How to Prepare Medications
and/or how to practice mindfulness while doing something ordinary
Today’s post is part of a new series including , , , , , and me. Over the past 18 months, once per quarter, we each write on the same topic. In the past, we’ve explored prompts such as our personal philosophies, fatherhood, work, and more. This week, we tackle Ordinary Things. When you’re done reading my entry, check out the links to their pieces at the bottom.
Total prep time: 15-20 minutes.
The time has come for an update as it has been nearly two years since we last went over how to prepare medications for your now nearly seven-year-old daughter who has cerebral palsy.
You’re in luck! You no longer need to administer her meds through a feeding tube on her belly at midnight while she sleeps. No, she doesn’t eat by mouth yet. Yes, she still has the feeding tube. And the 24 inch extension tube still needs to be attached to the feeding tube while she sleeps. But now her nighttime meds have been moved up to 9 pm so you can get to bed earlier, although you will still stay up too late too often.
After giving her the three already-prepped syringes containing Glycopyrrolate (13 ml dose in 20 ml syringe, light purple cap), Clonazepam (0.75 mg dose in 3 ml syringe, dark purple cap), and Gabapentin (1 ml dose in 3 ml syringe, clear-ish cap), return to the medication filling station (i.e. your kitchen counter to the right of the sink).
You’ve recently listened to a podcast where the guest was talking about how you can use ordinary tasks in your life as opportunities to meditate and be more mindful. Filling your daughter’s meds is about as rote of an activity as you do each day, so you figure why not try it.
Note: all syringes have EnFit-style tips, which are threaded and therefore do not pose any risk of puncture. Please be mindful about replacing syringes too often in case there’s another inventory shortage from the vendor.
How to Prepare Clonidine
Ingredients:
Two tablets of Clonidine
One 3 ml syringe
One orange cap
Cup of tap water
Paper towel
Self-judgment
Curiosity
Pull the rubber stopper from the 3 ml syringe and notice how oddly satisfying it can feel to push the stopper in and out, especially when the syringe is new.
Drop the two tablets into the opening. When the tablets are settled at the bottom, replace the rubber stopper and push it down until it touches them. Pull up roughly 2.5 ml of water and remove any air bubbles by holding the syringe tip upwards and flicking it like you see in the movies. The pills will quickly dissolve in the water.
Notice that you were zoning out and weren’t as mindful about what you were doing as you intended. Briefly judge yourself for already failing at this exercise. But also question what it means to be mindful while doing a task. Is it about really focusing on the task, or is it more about just noticing whatever arises, without judgment?
Attach the orange cap and wipe the syringe clean with the paper towel before placing it tip-down in the labeled section of the clear plastic organizer on the counter.
How to Prepare Glycopyrrolate
Ingredients:
Bottle of Glycopyrrolate solution
Small measuring cup
Three 20 ml syringes
Three light purple caps
Paper towel
Thoughts
More self-judgment
Close your eyes and take a deep breath to settle yourself and restart the mindfulness exercise.
Notice that you’re holding tension in your neck and shoulders. Notice the frustration that comes up when you realize that your neck has been stiff for over a week and somehow isn’t fully healed yet. Resist the urge to blame it on getting older.
Snap back into the present as you pour out 18-20 ml of the Glycopyrrolate solution into the small measuring cup. Pull up 15 ml of solution into one of the 20 ml syringes. With the syringe tip upwards, pull back on the plunger to add air, flick any air bubbles out of the solution, then push the plunger up until all the air has been removed. Be careful not to push too hard and shoot the solution onto your kitchen ceiling. Squirt excess solution into the measuring cup until the total volume in the syringe equals 13 ml.
Screw on a light purple cap, wipe syringe clean, and place it tip-down in the back of labeled section.
Repeat the process for the next two syringes while you think about how despite the persistent crick in your neck, and the fact that you’re rapidly approaching 50 years old, you’re in the best shape of your life. Look down at your arms while you flex and feel proud of your commitment to regular exercise for a moment.
Realize that you’re following your thoughts again instead of being mindful about the ordinary task you’re performing. Shake your head and feel a tinge of self-judgment again. Take a quick deep breath.
Place one syringe in the middle section, or on top of your daughter’s med pouch if tomorrow is a school day, and the other in the front section.
How to Prepare Clonazepam
Ingredients:
Three packets of 0.5 mg Clonazepam
Four packets of 0.125 mg Clonazepam
Three 3 ml syringes
Three dark purple caps
Cup of tap water
Paper towel
Thoughts
Daughter
Wife
Hospitalist
Refocus on being mindful again because this one actually requires some concentration.
Due to a newly increased dosage and the annoying way the pharmacy had to package this med in order to get approval from your daughter’s health insurance, you now have to do a bit of math. Don’t worry, though, this will become routine in short order too.
As you remove the pills from the packets, place them into three piles as such:
1 x 0.5 mg + 1 x 0.125 mg (for morning meds)
1 x 0.5 mg + 1 x 0.125 mg (for afternoon meds)
1 x 0.5 mg + 2 x 0.125 mg (for nighttime meds)
Pull the plunger out of one of the 3 ml syringes. Place the nighttime meds into the empty syringe. Insert the plunger into the syringe and push until it touches the pills. Pull up roughly 2 ml of tap water and remove air from the syringe. The pills will quickly dissolve in the water.
Screw on the dark purple cap, wipe off syringe with paper towel, and place it tip-down in the back of the labeled section.
Remember the story your wife, Allison, told you about when your daughter was getting discharged from the hospital earlier this year—how the hospitalist attempted to go over her medication list and said it was confusing and to, “just keep doing whatever it is you’re doing at home.” Notice the smile forming as you think about it but also feel some grief underneath the levity when you reflect on how you had to ride in an ambulance with your daughter on New Year’s Eve to transfer her to the hospital in San Francisco. Feel grateful that she’s healthy again after battling pneumonia she developed from RSV, which required frequent suctioning to remove secretions from her nose and throat, which required near constant care from you and Allison throughout most of January.
Think about how perfectly gross the word secretions sounds.
Notice that you’re doing the thoughts thing again. But also notice that you’re feeling into your emotions and body, which is something you’ve been getting more adept at doing ever since you’ve been practicing transformational-type work over the past couple of years.
Repeat the process for the afternoon meds (place in middle section or on top of your daughter’s med pouch), as well as for the morning meds (place in front section).
How to Prepare Omeprazole
Ingredients:
One pre-cut half tablet of Omeprazole
One 12 ml syringe
One clear-ish cap
Cup of tap water
Pill crusher
Paper towel
Noticing
Continue thinking about the transformational-type work you’ve been doing and how you’re simply noticing more now, rather than judging and creating stories in your head about what you’re noticing.
Pull the plunger out of the 12 ml syringe and set it aside. Screw the clear-ish cap onto the empty syringe.
Unscrew the pill crusher and place the half tablet into the bottom portion. Screw the top portion down until the pill’s outer membrane breaks. Notice how oddly satisfying it feels and sounds.
Consider how seemingly simple, yet profound, it is to shift from judging/stories to just noticing.
Unscrew the pill crusher and set the top half aside.
Realize that noticing without judgment is the path to being nicer to yourself.
Pour 5-6 ml of tap water into the empty syringe. Add the crushed pull to the water in the syringe by slowly tapping it in until no crushed pill residue remains.
Briefly wince as you register how this means you’re on the path to more self-love and that sounds a bit too corny for you.
Insert the plunger into the open end of the syringe until there is slight pressure. Flip the syringe so the tip faces upwards and the water and crushed pill solution falls to the bottom. Remove the clear-ish cap and push the plunger to remove all the air from the syringe.
Pause and recognize that the term corny is a judgment.
Screw on the clear-ish cap, wipe off the syringe with the paper towel, and place it sideways in the very front section of the organizer.
Think about how this is all in your head and so what if it sounds corny to you. Nobody else needs to know. And you know what? Self-love actually sounds pretty damn nice compared to how awful and berating the voice in your head has been for most of your life.
How to Prepare Claritin
Ingredients:
Bottle of liquid Claritin
Small measuring cup
One 12 ml syringe
One light purple cap
Paper towel
Self-judgment
Brain
Mindfulness
Self-love?
Recall that you just finished tapering your daughter off of Gabapentin, which is great because it means one less med. But also remember that you had to recently add Claritin when you figured out that she has seasonal allergies, so it doesn’t really feel like you’ve reduced her meds at all. And, not to mention, you’re also meeting with someone from the Cerebral Palsy Foundation next week about a potential clinical drug trial to help treat her dystonia.
Pour out 12-15 ml of the Claritin solution into the measuring cup. Pull up 10 ml into the 12 ml syringe.
Feel frustrated and sad about how many meds your daughter needs on a daily basis. Worry about her future and wonder if she’ll ever truly be comfortable in a body that doesn’t cooperate easily.
Add air to the syringe and turn it so the tip is upwards. Flick away any bubbles and push the plunger to remove all of the air.
Realize you’re thinking and not being present again and it’s causing anxiety. Clench your jaw and get frustrated about how you keep getting distracted. Call yourself an idiot out loud.
Briefly consider that maybe none of the transformational-type work you’ve done has really stuck and you’re always going to be an asshole to yourself.
Stop.
Close your eyes.
Notice your feet on the ground. Notice the weight of gravity pushing you into the floor. Notice the floor holding you up.
Notice how tight your jaw is. Soften it.
Notice how shallow your breath is. Breathe in deep through your nose and hold it at the top.
Remember that the point of mindfulness isn’t to have zero thoughts. Because if you didn’t have thoughts, you would be dead.
Exhale with a sigh out of your mouth as you remind yourself that mindfulness is about observing and being aware of what’s going on in and around you at any given moment. And, perhaps most importantly, it’s the practice of bringing yourself back to the present moment when your brain does what it’s designed to do—think.
Screw on the light purple cap, wipe the syringe with the paper towel, and place it sideways on the counter in front of the organizer.
Allow yourself to feel grateful for the self-love you’re cultivating.
Snicker at how corny that word sounds still.
Read the rest of the Ordinary Things Series 👇
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Lyle, this is so good. What’s thoughtful and creative perspective! It’s inspiring but also relatable. Even if we aren’t challenged by the same hand that life dealt you and Allison, we might also experience repetitive, mundane, or even demoralizing tasks that beg the same mindfulness, if only just to appreciate the present moment rather than let life slip by.
Whew. 😥 Amazing share my friend. An ordinary—and yet extraordinary—morning for the McKeany family. Thank you for taking us through that process with grace and love.