Learning slowly.

[DeansWife]

Today is day 3 since Dean had the Peg tube procedure. I think, I hope, I pray, that life is beginning to resume some assemblance of normal. He is still experiencing some pain/discomfort around the tube site but I think that is to be expected. He did have a good nights sleep, isn't running any fever and his b/p seems to have come back to normal.

Now the next lesson for me - he takes about 15 pill daily, half in the AM, half in the PM. I've bought two pill crushers and neither one seems to do very good. I believe the manufactures put coating on ALL pills these days. Any suggestions on how to get these to disolve? I've talked to the pharmacist and was told which ones I could crush. The thing is, they don't seem to really disolve completely in warm water. I've called our primary doc this morning to go see if any of them can come in liquid form. Will see what he says, meanwhile, Dean is back to trying to take them by mouth and choking.

Can anyone give me some suggestions?

 

[alador]

Used a small hammer, wooden cutting board and parchment paper folded. This worked well. Recently purchased online Silent Knight pill crusher. It is a little expensive and you have to use their special pouches, however you can crush several pills using one pouch.
This is easier for travel and also not as noisy as the hammer, however the hammer can get out some of your frustration (LOL) My husband has had his PEG since January and is so glad not to have to try to swallow all those pills. Hang in there, each day with the PEG gets easier and you will soon have your routine. I know how frustrating those first days can
be. Good luck and best wishes.

 

[cubcake]

Question....were you able to talk Dean into the PEG, or did he just decide by himself. My pALS is still saying No, and choking, spitting and sputtering through every meal.

Thanks

 

[Magpuff]

Not on PEG yet but my pills go down better with V8. Was choking on water.

 

[brooksea]

Boil a bit of water in microwave. Put pills that are hard to dissolve in shot glass. Pour boiling water over pills. Wait a minute. Crush with handle end of steak knife or similar item. Stir.

Pill coatings usually dissolve in boiling water. Good luck!

 

[DeansWife]

@ cubcake - Dean decided himself. We had attended a ALS support group meeting that had a speaker that talked about the Peg and showed a video. I asked him that evening if he still didn't want one and he said no he didn't. A couple of weeks later, after several days in a row of choking on everything that went in his mouth, he wrote me a note on his white board that said "After a lot of prayer and thought, I've decided I want the tube". His decision.

Brooksea - I'm going to try the boiling water method. Hope it works! He's back to taking them by mouth and choking. I had a good laugh at the RN that really ticked me off on Tuesday. She called (won't go into why) and I mentioned the pills and she said to split them into 4th's that they would crush easier. Uhh, his pills are small, very small. No way would they go in a pill spliter to do halfs let alone fourths.

His b/p was back up a little tonight but he says the pain is a little worse tonight as well. I hope its from the pain. Watching him close.. I'm hoping that the pain will start to subside. He won't take anything stronger than Tylenol and yes, they have a coating and don't crush well either!

The feeding routine is getting easier - who needs a In A Hurry RN?. I figured it out. Takes about 15-20 min start to finish.

So, I end another day, at least this one was a lot less stressful.

 

[Nikki J]

I hope things get easier for you. Just a warning re the boiling water. high temperatures can make medication ineffective. I wish I had a good solution for you

 

[momap53]

I'm so glad you're getting more comfortable with the Peg! Dean's pain is most likely the cause for the elevated BP.

I used a marble mortar and pestle I got at one of the discount department stores when I had to crush meds for Mom. After the first pound with the pestle, the coating could be picked out with a tweezer. We also had a small plastic pill crusher that one of the Hospice nurses gave us. I'm surprised that the pharmacist wasn't more forthcoming about which meds could be dispensed in liquid form. If you have a pharmacy in town that does compounding, they may have a solution for you.

I'm sure it will get a little easier for you each day. You're doing a great job!

 

[rachelg]

I used to use a kitchen pestle and mortar to crush pills to a fine dust and then add to water, put through the peg then flush again with water using the same syringe -tilting the syringe as I put them through so that all the bits go through. I now have a pill crusher that has a bumpy type surface seems to crush them down really fine.

 

[Miss]

I bought a marble mortar and pestal at Target (actually quite nice looking!) for about $15. It worked great for crushing the pills. After that, I put a small amount of very hot water into the bowl of the mortar to dissolve the powder. I would pour this into the syringe and add some room temperature water to fill up the syringe. After I put the medication through the peg, I would refill the syringe with more room temperature water, shake it a bit and send it through the peg. I would follow this with another syringe of clean water to flush the tube. (I know it sounds like alot of water, but remember, alot of medications really need to be taken with a full glass of water) Believe it or not, this will become second nature to you! Good luck! You'll be a pro in no time!

 

[panguinjen]

Try some cottage cheese or pudding... Rog isn't ready for me to crush pills yet... He puts the pills in either of those two to get them down! You are doing great!

Jen

 

[dragonflydi]

Are they prescription meds or supplements? My husband takes several supplements and when he could no longer swallow all those pills his doctor found them in liquid form for him. Good luck!

 

[Miss]

Don't forget to ask the pharmacist about getting some of the medications in liquid form.

 

[Jason's Dream]

Some pills simply will not go down the peg tube. If the peg tube gets stopped up, you can do a can of coke down it as a chaser, if that does it, then just rinse with warm water. If that doesn't do it, (if you do his tube via gravity open-ended tubes) take the "plunger of the gravity tube" (I know there has to be a name for that thing), and put it in, then try to drag it out. If some comes back out (into the tube), then that more then likely will have fixed the blockage and you might need to add more water over pills ratio. One thing you should really look into, is which of his medicines the pharmacist say can and can not be put down a tube, is there an oral suspension (or liquid) of any/all of those medications? Lexapro does come in oral suspension. So does hydrocodone. Morphene (or the liquid form: roxinol) can be administered subcutaneously (open-ended oral syrenge into the cheek of the inside of his mouth, and the cheek will absorb it). If he gets constipated with all the meds, can add milk of mag down his tube with warm water chaser. If they are capsules, you can open them up... but most capsules, the small "pebbles" inside will not go down the tube (as they seem to float on top of the liquid) anyways, you can open them up and stir them into a tsp of applesauce or pudding (which ever he prefers) and give it to him via his mouth. HTH and GL. *hugs*

 

[DeansWife]

dragonflydi - they are prescription meds and only one comes in liquid form :-(

Jen - wish we were not all the way across the country from each other. Our lives seem to be running close to parallel with our hubbies. Dean used to love cottege cheese so I'll buy the smallest container I can find and he'll give it a try. He's done the pudding and is still using applesauce. It seems the smaller the pill the harder it is to get down. The really big ones he doesn't choke as bad on. Strange!

Yesterday was a better day. Dean did not sleep as much, took 3 cans of food plus drank a Boost and ate a bowl of mashed potato's and gravy. He even had some milkshake but decided he didn't care for it. He never was one for milkshakes! He didn't complain about hurting as much yesterday either. Light at the end of this tunnel? I do think so! I can't thank everyone enough for being there for me during my stress breakdown! I'm back to where I need to be but will be getting something from my doc, just incase. Ya never know.....from my girl scout days, be prepared, oops, I think that was the boy scouts! Well, I hung out with them more - LOL!