the desire to void they use a special toilet named a uroflow. This toilet is connected to a computer so that we can measure the flow of the urine and the quantity of urine. Jasmine needed to wear special stickers on her tummy and bottom so that we could assess her pelvic floor and abdominal activity. She was feeling very nervous about the procedure.

Living with a catheter

Jasmine suffers from a bladder emptying problem, this has required her to have a special catheter called a supra pubic catheter put into her tummy. Jasmine has to empty her bladder on the toilet but then also has to use the special supra pubic catheter to drain her bladder further. Jasmine carries her catheter bag around with her in a small handbag which she has become attached to. Jasmine has learnt to clean around her catheter every day and she helps her mum to empty her bladder.

Benefits of a Mic-key button

Jasmine now requires another operation to change this supra pubic catheter to a Mic-key button. A Mic-key button is a small device that is surgically put into the bladder and can be accessed through the abdomen. Jasmine will then no longer have to carry her urine bag around with her and the mic-key button is more discreet, allowing her to swim and exercise like her friends.

Having a urine test

I asked Michelle, a Health Play Specialist, to support Jasmine during the urine test but she was very shy at first and her anxiety levels were high. Eventually she agreed to sit on the toilet, but Jasmine was so scared that her wee was going to hurt she couldn’t go. Michelle explained to Jasmine that by going to the toilet it would help her tummy not to hurt so much. I then had an idea of something that could help Jasmine to relax and feel less anxious. We showed Jasmine 'The Toilet Song' by The Wiggles (an Australian children’s music group):

After watching the animation, Jasmine started to giggle and interact. Michelle noticed that The Wiggles characters sing about children “wearing a crown sat on the throne.” So, she asked Jasmine if she’d like to make her own crown to wear whilst sitting on the toilet. Jasmine really liked this idea and with the help of her mum and Michelle she designed and made her special ‘toilet crown’.

Smiles all round! 

Girl wearing crown outsideOnce Jasmine had finished her crown she was much happier about going ahead with the bladder test and was keen to do a wee wearing her crown on the toilet. Janet played the song again whilst she explained to Jasmine what she needed to do for the bladder function test. What had started as a stressful experience ended up with smiles all round thanks to The Toilet Song!

Get more information about urology referrals at the Evelina Children's Hospital in London.