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Wednesday, December 30, 2009

Be prepared!


To prepare for your trip, I would advise that you should see your regular doctor a month before you think the ever elusive TA will arrive. This will give your doctor time to change meds, get immunizations and prepare.
Immunizations: the Centers for Disease Control (your Federal tax dollars at work) has a great site where your doctor can look up what immunizations you need per country and whether there are additional ones needed, if you are traveling to a rural location. Although the routine immunizations (tetanus, influenza, etc.) are at your doctors office some rare ones may not be, so it is best to see your doctor early. The site is also full of travel tips that are worth the read.

If you have any health problems see your doctor early: as an example, my wife has asthma and spent ten weeks of last fall with bronchitis and pneumonia. She was worried about the smog of Beijing since she already had breathing problems. Her allergist upped her inhalers and put her on Spiriva which completely took care of her asthma despite the Beijing smog (visibility 4 blocks). Her medicine, like many needed, took several weeks to become fully effective making it well worth her while having that appointment early. 
MEDS to take: 
Imodium: for mild diarrhea without fevers. 1 tablet after each stool up to 8 a day 1 box.
Cipro 250mg  for diarrhea: to take twice a day for 7 days if you get diarrhea and adding Imodium to this will help slightly. The CDC give guidance on this but the Cipro should be started if there is any heavy diarrhea or fevers. Pack enough for 1 round of all the travelers ideally, but it is not indicated for children under the age of 16.On our last adoption trip, we had a five hour “trip from Hell” between Guangzhou to Hong Kong on a bus (another story in itself and truly defined "Chinese Fire Drill") with a young adoptive parent who would have almost given the baby away for cipro given all the belly pain and diarrhea he was having. Ironically, of all things he was Chinese American!
Ibuprofen or Tylenol :  for multiple aches and pain. Also, take tylenol an hour before you land in China, since they have those pesky temperature scanners and a lovely quarantine area where they would love to put sick Americans.
Amoxicillin  or Azithromycin for the baby/child who will have a good chance of having an ear or sinus infection. The big guns (Augmentin, Cefzil, etc) are usually not needed because for Chinese children many of their prior ear infections were not treated so they have had little opportunity to develop resistance to the first line agents. Naturally, if your pediatrician or family physician thinks otherwise do what they suggest but I saved the hefty co-pay and did something nice for my wife with it-- like help to pay adoption fees! 
Have your doctor specify for the pharmacist to give you dry powder with instructions to mix just the right amount of sterile water which they can measure and put in a separate bottle- but be sure that bottle is less than 3 oz or it may get thrown out going through security.
Children's Tylenol or Advil: for the flights/ ear infections /aches and pains whatever. liquid or chewable.
Benadryl: Because you never know when you or your child might have an allergic reaction to something, like maybe the unusual food (eel, sea cucumber, silkworm cocoons, duck brains, pig intestines...) 

On giving a child medicine they don't want: If you've tried the mixing it with food (without them seeing you do it of course) or giving small amounts at a time along the gums and have had no success there are several  advanced techniques available. None of these techniques  include coaxing, cajoling or trying to talk your baby into it because it "is good for them" - you are now beyond that. None of this coaxing they will understand anyway since you don't speak Chinese! All techniques involve holding them down firmly and pinning the arms since their natural response will be to reach for the med, their mouth, or hit you! It is not for the faint of heart but nurses that work in ER's aren't faint of heart and this is what they do.

The first is just shove the dropper in and squirt the medicine in your child's mouth while the baby is lying down on their back on a hard surface - the beds in China more than fulfill that requirement in our experience. Holding the nose shut simultaneously sometimes helps as well. Yes they may cough and choke (in which case, sit them up) but the med will go down! Don't do this if your child has a known swallowing problem. The other method is to hold the child down as before with someone else holding his/her head and blow on his/her face just as you give the medicine. A pediactric nurse on our first adoption trip gave us this tip and it worked for us.

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