Thursday, January 10, 2008

Wrestle Mania - The Battle of the Medicines - It's going down!

Taking Medicine

Kid’s don’t like to take medicine and ASD kids often have to take a lot. Since we can't explain to most of our kids "why" it's important for them to take the medicine, they don't understand why it's so important, or that it will help them get better, which increases the resistance. Because our kids have different medical issues they can be on an array of med’s at one time. Nicky has severe allergies, seizure disorder and gastro internal problems. He takes meds for seizures, for sleeping, allergies, for brain function and supplements for everything else. If a child in on the DAN protocol or the GFCF (gluten/casein free diet) the number of supplements skyrockets! Since he was 2 Nicky has consistently been on no less than 4 supplements/prescriptions at any given time. The med’s typically come in three forms syrup, sprinkles, pills. Nicky cannot swallow a pill. He is very sensitive to textures so he spits out the sprinkles (which some kids like in apple sauce or ice cream). So my choices have been to find creative ways to work with pills and syrup.

Just knowing that we had to introduce a new medicine used to be an event for us. In the beginning I didn’t know what to do. Medicine time used to be like “Wrestle Mania” I’ll leave it to your imagination to decide the names of the wrestlers J. I remember saying to myself “He’s a little guy and I’m the mom so I’ll just hold him here, put it in his mouth and he will swallow it”. I could not have been more wrong! It seems impossible to me that I could not hold down those little arms and legs and quickly get him to swallow, but I couldn’t. I look back and laugh just thinking about how we must of looked as I would just try and force him to swallow the spoon full of syrup and we would struggle on the kitchen floor. We slid up and down the kitchen floor and in the end the medicine was not in Nicky, but all over me. I wish we had video’s of that, just so I could look back and see our progress and at the same time get a good laugh – not at Nicky but at me. It’s pretty funny to think that I was literally wrestling with my little guy over medicine.

We didn’t get there via one route, it took several. I cooked his favorite treats, including wheat free, gluten free chocolate cake and tried to hide the med’s that could be blended with food. Nicky could not tolerate dairy and he hated the texture of applesauce so I could not hide food there, however that works for lot’s of moms. Nicky only loves eating chicken and potatoes. These are not easy foods to hide medicine in (ever try spiking a French fry?) so I had to be creative and keep experimenting.

In the end a combination of crushed pills and a simple ABA strategy did the trick for us. You really do have to pick what is best from your child by finding a corner to build from. In my case I knew Nicky was not going to swallow a pill, I knew he loved apple juice – so the crushed pill in juice was a good plan for me and it still works. However you don’t always get that lucky. Some kids like apple sauce so med’s can be blended in the apple sauce, so kids like ice cream and you can blend there. Nicky has a very restricted diet so I didn’t have a lot of choices. This lead me to the ABA approach I call “First this and then that”.

Basically, there is always something Nicky wants at least three times a day (video, food, snack, juice whatever). It is the routine in our house - whenever I have had to give him medicine or food that he HATES - taking the medicine or new food is a prerequisite to getting whatever he may want. This did not happen overnight. I had to be patient and willing to wait him out, and it did work for us. It took time, however things are pretty smooth now. Nicky he has taken so much medicine that when he is presented with a new medicine, he looks at it, smells it, let’s out a very sad little cry of frustration and then soon agrees to swallow it. Which is followed by a direct statement of “Yuck” and followed by him looking at me with incredible expressive face which looks like he still had the most yucky thing in the world in his mouth. It’s all I can do to not break out in laugher it’s such a funny face. But I’m so proud of him I keep a straight face and praise him like he just won a gold medal at the Olympics!

Notes to myself and others –

  • When adding meds/supplements to food or drinks does not work try to crush a pill, add it to a table spoon of juice, yogurt or ice cream (something Nicky likes)- and then suck it up into a medicine syringe. This keeps the amount small, it’s in a spill proof container and it can be given quickly. I tell him it's going to be quick and it's just medicine in ice cream and I help him hold his head back and I squeeze the medicine as far back in his mouth as I can (to insure swallowing).

  • I have the desired item right in from of him (in our case it was a Barney Video) so I can reward him immediately. This has really worked for me and for the most part even when Nicky hates the medicine he will take it. Yes, it took some time and I had to be consistent with not letting him have what he wanted until after he took the medicine.

  • I stick with the script and in a level even serious tone (not angry just matter of fact). I say “Nicky before you can have Barney you have to take your medicine. On the count of three we are going to take the medicine. One, Two, Three”. Then offer the spoon, juice, vegetable or whatever you have. Okay but we can’t have Barney until you take your medicine.

  • It’s pretty much the same for blood tests and haircuts too.

  • Remember to say calm, whenever I start to get frustrated he ramps right up behind me

  • Be patient – I always knew Nicky watching and waiting me out, reading my every move, registering my every emotion. It’s a little like a chess game so I stayed patient and clam like it was no big deal, just want had to be done.

1 comment:

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