A Clarification

OK, so after hearing some feedback about my last post, I am realizing that I need to clarify a couple of things.  First of all, when I said that Jadey was shaking Oliver, I should have said that Jadey was trembling with frustration while holding Oliver.  He most definitely wasn't shaking Oliver in the "don't shake a baby" sense of the word.  Oliver was not being hurt in any way whatsoever by the movement.  Second of all, before all this happened, Jadey had been trying to tell me that he shouldn't be a part of the pill dosing since it caused him to get so stressed out.  I really wanted him to help me, so I pushed for him to still participate in the dosing.  Jadey knows when he is getting too frustrated to be of much help; he knows when to leave the room.  I think everybody gets a little stressed sometimes, so no one should blame Jadey for feeling that way!  He's a really good dad and is great with Oliver.  I apologize that this didn't come across more in my post yesterday- I didn't have as much chance to go over it as I would have liked.

The Topamax Debacle

Oliver’s dosing of his seizure medicine has been really difficult for awhile.  I want to share how things were and how we finally found our solution!  I feel like I never write when things are going well, so here’s a story that actually has a good ending. :)

Oliver started taking vigabatrin, his first seizure medicine, in mid-October right after his diagnosis.  We crushed the pills and sprinkled the dust onto applesauce.  It was so easy- at that point of life he would open up his little mouth for anything and everything!  Our babysitter at the time said he ate “just like a little bird”, opening his mouth as wide as possible to get as much food in as he could.  We started giving him Topamax around the end of December when he started having complex partial seizures, and everything changed.  Topamax is really bitter, and after the first bite or 2, he would refuse more.  Anyone who has had trouble getting their kid to eat will have some idea of our frustration.  It was so horribly stressful- I would actually start getting anxious around mid-afternoon since the evening dose was so hard to get down him.  He would usually be ok with the first bite or so, and then he would refuse everything else.  I tried everything- mixing the pill into more tasty foods like pudding and frosting, tricking him by giving him bites of food without Topamax and then sneaking a couple in, giving him milk in between bites, prying his mouth open and squeezing the spoon in as he shook his head crying, and so on.  Really bad and stressful!!  Jadey and I knew that if things continued on like this, he would have major feeding problems as he grew, but neither of us had good ideas.  Jadey didn’t handle the stress of dosing as well as I did, so he frequently took off in the middle of the dose and left me to finish however I could.  A friend whose daughter has TS and was on Topamax for a time gave us the idea to mix it into soda since it masks the bitterness of the drug.  So we dissolved the medicine in Pepsi for awhile.  We would give him 5 oz of Pepsi with each dose, so 10 oz of Pepsi per day- disgusting.  I hated giving him that Pepsi, but it was the only way he would take the meds on a consistent basis.  After drinking the Pepsi, he would spit up these tiny, sticky, dark brown strings.  I was determined to find a better way, even though Jadey was pushing to just keep going with the Pepsi since it was working.  Our friend had told me that she got her daughter’s Topamax compounded into a liquid, and the flavorings they used seemed to really help with the bitterness.  After lots of phone calls (some angry) to pharmacies and nurses, I finally was in line at Walgreens in Aurora to get Ollie some liquid Topamax- what I hoped would be the end of all our suffering!!  When I got to the front of the line to pick up the prescription, I asked them if I could choose the flavoring.  Which was when I found out that that Walgreens (and every other Walgreens I have contacted) would not flavor compounded Topamax.  What a huge disappointment.  Now, instead of having horrible-tasting powder, we have horrible-tasting liquid that costs 4 times more- thanks for NOTHING!  Of course, when we tried it, it didn’t work any better than the powder.  Pill dosing was still miserably stressful, and Jadey still stormed out of the room swearing whenever things got bad.  At one point, Jadey tried talking to a pharmacist at Walmart about getting the stuff flavored, which didn’t go well.  Finally, that Sunday, I decided that enough was enough- I made a plan to go to a bunch of pharmacies and to beg and plead for something I could use for his pill.  I knew they HAD the flavorings- why wouldn’t they share them with us??  The first 4 places I went were closed (even though they ALL had Sunday hours posted online and in the store- jerks).  Finally I found a Walgreens that was actually open.  After a long conversation with a pharmacist, which included me telling him how desperate I was and how unhelpful Walgreens had been, he finally sold me a bottle of cherry gunk that was used to mix with Theraflu.  Success!!  The cherry gunk allowed us to switch from Pepsi to Sierra Mist.  Not optimal, but still better than the Pepsi.  After a post on a TS discussion board where I asked other parents for ideas, I found out that Topamax comes in a sprinkle capsule- a plastic pill filled with teeny gelatin-covered pellets of Topamax.  You open up the capsule and dump the little granules onto food.  The gelatin covering allows you a couple seconds of non-bitterness before it melts away.  I was pretty hopeful but still skeptical because of all our failures.  It turned out to be the best solution though, by far!  The dosing still hasn’t been perfect by any means, and Oliver dislikes the feel of the pellets in his mouth, but dosing time is no longer horribly stressful.  As Oliver got used to the pellets, he minded them less and less.  The last really difficult time with the pellets was the last dose that Jadey has helped with, about 3 weeks ago.  Jadey had been threatening for awhile that he was not going to help me anymore if I kept changing how we administered the dose, and that night he finally snapped.  Ollie was not super excited about taking his medicine, and he finally gagged and spit out a huge mouthful of food mixed with pill.  Jadey was holding him, and he totally lost it- he started shaking Oliver (more like trembling with frustration than actual "shaking") and yelling at him, “Eat it, just eat it!”  I grabbed Ollie and told Jadey to get away from him- I guess my protective mom instinct kicked in.  Since then, we both agree that I should do the medication myself.  Jadey has even gotten to the point where he refuses to be in the same room with us until the dose is done because he gets too stressed out.  Anyway, dosing isn’t a very big deal anymore.  We just try to feed him very little after about 2:00 or 3:00 in the afternoon so he will be hungry in the evening.  Around 6:30 or 7:00, I get the fruit puree, warm milk, and pill sprinkles ready.  I put Ollie in the car seat.  To dose, I get a bite of fruit, sprinkle some Topamax on top, and feed it to him.  Then I chase it with warm milk and rock him in the seat for a few seconds.  I repeat that procedure until the pill is gone.  He enjoys the rocking and milk, so the medicine goes down easier.  The Topamax still seems to be controlling the seizures!  Oliver has been developing very well lately- standing by himself, crawling, and possibly understanding some words (!!!!!).  (Can you tell that his speech therapist mommy is excited about that one?)