4yo fever, ruptured ear drum, refusing medication,food,water

[mrskingred]

My 4yo DS complained of his ear hurting on Friday morning whilst at school so the called me to pick him up. At home he said he was OK, was active and ate well at dinner. Friday night he developed a fever 39.9C, which keeps coming and going. He refuses both ibuprofen and paracetamol, and when we tried spits them out. He refuses food and will only sip a little water and milk. He still nurses a little at night. His left eardrum burst yesterday (Sunday) and is oozing pus. He will not let us clean the outer ear or neck where it is running out. This morning we saw the doctor and I physically had to restrain him so she could do the exam and clean his outer ear. She has prescribed an antibiotic 2X for 7 days and wrote a script for paracetamol suppositories, although she stated that she prefers Dalsy (ibuprofen) as its an anti-inflammatory.
Questions: 1) how do we get him to take the antibiotic without physically forcing him, and I'm not sure that would even work.
2) Antibiotic is supposed to be taken with food.
3) The fever itself doesn't worry me too much as long as it doesn't get any higher, but I am concerned about the pain he is in and the lack of eating/ drinking. He is weak and dehydrated and very quiet and still - not my usually boisterous and spirited little boy.
4) Reasoning with him is not working.

Any ideas please.

[lynsage]

Have you given him the paracetamol yet? He might be more willing to take food or drink if you can take the edge off the pain.

Does he have any soft foods that he really loves such as ice cream, yogurt, oatmeal with sweetener? You could try to slip a pill in there if he would take one mouthful.

Are you willing to consider hospitalizing him and putting him on IV fluids/meds if he gets worse/lethargic?

[babygrant]

Poor little guy.

I was also thinking like the above poster. I remember having ear infections and the horrible pain that would come just from chewing and swallowing. I personally would give him a supposatory and give it a bit to kick in and then try giving the antibiotic again. If push came to shove, I would also ask for hospital admission so IV antibiotics could be given.

[luv-my-boys]

poor little guy its tough at that age becasue they dont know that the meds will make them feel better they just know they hurt.

With my sons I found that offering things like popsicles,pedialyte really helped to keep him hydrated. At worse I did end up taking them to the hospital for IV hydration but this was for days of not being able to hold food down.

Although his drum ruptured, which surely provided some relief from the pressure, it still hurts. I would really try to get the supp. in him asap. chewing/swallowing will hurt due to the rupture to the meds will take the edge off of that. If he is able to take the meds just not the antibiotic have you considered asking for an antibiotic shot? yep it hurts but the meds will get in him quicker and you dont have to go thru the agony of getting him to drink it and keep it down

[elmh23]

Have you tried bribing him?

[mrskingred]

Well, I gave him the choice of ibuprofen by mouth or the paracetamol suppository and after saying he didn't want either, he finally decided on the suppository. We've offered him every food he's ever shown an interest in - he managed to eat about a tblsp of sunflower seeds and 2 choc chips from one of his favourite cookies - bought specially from the pasteleria for him.
DH and I finally managed to get the antibiotic in him - his whole cheek had been getting redder and more swollen all afternoon and his ear is bright red with oozing pus. We held him down - it was upsetting for all of us, especially as he kept spitting it out and vomited twice. (We only have to do this twice a day for a week) The pharmacist told me that I would be able to get sufficient antibiotic to complete all the doses.
An hour later and he's better than he was and is now talking to us but is still adamant about not taking any more medicine.
We really want to avoid the hospital route as we only have a little spanish- its hard enough at the Drs. I wasn't aware of the antibiotic being available as a shot -that is if they do that here- I'll keep it in mind.

[elmh23]

Next time he's due for a med, remind him how much better he felt after the last time he took it. Sympathize with him, "Yes, I know it's not fun but it will make you feel so much better so lets just get it over with. Do you want some juice to chase it with?" Worked well with my kids (and I may have bribed my son with soda on more than one instance to take a yucky tasting medicine )

ETA: watch the vomiting. if it's just from the force, then that's okay, but that was the first sign of my daughters allergic reaction to medicines. With her, she puked every time we gave it to her for 2 days and then broke out in full body hives (so much fun when it's coupled with a double ear infection and a tooth coming in!)

[mrskingred]

We've been forcing the antibiotic into him - we have bribed , offered treats, tried reasoning, everything. We started the second bottle after going back for another prescription as we ran out in 2 days due to his spitting it out. He has been refusing the ibuprofen and so we've let that go, as his fever wasn't as high and is now absent (24+hours).
Yesterday he started complaining about his neck hurting and he wasn't moving it, so went back to the pediatrician this morning. We're just back from the hospital (she referred us), and he now apparently has inflammation/infection (not entirely sure which it is, as my brain got overloaded with spanish at that point) of the adenoids. They asked why we were just bringing him in for treatment now - hang on, we've been back to our own ped twice and she just referred us. They were surprised at the antibiotic he was on and have prescribed a new one to be taken every 8 hours round the clock (I did clarify this) for 10 days and he MUST also take the 5.5ml of ibuprofen every 6-8 hours for 3-4 days for the inflammation. We are to go back to his own doctor in a few days.
Not looking forward to trying to get his all down him. Also is it too much ibuprofen - it seems a lot to me especially for 3-4 days. His ear is still leaking pus - they did take a swab at the hospital to test - how much longer will it ooze or will it stop if/when the antibiotics start working?
Thanks for letting me talk - I'm one very tired ama.

[mbravebird]

Hugs, mama -- I know it's hard.

Have you tried a syringe with the medicine followed *immediately* with a syringe of water? Sometimes that makes them swallow it down rather than throwing it up. It also allows you to place them both in the back of the mouth, where they really have to swallow it.

Also, sometimes it's worth getting a prescription of pills rather than syrup. It can sometimes be easier to hide the taste in yogurt or honey that way. The syrup is often a very gagging type of taste, whereas yogurt or honey is more normal-tasting.

If you have a pill and the yogurt/honey combo isn't working, you can try putting a very, very small drop of honey into the crushed pill, then working the powder into the drop very slowly and persistently. If you use a small enough drop of honey, it makes a sticky little ball, and the child will sometimes find it pleasant to eat or swallow.

If he's really not getting enough meds in him and the forcing is very traumatizing, it might be a better solution to just get admitted to the hospital and get an IV. I know it sounds extreme, but keep it in your head as an option, so you don't feel trapped in a traumatic situation.

[mrskingred]

Thanks for all your advice.
It's as though a switch has gone off in his head, or whether it was the result of seeing 3 doctors yesterday - 2 of them in the hospital but he is now grudgingly taking the medicine. We have been offering sips of water or milk to help take the taste away and wash it down as both antibiotics are suspensions that are barely liquid. He doesn't like honey or yoghurt ( at least all the brands we've tried in Spain), so I'm glad we don't have to try that.
I'm annoyed that I discovered at the pharmacist yesterday that the prescription for the antibiotic is only sufficient for 2 days - we have to go back to the drs and get another prescription so we can complete the course. I've been to the drs. office every day this week so far!

Thank goodness this is only the 2nd ear infection he's ever had - I don't know how we'd cope if he had them all the time.