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Ugh - that didn’t take long

Step lightly's picture

So. SD has had an ongoing episode of constipation. Bad. Real bad. She’s been to a specialist and they have recommended laxatives. Big surprise. 

The issue is the Dr instructions say for a toddler to drink 48 oz of water in one sitting... so even on a good day that’s just a huge ask. SO has tried to do one of these cleanouts three times now, with partial success. BM always conveniently asks him to take care of it, or couldn’t get it to happen.. or whatever. My opinions of that subject won’t change anything. 

The point is... we had a little success this morning but it was short lived. Who could have guessed a waterlogged toddler would get fussy... SD starts pushing back, SO starts issuing time outs. Wash, rinse, repeat. Screaming for mommy the whole time. Everyone is at their wits end.

I check with him to see if I could try talking to her, make a really concentrated miralax sludge, it would suck, but it would be one and done. Quick. Easy. No more fighting, no more time outs. He agrees. She agrees to try. But as I’m mixing up the goop. SS comes in with BM on video chat. 

SD starts talking to BM about how she’s having a terrible day and how dad is mad at her and everything is the worst. My patience with all of it was no longer existent so I just had to leave for a walk. I didn’t have it in me to fight with this kid, only to be “the worst” and for her to cry for her mommy who keeps pawning off this kid’s medical care. I’m not gonna be the effing bad guy for mommy to get a free effing pass. Eff all of this. 

 

Comments

tog redux's picture

How in the world does a doctor expect a toddler to drink 48 ounces of water, or more importantly, how does he/she expect the adults to MAKE the toddler do that? Enema time?

Step lightly's picture

Lol right?? I think it’s SO’s turn to tell BM, “hey I have tried this with no success four times now. Why don’t you try giving her an enema since whenever I try to do a clean out she cries for you anyway.”

or it’s just my turn to practice “not my monkey” 

tog redux's picture

My niece had this issue too, she was anxious about pooping on the toilet (versus a diaper) , so she withheld - she finally needed to have an enema.  It's not fun, but it's better than everyone pestering this poor girl all day to drink.

Step lightly's picture

Yeah. I’ve told SO a time or two a while ago that inaction was heading this way, and the poopball was growing. He and BM were both kind of just hoping it would revolve on the other’s week. SO had an epiphany after the first specialist appointment, literally told me I had been right the whole time, did a compete about face on the matter. 

2Bloved's picture

Why would he require it in one sitting? We don't even require that of adults while they're prepping for a colonoscopy.

Mix the miralax in juice, her milk, whatever she normally drinks or likes and put in in a sippy cup or a water bottle she can drink from throughout the morning. 

Mix in pudding, yogurt, slushie,  smoothie. Don't make the experience a traumatic one. Get the miralax in, then offer lots of fluids throughout the day. 

Step lightly's picture

It’s fecal compaction. They tried a more typical dose but it didn’t work. Dr. Said since that didn’t work they have to really treat aggressively 

2Bloved's picture

Mix it in juice or whatever she loves to drink. Bit mix the dose in a small quantity of liquid. Take her outside to run around so she wants to drink more. And, consider a suppository.  If all else fails, enema.

I had a 4 year old in the ER who did great tolerating his enema, which is not the norm. 

Step lightly's picture

Well. Whatever it is, it’s nothing I have any power to change so I didn’t bother to find out.... Figured I wouldn’t want to know. So I’ll just assume it’s circus peanuts, since you know... monkeys...

Step lightly's picture

They are.

SO has owned up to getting lenient and has been making real improvements with diet, and has attempted about four of these cleanouts. He did have a successful one but apparently it wasn’t enough to get the all clear from the Dr.

He has taken her to all of the appointments except the most recent one, a follow up, BM’s first Dr visit for this issue. 

thinkthrice's picture

no "kid friendly" food...no mcnuggets, oreos, doritos etc etc

momjeans's picture

Yeah, that’s an unrealistic request to make to someone caring for a toddler, and a constipated one at that.

I also recommend Miralx. It’s tasteless. Just mix it with water, as you should really be pushing her to drink lots of water not only today, but most of the day - every day.

It could take up to 3 days to start working, and then holy heck, be prepared. 

Step lightly's picture

Yeah- we’re using miralax. I mean, I want her to get better, but I’m not gonna drive myself up a wall over it. SO is doing what he’s supposed to. It just grinds my gears that he seems to be the only parent taking it seriously.

fourbrats's picture

from the doctor and from mom. No toddler is going to drink 48 ounces in one sitting. The end result is going to be her puking not pooping. I would get a second opinion and if necessary just have dad do the enema. 

fourbrats's picture

does it really matter? I mean honestly. Yes mom should do some work but this isn't a situation where dad should be stubborn. Give the kid the enema and move on (dad) and quit worrying about mom not doing the work at this moment. If mom is refusing to follow doctor's orders then dad should take it to court and deal with it there. But at this moment when the child is in pain it doesn't matter. Restrain, enema, done. At least the child is getting some help from dad since mom won't do it. 

Step lightly's picture

Ultimately? No it doesn’t matter who does it. 

But if I’m venting? Heck yeah mom should do it because I think she’s been passing the buck to SO and it irritates me that she’s taking advantage of him.

Should SO give her an enema? I’ll let him follow doctor’s orders, he’s the one going to the appointments, I’m not since she isn’t my child.

we don’t have resources for court fees so that isn’t an option. BM and SO have managed to stay out of the courts as much as possible and would like to continue to do so.

2Bloved's picture

Seriously,  have you even tried mixing it with juice? Or  putting it in a smoothie? Or any of my other suggestions to get her to ingest??

Step lightly's picture

The kid hates juice and smoothies. Pickiest eater ever. We had some luck with applesauce though

Also SO has tried suppositories for the last cleanout he attempted. No dice. 

2Bloved's picture

I can't stop thinking of this post. I'm questioning the doctors orders and/or your interpretation of the orders. 48 ounces of fluid in ONE sitting for a toddler seems excessive (without knowing her age or weight). That amount could be enough to throw her electrolytes out of balance and cause her extreme harm. 

Any other nurses have an opinion??

ndc's picture

Has your husband called the doctor to clarify/verify the instructions?  I cannot imagine a toddler drinking six 8-ounce glasses of water in one sitting.  Hell, I can't imagine ME drinking six 8-ounce glasses of water in one sitting.  If neither of the parents can get this done, I'd be going back to the doctor's office and requesting help.  

2Bloved's picture

I'm fearful of water intoxication at that stage. And really hope they're not continuing to "waterlog" her. 

Want2's picture

"I didn’t have it in me to fight with this kid, only to be “the worst” and for her to cry for her mommy..."

Here's where your ego gets involved and makes a bad situation worse. Stop competing with BM, just do the right thing and don't worry about what BM thinks. If you're going to help the kid go for it but if you're compelled to walk out in the middle of helping because you're mad she won't appreciate your efforts you probably shouldn't be involved at all. 

Step lightly's picture

I’m not walking out because I’m mad that my actions won’t go appreciated, but rather I’m frustrated that BM has not put forth effort to address this medical issue when SO has. I’m frustrated because she has once again handed this task off on SO when she had her entire week to address it.

I went for a walk because SD was video chatting with her mom, she initiated that call as I was mixing medicine. Maybe there was ego involved, but it wasn’t because I was mad at the kid. I came to my senses that continuing to help at that point would be putting me in a position I was not comfortable with. I saw an opportunity to exit quietly and took it. 

Step lightly's picture

Do you mind clarifying what excuses you’re seeing? 

From where I’m standing.. my SO is in a tough spot, frustrated that he can’t get his daughter to take medicine she desperately needs, he knows he’s making the situation way more stressful because he is stressed and i generally have a temperament that keeps me calmer in these situations. I offer a solution that might make life easier for everyone in the house because at the end of the day I don’t want SD constipated. The whole while I’m kinda miffed that BM drops her off yet another week saying that SO needs to do another cleanout. But being miffed at BM doesn’t change the fact that this kid needs medicine and my SO is asking for my support.

I’m not expecting anyone to appreciate it, it would just be nice if it didn’t always happen to be on SO to do these miralax standoffs. 

 

DHsfamilyfromhell's picture

feel free to ‘virtually slap’ me. You may like to try no bananas, swap to whole meal bread and pasta (depending on the fussiness of child) pizza and chips wouldn’t be great in this situation (I wonder if bio mum feeds kid this at home). We have all done it, no shame. Kids like the food. Though my sisters daughter spent years on laxative so I do understand that some kids just have a problem.

Step lightly's picture

Already eating whole grain, pizza is once a week in our house. She prefers popcorn over chips (More fiber). SO gets her to eat more carrots and broccoli than she used to, swapped out regular tot/fries/Mac n cheese for cauliflower versions. She likes black beans. Tried to get fiber filler water flavoring but she just likes plain water, no juice.  She eats more chicken nuggets than she should. But bottom line she just kind of picks at food. 

I think her diet could improve more, I’ve told my SO this a few times before but I’m not going to keep nagging him about it since I’m not her mom. Diet would help, for sure, but this is beyond diet at this point. This is a kid who is afraid to poop so she’s holding it in and making it worse. 

lieutenant_dad's picture

Has the doctor recommended a stool softener at all? Relieving constipation HURTS. Stool is large and hard, and if she knows that pooping = pain, she'll hold it in and make the whole situation worse. A separate stool softener might help.

lieutenant_dad's picture

Been there, done that with both myself and YSS.

With YSS, he was on Miralax pretty frequently and would fight having to drink enough fluids. Miralax isn't entirely tasteless, and there is a texture even when you mix it in entirely. And even after you take it, you have to drink enough fluid to move it through the system, so while it only takes the 4-8 oz to drink it, you have to keep adding liquid on top of it.

Two things we found successful were mixing it with Capri-Sun and mixing it with watered down Gatorade (or the Gatorade Ice or whatever kind has less sugar). YSS wasn't a fan of regular juice, but he'd suck down a Capri-Sun no problem. You can even use the less sugar kinds or just add a few ounces of water.

Also, let her go pick out a cool cup that she wants to drink fluids from. Get some crazy straws. Let her drink out of the nice glasses if she likes them (I loved stemmed glasses and always wanted to drink out of them). Try making it more fun, and you might distract her.

You can also try low-sugar popsicles for fluids. YSS could kill a few popsicles before he'd ever think about drinking a full glass of any liquid. 

Also, try drink breaks. Every 15-20 minutes, have everyone stop playing to take a drink. It can just be a few sips, but just so liquid is getting into her system consistently (or at least had the opportunity to drink it consistently).

Sno-cones are another fun way to get liquids in. Just be mindful of sugar.

Avoid milk and dairy-based products as much as possible.

One suggestion my doctor has for me was massaging my gut. Basically, rub small circles in a clockwise fashion around where the colon is. Very light and gentle pressing. It helped move things along in combination with laxatives while also relieving some of the pain.

I would avoid high-fiber grains if she is having trouble with fluids. Pastas, breads, and grains all need liquids to move them through the system, especially if they are high in fiber. Fruits and veggies are a better option because they are already filled with water to help move things along.

Prunes and prune juice help, but they definitely have a taste that not everyone enjoys.

Exercise, exercise, exercise! Get her to do some games that require movement, or take her to the park. Stress-relieving yoga can help, too.

Hopefully some of this helps. I'd be less concerned about hitting some crazy amount of fluids (48 oz is even tough for adults in 4 hours) and more looking to just keep getting fluids, no matter how small, into her system. Plus, the less stressed she is about the process, the more likely it is that her bowel will loosen up. Stress makes digestive issues worse, and you can end up with both diarrhea and constipation at the same time. 

 

Step lightly's picture

Thanks for the tips. That’s more or less how we’ve been approaching things at this point. Except this kid is the only one I’ve even met who doesn’t like popsicles or snowcones or juice or chocolate (for the chewable chocolate laxative).... seriously... at a birthday party she turned down cake for plain bread....

It seems like we were able to get enough in her system with the applesauce though,  things have started to get moving. 

lieutenant_dad's picture

Will she drink warm tea or warm water with lemon? I find warm beverages help as well.

Also, look at getting a stool that raises her knees to her chest when she is on the toilet. Basically, trying to get her to squat over the toilet versus sit. It opens everything up a bit more and makes it easier for things to flow. Helps alleviate some of the pain, too.

Can she tell if you try to hide foods into things she eats? If not, try puree-ing a squash and mix it in with mac and cheese, or look into veggie nuggets/hot dogs. Switch her dairy products - like cheese and milk - to non-dairy versions.

Lastly, water down that applesauce! Seriously, just really soup everything up. Adding an extra ounce or two of liquid won't be super noticeable to her, but it will just make it easier for her to get liquid in.

Step lightly's picture

I doubt she’ll drink tea. I’m not complaining that she only likes water and milk (we’ve cut her milk consumption down to maybe 1 or 2 4oz glasses a week) because it means she isn’t getting all the sugar in juice. But it makes it tricky in situations like these. I’ll suggest warm water to SO though! Usually we keep water at room temp.  Water in applesauce seems risky -she’s pretty hawk-eyed about food- but I’ll give SO a heads up on that idea.

BUT! Good news. SO talked to BM- told her he isn’t having luck and maybe she will since SD is screaming for mommy. BM is scheduling an appointment for an ultrasound. Maybe she’s starting to get with the program.

Wrong Way Diva's picture

My granddaughter has had pooping issues since she was a toddler.   Her early life with her parents was chaotic and one of the things she could control was going to the bathroom.  It also helped her get 'attention' from her drug addled parents.   Her pediatrician said constipation can be caused by anxiety and to use Miralax, but don't make a big deal out of it.   I just put a couple scoops in the jug of apple juice and warned SO--don't drink to much, it's 'loaded'  :)     Things like cut up watermelon and strawberries--which are in season and so yummy--eaten with a toothpick are fun and easy ways to get good foods in her.

Her therapist also showed her some relaxation techniques to help her with anxiety--simple things like "smell the cookies" (deep breath in)  "blow on the hot cookies"  (deep breath out).    A few times a day or as needed really helped her calm herself.   Now she is 'regular', about every night at 6 pm---usually during dinner--hahahahaha, not. 

Step lightly's picture

Thanks for the tips! I love the smell the cookies/blow on the hot cookies idea! Anxiety runs in their family so I know it certainly isn’t making things any better, even if her diet is mostly to blame.

 I’m gonna try to make some avocado/melon “ice cream” tonight to see if she’ll eat that. I might slice up some strawberries extra thin to see if she wants to decorate her dessert too. 

strugglingSM's picture

I agree with the post above that it's likely a control issue. Young children don't have much control over their lives, but they can control how often they poop, so it's pretty common for young children to be constipated. They might not be doing it consciously, but for some reason, not pooping becomes a common control mechanism. 

GhostWhoCooksDinner's picture

I don't think a toddler's stomach can even HOLD 48 ounces at a time. Are you sure he didn't mean 48 ounces in a DAY. Damn, that poor little girl.