DAILY FEEDING and MEDICATION SCHEDULE

6:30AM   Disconnect tube feed, give 4cc of tagamet, and 10 cc of vitamins. Then flush with 120cc of water, two teaspoons of miralax should be mixed in water flush. Give Paul his seizure meds (500mg of depakote and 1mg of klonopin) by mouth with some applesauce or yogurt or something. Then a cromolyn (one vial) and a  flovent (two puffs) breathing treatment.

10AM  Give a four-ounce bolus feed of  juice and a water flush of 15cc (before and after feeding). Paul needs to sit up for a while.

 2PM  Give Paul a four-ounce bolus feed of nutren formula/liquified food and 15cc water flush( before and after feeding).  (1 mg of klonopin) by mouth with food. Paul needs to sit up for a while.

4 PM   A cromolyn (one vial) breathing treatment

 6PM   A four- ounces bolus feed of nutren formula/liquified food. He also has 4cc of tagamet, and a 15cc flush, the flush should have two teaspoons of miralax mix in it. Paul needs to sit up for a while. 

8 PM   Paul has his seizure meds (500mg of depakote and 1 mg of klonopin) by mouth with some food before he falls a sleep and a cromolyn (one vial) and flovent (two puffs) breathing treatments. 

10PM   He has the last does of 4cc of tagamet,  the night feed is one eight once can of nutren and one eight ounce can of spring water, set at 60 cc per hour. What is left of the miralax bottle mix in water, is put in the bag also.

Please feed Paul even if he is sleeping, Thanks :)

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PAUL'S DAILY ROUTINE

Paul's day usually begins around 6:30 a.m. We get up and get ready for school. He gets a diaper change, dressed and has a four-ounce bolus of water along with his Tagamet, liquid calcium  and vitamins. Paul has a flovent treatment. Then he has his seizure meds with some kind of a small snack. ( Ex apple sauce) Then we wait for the bus which usually comes about 7:20 a.m.. You can call the bus garage if there are problems or you think you missed the bus, 477-9288, he rides route 46 with Pat and Cheryl.

7am  If Paul is home from school, he wakes about 7 a.m.. He needs to wake slow.  He may have some seizure activity. Once he wakes follow what was just stated above about school day mornings.

10am  He is ready for breakfast, a 4oz bolus of juice. He is to eat all snacks and have his feeds in his chair so that he properly positioned. Paul does not chew or swallow properly so you need to take your time when feeding him by mouth.  Then he is to sit up for a while after feeds to prevent reflux. He can watch cartoons with his glasses on. After sitting up for a while, position him on the toilet to encourage a bowel movement. I usually sit for about ten minutes, he may not go to the bathroom but does know what to do if he has to go.                                                                         

11 a.m. to Noontime   He is ready for a bath in his bath chair.

(in an up right position ) Turn on the water before Paul goes into the tub. Use warm water, wash his hair and brush his teeth. After his bath he likes to be rubber down with lotion, which is a good time to do ROM exercise. His g-tube site should also be cleaned, cream applied (the gauze needs to be changed if there is one). After may be a good time of the day to go for a walk. If you don't go for a walk, you need to stimulate Paul. (Ex. video with glasses on, stander, musical books, color . . . ) He is in the standing unit up to 40 min. at a time.  

2 P.M.   Tv, radio or any other distractions are turned off. He should have a four-ounce bolus of nutren formula then a 15 cc water flush. (Water flush before and after his tube feed) Paul needs his afternoon meds  at this time. DO NOT crush any of his meds. , put them in his food for him to swallow! He may eat a pudding or something with his meds. Allow him to remain sitting up right for a while. Then a breathing treatment.

2:30 til  Nap Time   It is playtime! Be creative in occupying Paul. Put on a video, but him in the stander, ROM exercise, but his head phones on . . . Read a musical book, color . . .  play on the big ball . . .  

            3 to 5 P.M.   Seems to be his consistent nap time. He may nap part or an hour and a half. Paul lies on his side with a pillow between his legs, head elevated and an animal between his hands. Side rail up. If it is a school day, no napping after 6 P.M.!

           6 PM   is dinner time. He once again needs to be in his chair.

He should have a four-ounce bolus of nutren formula and tube meds.  He needs to have his seizure meds  and singular (7PM) as it is getting close to bed time. Once again DO NOT crush them, add them to his food to swallow. Then a flovent treatment.  

7PM to 9:30 PM   It is bath time (if he didn’t have one in the morning) and time to get ready for bed! He probably has school the next morning so encourage bed time by 9:30 P.M..  He needs his night feed started at 10 pm w/ tagemet and zyrtec! Make sure you are flushing his tube before you start the night feed, with 15cc of water. Also make sure his diaper is completely dry and a chuck mat is under him. (He may pee through his diaper before morning time.) Paul lies on his side with a pillow between his knees, head elevated and an animal between his hands. Side rail up,  turn the baby monitor on, and check him periodically as he sleeps! :)