For over a year now, my son has needed blood work done in order to start immunotherapy, a year-long process that could help with his pet allergy so that we can replace the beloved cat who died last year.

I have not been enthusiastic. His fear of needles is legendary, and until recently his vaccines weren’t up to date– not because I worried about the autism implications but because I simply couldn’t stand the flailing, screaming irrationality of his fear. Last year when we needed a booster for his measles vaccination, I begged the doctor for some kind of prescription drug to help calm him down. If childhood shots are a metaphorical mountain range, the blood test is K-2. It ranks right up there behind the Mount Everest of our lives, which is dental work. With a blood test, my son would have to be:

A. Alive

B. Conscious

C. Still

To me, it’s an insurmountable list. Still, he desperately wants another pet, and so we began prepping him over a year ago by participating in a study geared toward helping children on the autism spectrum face their sometimes overwhelming fears. We learned some useful strategies along the way, but I wasn’t holding my breath. No matter how often we practiced relaxation techniques or calming self-talk, I suspected that once he arrived at the clinic, panic would set in. We’d be back to square one. Just the mention of the unscheduled blood test had been enough to induce hysteria at home.

“I’ll jerk and bend my arm!” he shrieked a few months ago. “Then the needle will go right through!”

So I prepped for the blood test in secret, purchasing coveted toys to use as bribes. I discussed different drug options and strategies with his doctor and a psychologist. The Xanax we’d given him for the measles shot had reduced his language abilities to those of a slurring drunk, but it left him with the strength of a champion wrestler when the time came to get the shot.

“Can’t you just knock me out?” he’s begged more than once. I’ve had to tell him, “Sorry, sweetie, they don’t give general anesthesia for a blood test.”

Anyway, I didn’t want to knock him out. Some parents are probably thinking, “Just pin him down and get it done.” In the short term, yes, that sounds great. I would love nothing more than a Frankenstein-like table with straps to hold him still. In the long term, however, it’s not about me, and such a strategy has major flaws. Blood tests and shots will always be a part of his life, and he won’t be able to go through the experience kicking and screaming when he’s six foot two. At some point, he’s got to learn to master his fear. Apparently, so do I. After I put off scheduling the blood test for months, my son finally handed me the phone.

“Just call them,” he said. “Make the appointment.”

My response was to stall yet again. We’d only just ordered the latest coveted toy. I  didn’t yet have the new prescription drug. We hadn’t practiced the self-calming tools in our “tool kit” lately. I hadn’t even decided on the best place to have blood drawn: hospital or local clinic? Male or female nurse? The details mattered, because when it came down to it, I would be expected to know how to handle my child in public. And after ten years of trying different strategies to calm him down at shot-time, the truth is, I didn’t.

“Let’s just practice and see how you do,” I suggested and dug out his toy doctor’s kit. I called him into my “office” and wrapped a rubber band around his arm. When I asked him to show me his arm, my enthusiasm for the experiment waned. No easily prickable vein presented itself. Oh, hell, I thought to myself. What if we get him in there and then they can’t even find it?

I gently smacked the skin of his inner arm as I’d seen nurses do, and my son yanked back his arm. “Ow! Why’d you do that?”

My heart sank. If he couldn’t stand a little flick with my finger, there was no way he’d sit still for a blood draw. The only thing that would be accomplished by making an appointment would be my own nervous breakdown.

“The thing is, I don’t want to see the needle,” he said. “I’ll do better if I can’t see the needle.” So we trooped out to the garage and selected a three-foot by two-foot cardboard box and cut a hole for his arm to slide through. Now he wouldn’t be able to see half the room let alone the needle or nurse.

Then he handed me the phone again. The nurse at the local clinic was sympathetic, but she didn’t have experience with kids on the autism spectrum.

“He gets really anxious,” I warned her.

“Does he bite?” the nice lady inquired.

“No. He’ll squeeze himself into the smallest space in the room and then refuse to come out.”

“Maybe you should consider going to the hospital,” she suggested.

I hung up somewhat relieved and reported to my son that I’d call the hospital later in the week.

“No, call her back,” my son insisted. “I want to go talk to her now.”

Despite my misgivings about our lack of preparation, we packed up the cardboard box, the mini dvd player with the episodes of his favorite series that he hadn’t yet seen, some old but still potent bribe toys, and, just in case, the Xanax left over from our shot the previous year. By the time we arrived at the clinic, we looked like a homeless couple planning to move in.

My son lasted exactly one minute in the nice woman’s office before his voice took on a tremor.

“Okay, no worries,” I assured him. “We can come back another time. You did great.”

“NO,” he insisted loudly, clutching a new bribe toy in each hand. “I want to do it today.”

The nurse shrugged and pulled on her gloves. I knew what was coming even if this poor woman did not, but I went through the motions anyway. We set up the video. We installed the box. He removed the box and clutched his arm to his chest. His voice rose to a shrieking pitch. “I want to do it, but I can’t do it. Help! Help! Help!”

The nurse moved us to a private room with a bed (alas no straps), but his agitation only increased.

“Honey, we can still go home,” I suggested, secretly hoping he’d agree. Instead, the crazed voice of a woman on the verge of giving birth emerged from his mouth.

“Give me the drugs!” he cried out.

I complied, but only with the understanding that if I gave him a pill, he was committing  to follow through with the procedure no matter what. He shakily agreed. Then we moved him to yet another room because we now had to wait a half hour for the medication to kick in.

“I think it’s better if you do it faster,” the nurse whispered, but I couldn’t see how. My son’s big for age ten and I didn’t want to risk his strength overwhelming the both of us while a needle was in his arm. In the end, it made no difference. Drugs or no drugs, bed or chair, toys, self-talk, box, books, bribes. In that final moment, he screamed as if being murdered and I still had to pin him down.

“You did it!” I congratulated him with false cheer once the nurse was done.

“It hurt!” he accused. “A lot! At least I never have to do that again.”

I didn’t have the heart to tell him otherwise. We gathered all our belongings and trudged back out past the front desk. He must have been even louder than I’d thought. Every single person in that waiting room, including the two front desk staffers, turned to watch us go. When we got home, my son weighed himself and announced in a slurred voice that he’d lost upwards of two pounds.

“But you did it,” I reminded him. “And now you can start working toward getting a pet.”

“Yeah,” he grumbled. “That means more shots.”

That irony hasn’t escaped me. The immunotherapy he so desperately wants involves a weekly shot in the arm for upwards of six months. I’m already stocking up on bribe toys and thinking about some Xanax for myself.

Allison D. Johnson trembles to imagine what the next six months of her life will be like. She can be reached at www.allisondjohnson.com.