Wednesday, July 22, 2009

Just a little dose of medicine

When I was a brand new nurse I was assigned to the paediatric unit at the local hospital. I didn't know a lot about kids from personal experience, and I didn't know much about them from my nursing training either. But I had good mentors and I learned a lot about children, some of which would help me raise my own child without making all the mistakes I might have made otherwise.

One trick I learned was how to give oral medication to unwilling recipients. Babies and toddlers would fight tooth and nail to get out of taking their liquid medication. I can't blame them, I have never been able to drink medication myself - I gag on every sip and it is torture. Yucky!

But my mentors taught me their techniques to confine the kids in a grip that gave them no choice but to submit to the medication being dumped in their mouth. It went something like this:

Put a chair near the bedside table, and put the cup of medicine on the top of the table. Pick up the kid and sit in the chair with your left arm supporting the child. Place the child's right arm behind your left arm so they can't do much with it other than pinch you (if they happen to think of that). With the child's legs across your lap, put your right leg over the child's legs which stops them from kicking and gives them no leverage to get away. With your left hand hold onto the child's left arm so they can't swing at your face.

With your right hand (the only thing either of you has free by this time), pick up the medicine cup and place it on the lips of the child. If you are lucky they will start to cry or scream which causes them to open their mouth and that is when you quickly dump the medicine into their mouth. Some kids will gargle the medicine as they continue crying, some kids will quickly spit it back at you, and other kids will know they're beat and will swallow it. The odd kid will gag so hard that the medication as well as their last meal will end up all over you, the child, and the floor.

Animals aren't a whole lot different than kids when it comes to avoiding medication, and this week we are getting plenty of practice.

Minina has Bell's Palsy and needs eye ointment put into the open eye three times a day. Minina starts fighting as soon as she sees me coming at her with a finger loaded with ointment. I know it is poor technique but it's the only way to get the ointment even close to her eye - I wipe my finger on her bottom lid and then manually open and close the eyelid a few times (until she breaks free of my grip and runs off).

The injections Minina has been getting are hard on all of us - Delfino and us because we know it is very painful and we hate doing that to her. And it's hard on Minina because despite being wrapped in a towel, including her head, she scratches and struggles and bites and screams during the entire process and finally gets parts of her body free and becomes a dangerous animal. We hold on with all our strength because we know we won't get another chance, and at the time of injection Minina screams so loud you would think we were chopping off her tail or something. Once the shot is done we release our grip on the towel and she flies off the table and runs far away from all of us. She pouts for several hours before she returns to her normal sweet self. Thankfully she had her final shot tonight (we hope). There is some improvement in how she looks but her face is still paralyzed so we have to give her massage and now physio to get her to use the muscles.

Smokey came through her surgery on Monday but took 28 hrs to come out of her anesthetic. Smokey couldn't control her muscles, her head just flopped around when she managed to lift it for a second, and she basically slept for almost 24 hrs after she came home Monday night. She would not drink or eat yesterday morning and I knew she needed to get something into her system so I syringed water and milk into her mouth, and put small amounts of canned cat food into her mouth too. I also started her antibiotics. She was too weak to fight me but by last night she was starting to recover and half of her antibiotics ended up on the towel instead of in her mouth. And today it's worse, a battle over 1 lousy ml of medicine, with half of it ending up anywhere but in Smokey's mouth. I usually wipe the excess on her paws, hoping she'll lick it off. At least she's well on the mend now, so we are relieved.

Loco gets monthly heartworm pills. Pills they claim are like dog treats - dogs just love them. Uh huh. Not Loco. We coat the pill with canned food and pop it into the back of his throat and then hold his mouth shut. Loco works his tongue inside his mouth and when we decide he must have swallowed the pill, we let which Loco does "phptt" and spits the pill (minus the canned food) on the floor. We repeat this process until we have canned dog food all over the floor, on our legs, under our fingernails, and on our clothes. By this time I am saying some unkind things to Loco but he doesn't care. He doesn't care that we are trying to keep his heart healthy.

Tonight is the night for Loco's pill. And Smokey still needs her antibiotics. We're both tired. I haven't packed, I haven't done anything to prepare for my trip tomorrow. I decided to write this story to put off the unpleasant task of giving medication. But now it's time to get on with it. Wish us luck!


Mic said...

You deserve some MAJOR GOOD FUN on your trip for all your nursing. What a good Mom you are to everyone!!

Life's a Beach! said...

Sue, I hope the animals are much better by the time you get back! Poor little Minina! How long do they think it will last? I had a friend who had it and hers lasted months before she began to recover -- I think almost six. But hopefully that medication will shorten it? And Loco! Funny how a dog will eat almost anything except for the 'tasty' meds. Fortunately, Saby likes the heartworm tabs because they're huge!

KfromMichigan said...

I wish you both luck and a safe trip.

Bennie said...

Well I may have to try your technique on Stefan next time he has a liquid med to take. It sounds like you need a vacation.

Larry in Mazatlan said...

A tip on dog meds. Open their mouth and place the pill at the back of their tongue. Then, when you hold their muzzle shut, tip their head up and gently stroke their throat. You can see them swallow, and their tongue popping out is a good sign.


Sue said...

Mic - thanks but this trip isn't a fun one, unfortunately.

Beck - it's hard to know with Bell's Palsy - sometimes there is no recovery, other times it can be weeks/months. Minina is looking better than she was, but still has paralysis, so I guess I just have to wait until I'm back at the end of next week to see if there is really a difference.

K - thanks.

Bennie - I DO need a vacation!

Larry - what you describe is exactly what we do, but Loco will not swallow, he just works that pill forward. I've never had a dog like that one. If you are ever on Isla, please come over so we can see your technique. It would be a nice break for us to have someone else give the dose. :-)

Leslie said...

we have the same problem with Sam...he hates peanut butter, he hates cheese, he hates canned food, he hates the pill pockets the vet has...but he loves we have those frozen chicken nuggets..I cook it in the micro, cut it open and slice a pocket in the middle of it for the pill...that he will for liquids, I put them ina syringe and hold it against the side of his teeth and slowly squirt it works...

Sue said...

Leslie - chicken nuggets sounds like a good idea for Sam. And yes, we do the same with the liquid meds for Loco - much easier than the heartworm pills.