Giving children medications can be the most daunting task of treatment.  Here are stories and strategies that may prove helpful.

Education

A key component in getting cooperation from Kayla was to thoroughly educate her on her cancer and its treatment.  We had to repeatedly look at pictures on the Internet, draw diagrams of the cancer to illustrate what the cancer was doing to her body and how the medications stop the progression of disease.  Originally I made the mistake of thinking that she was too young to take this all in, when in fact it was all being done to her body, so it was my responsibility to make it comprehensible to her.  She loved gaining understanding of all areas of her treatment!  Remember the younger the child the more repetition they will need.

One Story

When Jordan was diagnosed he was 2 ½ years old.  We had to give him medication in the hospital and we were given a choice of liquid or tablets. I thought since he was so young that the liquid would be the best choice, because he had taken liquid medications before. This did not go as I had planned. He did not feel good at all and was never really good at taking any medications. Now I had to give him several medications every day.  He would push the liquid out with his tongue every time we gave it to him.  We then tried to mix it with a cherry syrup or a beverage, but we never knew how much medication he actually took, while fighting with him to drink all the liquid.  Then we switched to tablets.  This did not turn out any better.  We received several suggestions on how to mix the medication in with his favorite food like yogurt or pudding, but some how he always knew that I was putting the medication into his food.  We never felt sure that he was getting all of the medication when we used this method. I then tried giving him an M&M with the medication for some of it is very bitter…. He would take the M&M’s and spit out the medicine.

It got so bad that I had to hold him down and push the medication down his throat with my finger.  I would often get bitten and all of this became very dramatic.  Each night I had to mentally prepare myself to give him the medication.  He was also very upset and would work him self up to a point of almost getting sick.  Neither one of us liked this arrangement at all. One day, (as he often did) he was begging me not to give him his medication, and it just broke my heart. I thought to myself that we have to do this for over 3 years!  I said, Okay…either you take the medicine yourself or I have to give it to you.  He said Okay mommy I will take it!! And he did.  We did have a few set backs after that, but every time I would quickly remind him that if he did not take it, I would have to give it to him.  He quickly took his medication and he chews it up! Giving him the power of taking his medication on his own volition worked for us. D.I.

Options

Many medications have available options such as; tablet, chewable or liquid. When the doctor brings up the subject of a prescription ask what choices are available.  Your nurses are more likely to have information as to how to get the patient to take their medications as they are the ones that have to give them to patients in the hospital.

Slippery liquids and thick liquids can be helpful.  The patient has to be told to swallow in one go.  We have used applesauce in a spoon with the tablet placed in the middle of it. I instructed Kayla to pretend it was a big gulp.  This worked so well that eventually she could take her pills with anything. Some people have suggested the use of syrups, which make the pill slippery. We have crushed tablets in the past and put the powder into a spoon of applesauce.

Pharmacy

I cannot tell you how many times I have gone to CVS late at night for help.  Late night is the best time to go because their not as busy as the day time, allowing the pharmacist to spent more time with you.  From sitting down to standing up, food, no food, our local pharmacy was a treasure chest of information that our doctors did not provide.  If you are unsure or just want more information, go to the pharmacy at night and they will help you!

Small children

Children need to be told what is happening in their treatment, every step of the way.  Months ago I received an email from a family whose child was approximately 13 months old.  Every time his port was going to be accessed he screamed bloody murder.  The parents did not know what to do.  I told them to tell him every step that was going to happen.  From the sterilization being cold, to the needle pinching a little bit and even giving a pinch on his arm to demonstrate.  I also warned them that the medical personnel would give them looks as if they were crazy. Just ignore that and continue. The parents wrote me back saying that the instructions for their son worked wonders.  Even down to the looks the staff gave them, which they ignored.  My whole point is to take the time and talk to your child/baby, explaining everything.  It makes them feel involved, important, and most of all, some concept as to what is going to happen.  Do NOT use baby talk, just simple, clear instructions.

I realized at some point in treatment for Kayla that I was not doing this enough, which compounded her feelings of being completely out of control.  I instituted asking the nurses what was coming next so that I could prepare Kayla.  It did not matter what was being done as long as I explained every piece, Kayla remained cooperative even when terrified.  This has stood the test of time.  Give it a try!  You have nothing to lose and everything to gain.

Leg Shots

The first time Kayla was to receive her leg shots of chemo, she screamed for 40 minutes while we tried to talk her down.  It got to a point where we were going to have to hold her down and just do it.  With a nod of my head I signaled the staff to hold her while I wrapped my arms around her. These motions somehow triggered in her brain and she asked, “can I count to three and then you put the needle in and can I push in the medicine?”  The nurse said yes.  Although she was quietly crying throughout, she did use the plunger on the syringe to slowly push in the medicine.  This made her feel in control.  Eventually she had no emotion as she handled these large shots in her leg as if it were a daily routine. If you would like to see a video of Kayla getting her leg shots here is the link: http://www.youtube.com/user/debwitter#p/u/41/SWy2najUOb8

The Parents/Care-Giver

No matter how torn up you are by a medical procedure, the parent or care-giver has to find the will and strength to remain calm throughout.  Many times I held myself together during the procedure and then I would go out to the parking lot for a good cry.  There is no shame in this.  Just remember that you, as the parent, are the rock in which your child depends!

Request for tips

If you have figured out solutions to the many problems one encounters during treatment, please email me.  I am always looking for helpful information that I can publish for others.