Wednesday, August 15, 2007

Where is Mary Poppins when you need her?

We've been fortunate that Little Frog has always been a very healthy little guy. We've hidden a few nutritional supplements in the maple syrup on his waffle or the jelly on his sandwich and slipped the occasional 3mg of melatonin into his ice cream, but it is a rare occasion when we have to give him actual medicine. Tylenol is the most common followed by the occasional 10 day round of antibiotics. He always gets better after we administer these medications, but the thing is - rarely does enough of the medicine get into his system for me to believe it is having any real effect. I think his "recovery" is due more to the heightened sensory input he gets from the struggle to avoid the medicine or he has some amazing ability to absorb the stuff transdermaly.

I have a dear friend, another autism mom, who has taken a much more biomedical approach to Autism. She has two boys who at any given time are on a variety of meds and supplements given on a daily basis. She firmly believes that I should desensitise and use behavior modification to teach Little Frog to take his medication without the aid of dramatic hiding rituals. I agree, that when he actually needs medication, ie antibiotics, he is not getting them and the struggle is monumental. One of her sons has PICA issues and getting him to swallow things was not a big deal. Her other son was very resistant and she describes a three year process of behavior modification, reasoning, consistency, and heavy duty reward systems that have recently culminated in her son agreeing to take a new, foul tasting medicine without incident. I would love to be able to give Frog some Tylenol when he is hurting, or make sure the antibiotics actually got into his system, but his reaction to taking medication and to us pushing him are worrisome. I fear creating more problems than I solve.

Frog's inability to swallow things seems to be a sensory issue. His throat closes in an almost instinctive way. (I'm channeling Grandin now - correct bad behaviors, accommodate sensory issues). This time around, by day three, we had to chase him down and wrap him and his arms in a towel, but then he would open his mouth and let us put the syringe in - there was just nowhere for the meds to go. Even with him mouth clamped shut by us, the meds just pooled at the back of his throat. I don't think we want to completely undo this protective reflex, as it is what keeps him from swallowing the various rocks, dirt, rubber bands, toys he pushes around inside his mouth. It is also what keeps him from sucking in a lung full of water when he swims under water with his mouth open like a baleen whale.

We do continue to reason with him, and maybe I should work on that when we are not in crisis mode - daily vitamin in jam perhaps. To this point, the very act of "forcing" an issue with Frog, no mater how gently we do it, pushes him just over the edge and I don't know if he can continue to process the language adequately at that time to engage in "reasoning". Also, with the language issues, I don't know if my reasoning is addressing his actual concerns and is therefore valid or persuasive in his mind. I do think that if I could come up with a new preparation to replace the pink suspension, that would not require two teaspoons of liquid, I could make a killing! Spoonful of Stevia anyone?

Does anyone have suggestions, opinions, or experiences that might help me decide what my next course of action should be?


mcewen said...

Take heart dear heart! We all do the best that we can with what we've been dealt. We share many similar issues. For us, I spend so much time juggling between all the different issues that they have, it's always a compromise.
Best wishes

Frogs' mom said...

Thanks Mcewen,

I'm a real "pick your battles" kind of gal, but sometimes I worry that I’m choosing to forego some battles just because I'm worn out. For the most part I'm pretty confident, but then something comes along and all the self doubt/ mother guilt comes pouring in. I agree with you - compromise is best, do what you can, and don't forget to give the kids their say when you can.

Ian Parker said...

We give the Bear various supplements on a daily basis, putting them in her food. The flip side of the issue that much of her food is not 'solid' (lean ground beef and lamb and fruit 'chunks' are as solid as it gets, although her chewing and chewing requirements are progressing over time) is that one can easily burst a capsule and mix it in. We also add items to the Bear's (rice) milk. FWIW, we don't hide this, in that the Bear can and does watch us add various items. We just make it a normal part of the preparation process - part of the routine.

FWIW, I tend to agree with the idea of not forcing unpalatable items (food or other). I've tasted everything that we give the Bear, so I know that nothing she eats or drinks tastes bad when given in the right format. If it does then we need to change the delivery mechanism, not force compliance.

I don't see this as hiding (although maybe I'm fooling myself), but instead as just part of the process of providing palatable (and healthy) food. It is more important to us to have a happy and willing eater who will try new things than one who is trained to eat bad-tasting items when ordered to, and I don't see the ability to eat bad tasting items as a required 'life skill' at this age.

I also try reasoning with the Bear or at least explaining things before and as they're happening (in general, not just with food), whether she understands or not. I figure that it a good habit to get into, and you never know how much more understanding exists than can be seen. But I think this reasoning capability will develop according to the Bear's schedule and capabilities, rather than according to our schedule and needs.

Since Little Frog eats solid food (harder to mix items in), any thoughts about getting him used to a bowl of apple sauce? Most kids like the taste and it is a good medium in which to hide stuff when required (more evidence that maybe I'm fooling myself). Puddings might be good too, and some of them are even supposedly healthy (tapioca?).

If Little Frog also sees others eating these items it might make them more acceptable. If he sees others eating them with a vitamin added, this too might become acceptable. Maybe make it a 'normal' part of the process? Perhaps even start by visibly giving everyone except him a vitamin?

I've also heard of a cup with a pill slot in it, such that taking a drink automatically flushes the pill down one's throat (presumably you start with small pills and work up in size). Even for those willing to swallow a pill, actually doing so is not always easy. I'm not sure where one can find this cup (we'd be interested too if we could 're-find' the website - we haven't looked yet).

Eileen said...

Wish I had some good advice for how to get Little Frog to take his medicine, but Andrew isn't the best about this either. Luckily Andrew will take most chewable vitamins as well as chewable motrin or benadryl, but liquid medicine we have a problem with. I usually just try to hide it in his drinks little by little, but like you said, I always wonder if he is getting enough.

Hope all is going well with you all.

Mom to Max said...

we face this issue too! for vitamins we give him yummy bear vitamins. let's see...we give him melatonin to get to sleep. we use a sublingual which we crush and put into his drink. and for other things we try to get it into liquid form and put it into his drink. i show him what i am doing and try to explain what it is all for.

good luck...and i hear you about choosing your battles. so true!

mom to max said...

just stopping by to say hello. how is the giving meds working out?

mcewen said...

I can't find an email for you on your profile, so I'll just have to ask here and you can delete it afterwards.

I just wondered if everything o.k.? It's been nearly a month since you last posted.

I've checked back a few times but.....are you and the family alright?
Best wishes

Frogs' mom said...

Thank you all for your suggestions and support and, McEwen, for your concern - bless you for being so thoughtful. We are fine; I've just had a spell of the blues. Every time I sat down to respond to your comments or plan a new post I had trouble finding the words, and then I'd hear a crash from the kitchen or get that nagging mom 6th sense that says "something is not right" only to find Frog wandering down the road in front of the house, or hanging precariously from the top shelf of the bookcase or cupboard. We are in the middle of transitioning from summer to school year and that too has thrown me for a loop - I guess I don't transition well either! I expect to be back to my old self in a few more weeks. I've a charity auction, a gymnastics home meet, and a 3 day CLE away from home before I get back to the routine. I'm still lurking out here, checking in on all of you and I promise you will hear from me soon :0)

Dadof6Autistickids said...

We've been very lucky as far as sickness and food allergies. Our 3 oldest do quite well with just mainly our 9 yr old girl not liking certain foods. She does get headaches usually from food with additives, then she throws up.

Our 8 yr old boy still get VERY car sick, but eats a boy. ; )

The 3 youngest mainly are just VERY picky eaters. We haven't figured out a pattern of what they like and don't like. It seems like its ever changing.

The Glasers said...

Here is a trick I heard about when I was dealing with this with my daughter. Buy some empty gelcaps and practice swallowing those. Because they are empty, your son will not have an unpleasant taste if he does not swallow it correctly and you do not waste money on precious supplements or meds that end up in your sink.

VAB said...

The French give everything, including aspirin, in suppositories. The Italians give everything, down to vitamins, in subcutaneous injections. As a kid, I used to get things mixed in treacle. You might try talking to your pharmacist or doctor about what options exist other and orally administered liquids.

rainbowmummy said...

When son had in an infection he was given medicine called fluxoclaxilin, that won't be the correct spelling lol, anyway he reacted badly. I put a dot of it on my finger to taste, it was VILE. So he got a sqaure of choc before and after, now he would prob get a sugar cube..
Anyway the next time he had an infection I said he was going to have to find him another med that would work lol.
I also read that you can get flavours added to meds.
We are lucky that he has hardly ever been ill.