Wednesday, September 17, 2008

A Hard Pill to Swallow (8.16.07)

Literally. I have to take these enormous antibiotics for my ear/sinus infections and it has been a great source of consternation for me. I can relax in the fact that I'm not only. Apparently 40% of all American adults share in my anguish. Too bad that doesn't relax me enough to get the pill down faster!

According to a 2004 poll by Harris Interactive, "To facilitate swallowing, more than half (55%) of those who have had difficulty swallowing pills drink lots of liquids, 48% drink water in big gulps, 43% tilt their heads back, and 31% place the pill on the back of their tongue. Some of the other coping strategies are trying more than once to swallow the pill (30%), splitting the pill in two (17%), and taking a deep breath before taking the pill to minimize the gag reflex (13%).

About twice as many women (51%) as men (27%) experienced pill-swallowing problems, and interestingly, more people between ages 18 and 64 reported having these problems (44%) than those age 65 and older (26%).

Most people that had problems taking pills described the sensations as having a pill stuck in their throat (80%), having a bad after taste in their mouth (48%), or gagging (32%)."

It's not about phagophobia, the general fear of swallowing... no, it has more to do with a sensitive gag relfex and the tightening of the throat muscles.

I'm not sure when my problem developed, but I think it may have stemmed from choking on London broil when I was 10 and having to have the Heimlich maneuver performed on me. It was not a pleasant experience and all I could think about at the time was that I hadn't finished reading "Prince Caspian and The Voyage of the Dawn Treader" while I was gasping for air. Since that time, pills bigger than a small tablet of aspirin have been an issue for me.

For the most part, I handle it by chewing pills or cutting them into pieces. It usually doesn't bother me if there is an icky taste, although prenatal vitamins tested the limits of my ability to withstand the assault on my tastebuds. Often after trying to chew a prenatal vitamin, I'd wind up worshipping at the porcelain much for those extra nutrients.

My super-wonderful doctor in Florida used to give me such a hard time about this, saying "For Pete's sake, don't you swallow beans?" How silly, of course I do... I chew them. I bet he didn't realize 40% of his patients probably had issues, they just weren't brave enough to admit it. Me? I always asked for liquids, for itty bitty pills, or things that I could break, crush or chew.

For the past week, I've been taking Erythromycin 333 mg, 3X a day. It is a large, hard tablet. A big warning label on the side of the bottle reads: DO NOT CRUSH OR CHEW. SWALLOW WHOLE. This sucks, it just plain sucks. So for a week, I wrestled with the dang things and ended up waterlogged. Every night it would seriously take me 32 oz of water and 20 - 30 minutes to get one stinking pill down. That meant, of course, that I was waking up at least twice in the middle of the night to pee. Not fun. Amazingly, first thing in the morning was only a 3 - 5 minute, 8 - 10 oz problem. I called the pharmacy after a week of torment to see if I could cut the dang things in half (I actually did it a few times before asking). The response? NO, absolutely not! They are time-released, chopping them up is a big no-no. (Oh well, I'd done it and hadn't died in the process).

I felt defeated by the pharmacist's words. I'd hoped that I could cut them and then I would have done so in fourths. She worried me enough about it that I haven't cut them since she said it was taboo. So I thought...why is it that my morning dosage only takes 3 - 5 minutes? It dawned on me that I was so thirsty that I wasn't tensing up as much because my body wanted liquid, quickly please. Therefore, I let myself get feeling almost dehydrated for my afternoon dosage and BINGO! Down went the pill. It wasn't as easy at the bedtime dose, but it didn't take 20 minutes either.

I've read that drinking your water from a soda bottle will help. It has to do with the sucking action of pursed lips triggering the swallowing reflex and I guess that trumps the gag reflex. Supposedly bubbly things make that trick work even better. Putting things in applesauce or peanut butter never helped me...that only meant "more" that I was having to get down with the pill.

I was listening to Brad Paisley's new single, "Online" and part of the chorus goes, "I'm so much cooler online." I have to laugh - not me! I repeatedly expose my nerdiness and/or wimpiness on a regular basis.

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