I would feel remiss if the last thing I had to say about using a syringe and catheter was the struggle I wrote about in my first week of recovery - 10 days ago! So, in this post I’ll share a few things I learned that helped me manage the process of eating and medicating myself with the syringe-and-catheter set up. As always, I’m hopeful that any patient recovering from surgery like mine will find it helpful information. I’m going to address this blog post directly to those readers.
I’m thankful to Lorraine for her creativity, patience, and comfort in helping me through this aspect of my recovery. One of the hardest parts! I also want to give lots of credit for some basic foundational knowledge to Jonathan (JonPaul70 on YouTube), whose videos about eating with a syringe-catheter setup were fundamental and even inspirational. As Jonathan says, you don’t have to starve. There are many options for food out there that you can make work through a syringe. (And this man had to experience that for four+ teeth-wired-shut weeks, while I was cut free at 9 days…)
I think Jonathan’s eating-demonstration and “don’t starve” videos cover most of what I would say here about food. Even though it’s not that important, I’ll include another tip from Jonathan just to make sure you get it: to keep the plunger moving easily in the syringe, coat the edges of its rubber stopper with olive oil. A big thank you to Jonathan -- You can see that thousands of people have watched his videos, and have probably been helped as I have.
What I didn’t see Jonathan address in his videos was taking medications through the syringe, and this is the area that I struggled with the most. These are the medications and amounts I was taking:
Sudafed (children’s) – 10 mil
Oxycodone – 10 mil
Durosill – 10 mil
Amoxicillin – 10 mil
Ibuprofen – 30 mil
These varied in their noxiousness. The Amoxicillin wasn’t too bad for me, and neither was the Oxycodone. For the others, taking them in was never easy. Most mornings and evenings I had 4 medications to take at one time (keeping Oxycodone and Ibuprofen offset from one another). I always began with the ones that were the worst to take – Durosill and Ibuprofen especially. That way, it got easier as I worked through the list. Also, I would always alternate medicine and other drinks: 10 mil medicine, 60 mils good juice, 10 mils other medicine, 60 mils other comforting liquid, etc. That helped me calm down in between doses.
For the first few days, I was squirting the medications undiluted straight to the back of my mouth and into my throat. I’m pretty sure they touched the “bitter” taste buds on the way, oh yes. Since I was bypassing my tongue (running the catheter along the side of the rubber-banded-shut teeth), it couldn’t help by performing its function of regulating the amount of liquid coming down. And, wanting to get it over with, I sometimes (often) squirted more in at a time than I should have. I sometimes kept the medicine coming, to “finish the dose”, when I wasn’t dealing well with what I already had in my throat, and really just needed to take a break for a few seconds. I found many times that 3 mil of medication – not a lot of liquid – was plenty to choke me if I wasn’t ready for it. At the worst times, the liquid coming in fast got down into my larynx and trachea and triggered a strong and painful cough, and I sprayed out medication on anything nearby. Miserable.
Regularly a little bit of medication would get into my larynx, and depending on what it was, burn there. I was deeply concerned about some kind of damage to my vocal cords. I didn’t have any information about whether liquid medications sitting on the vocal cords can do damage, and I still don’t. I’ll hope to learn more about that in the future, but from an abstract (not experiential!) point of view. But in the meantime, it was certainly painful.
If the first 3 mils of a 10-mil dose of Durosill (perhaps the worst of my medicines) were already causing me pain and discomfort, it was certainly hard pressing the plunger to deliver the remaining 7 mils. I’d usually deliver 3 mils at a time, very slowly, so 10 mils would take three or four times of gathering courage, taking the breath in, and gasping and lunging (can’t think of a better word) to take the medication in again. 30 mils of ibuprofen took an eternity, and I wasn’t displaying a lot of patience. Recipe for problems! And, sometimes the plunger wouldn’t move smoothly and would jerk forward accidentally, shooting in an extra several mils of medicine. That usually was upsetting and painful. (Reminder: OLIVE OIL on plunger helps keep it moving smoothly.)
This remained the state of things through several cycles of medicine-taking in the first few days of my recovery. I had the intention of applying some Alexander Technique to the process, finding some means whereby I could better take in the medication in a controlled and thoughtful way. But I couldn’t rise above my response to the sensations and emotions aroused by the medications, and remained stuck in the patterns as described above. It wasn’t getting better or easier.
Finally Lorraine realized that we could mix the medications with some other liquid (juice, smoothie) to make them easier to get down. (The food and medications are all mixed together down there in the stomach, after all - as long as they can be taken with food.) Once we thought of that, we started experimenting with different liquids to add. I found that a 3-1 mix, like 30 mils of something tasty with 10 mils of medication, seemed to dilute the Sudafed so that it wasn’t hard to take anymore. Docusill still wasn’t great even at a 5-1 mix, but it wasn’t painful anymore, just nasty.
Ibuprofen didn’t benefit from mixing much, since at 30 mils there was only room in the 60-mil syringe for a 1-1 mix. Still, 60 mils of a somewhat less bitter mix was still somewhat better than 30 mils of straight Ibuprofen. I’m sure if I was still taking it I would have continued to experiment with different combinations, and perhaps I would have found something that more successfully masked it. Thankfully my run of Ibuprofen ended some time ago, so I didn’t have to keep at it.
I encourage anyone trying out this “mixing” idea to experiment and try different things. I found that one of my favorite staples, Bolthouse Farms “Berry Boost”, helped mask the Sudafed (kids’ “grape” flavor, yum! Not). By contrast, apple juice combined with Docusill just made a much larger nasty drink, and likewise for a citrus-y drink combined with Ibuprofen. I settled on Bolthouse Farms “Stone Fruits” to combine with Ibuprofen, but it wasn’t great and I’d look farther afield now, if I still needed to. (I might never want to drink that flavor again, now.) You might be able to think ahead about what sorts of qualities the medicine has, and what sorts of qualities in the juice that might balance that well: for example, astringent mixed with creamy.
Tip: When you combine the medicine and other drink, make sure you shake them up (carefully) together. In the photo you may be able to see that there are two purple colors in the syringe. One is the grape-flavored Sudafed, and the other is the Berry Boost smoothie – not mixed together, about 10 mils each this time. (Though it seems like the two liquids would combine when you draw in first one then the other into the syringe, it is an interesting function of hydrodynamics that they don’t, but stay separate, one liquid being sucked through the other.) If I had taken this as it was, I would have gotten a big surprise of several mils of straight medication, which would not have been pleasant. So, make sure to visually confirm that the medicine and the juice are mixed well.
In the photo you’ll also notice I have a glass standing by of another drink. An innocuous Chocolate Protein Shake, a staple for me, is ready along with another syringe-catheter setup for when I’ve taken the medication and need to follow it with something comforting.
Tip: For cleaning, vodka makes an excellent disinfectant. Somewhere Lorraine picked up a method to clean the syringe, plunger, and catheter: Mix a couple ounces of vodka with a cup+ of water. Draw in the vodka-water mix into the syringe, and squirt it out. Do this 2-3 times. Repeat with straight water 2-3 times. Done! (Vodka is also helpful when squirted into the armpits of smelly costumes, by the way.)
At one point while struggling with all of this, I realized that I had not had any coaching on medicating with a syringe/catheter setup from any medical person. At first I was indignant at what seemed an oversight. But I realized that while I was in the ICU, I was on three IVs and constantly had medication and fluids coming in. So, there was no need to take any medications, and no opportunity to try taking additional medicine through a syringe-catheter. I’m not sure that a test run with something like water would have been to the purpose, as the issue with the medicine is dealing with its noxious qualities. And, with Lorraine’s help and as the staff looked on, I did a lot of eating via syringe on my last day, so they knew I was competent at that.
I’m not sure what the answer is with this. I think more could be done to prepare patients before or just after surgery for this upcoming reality, but I’m not sure when. But, hopefully this posting will be a bit of help that is available – and might even prompt some improvements.
Skip the part of taking the medicines straight! Go straight to mixing them!
*** Note: I just realized that I could have split the 30 mils of Ibuprofen into three 10-mil servings, and made the proportions of whatever I mixed with it much higher. It never occurred to me, mostly I think because I always just wanted to get it over with. But I'll leave that thought here as another option...
MARY ANN SCHRADI
9/2/2016 02:38:23 pm
Gee, what an ordeal. Thinking of you and glad you are getting along despite this most difficult journey. Take care and see you in a week. I have a card for you which I will deliver in person.
9/2/2016 10:14:23 pm
I'm so thankful you are recovering well from such challenging surgery. What a journey you and Lorraine have been on! Your daily log detailing struggles and victories and highlighting your personal feelings and insights has been wonderful.. How generous of you share this journey. You will continue to be in my prayers and thoughts. Look forward to seeing you next Tuesday. Blessings
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Dr. Adam Burdick has been a professional musician for over two decades. Teaching, conducting, and performing in various music genres, he is also a perpetual student with interest in a wide range of topics. He loves to ponder and share his discoveries with anyone interested!