Dealing with Latent TB in a ToddlerNormally I don’t talk parenting but when we found out Mr T was TB positive I went searching and found nothing from a parent’s perspective about this.  So if one Mom or Dad stumbles upon this post then they will know they are not alone and it may prepare them for a bit of this chaos.

A Little Background

We adopted Mr T from South Korea.  We just brought him home in March 2014 at the age of 2.5 years. (there are issues here that I may have to go into in a future post – let’s just say adoption is not all rainbows and unicorns)

Adopting from Korea - Coming Home

One month after his arrival we got his physical and to our surprise his TB test came back positive.  South Korea is known for great medical care so we did not see this coming.  After chest x-rays and blood work we learned three things:

    1. Mr T was diagnosed with Latent TB.  This means he is infected with the tuberculosis but it is not active or contagious. But he needs to be treated so he does not develop the TB disease.
    2. X-Rays and blood tests are useless on a toddler.  We found out after the fact these two tests really cannot tell you anything about TB in a toddler.  It seems toddlers do not present as adults.
    3. Our lives were about to be turned upside down for 9 months. We got the news that this 2.5 yo that speaks no English was about to have to take medicine daily for 9 months.

Let the fun begin….

The Medicine (or the daily torture)

For latent TB both adults and children are prescribed isoniazid.  In adults it is in a pill form but for children they get it in liquid form.   Mr T gets 15 ml of this per day in one sitting.

Dealing with Latent TB in a Toddler - the medicineThink about that for a moment.  A typical dose of adult cough medicine is 5 ml.  We have just upped this 3 fold.  It is like a shot glass of medicine.

Let’s talk about the rules:

    1. Cannot eat 2 hours prior to our 1 hour after taking the medicine. This effects the absorption into the system but slightly reminds me of the rules for Gremlins.
    2. Cannot be mixed with anything having sugar in it. So no mixing it with honey to make it go down easier.  This just adds to the fun.

We have an added bonus that Mr T is stubborn and doesn’t drink much in the first place.  So let’s just say everyday we have about an hour in our house that is full of screaming, kicking, and throwing of cups.

It is hard explaining this to a regular 2 yo. Try one that does not speak the same language and is still grieving leaving his foster parents.

Tips for Getting the Medicine to go Down

Dealing with Latent TB in a Toddler

Our normal experience at medicine time. He hates to drink it.

Here are things that work for us (sometimes).  Every kid is different but maybe this will give you a starting place.  And hopefully your child will just go with it.

    1. Set the right time for you and the child each day.  The medicine is supposed to be given at the same time each day so think about when that should be.  For us it was right after afternoon nap.  We knew he had not eaten for two hours and we easily had an hour before dinner.
    2. Mix with diet drinks.  Yes, as parents we have been told to not give our children diet soda because of the artificial sweetener.  Unfortunately the 15 ml you are giving your child is full of sugar alcohols (lower cal sweetener) so you have already broken that rule.  Time to get over this one.  You only need to mix it with a small about as the medicine has no flavor so it will pick up the flavor of whatever you use.
    3. Keep them guessing.  Mix up what drinks you have for them.  Try to make it a treat rather than medicine.  We have even upped our game with no calorie syrups (the new Crystal Light liquids are perfect!).  That way we can add the medicine to a lemon lime drink and then add different favors so it is never the same twice in a row.

Crystal Light Liquid Flavors

Word of warning.  This medicine is STICKY.  If they spit it out be prepared for a shower.  And with 15 ml there will be days they win and a good portion of it runs down their face in defiance.  And just wait until you get it in your hair.  Lots of shampoo will be needed. 

The Crappy (no pun intended) Side Effect

Disclaimer: graphic content ahead.

There are of course the normal side effects of any medicine – upset stomach (short lived), liver damage (rare), etc..  But the one that will make your life miserable for 9 months is the diarrhea.

There is nothing but diarrhea – no solid poo for 9 months.  It is explosive and cannot be controlled by the child.  It’s daily. It’s liquid.  It’s stinky. It can clear a room in seconds flat.

Be ready to have these smells and sounds coming from your child in public.  It will make for fun times in a public restroom trying to figure out how to blame the contamination on someone else’s kid.  Bio-hazard is an understatement!

Dealing with Latent TB in a Toddler

Unfortunately this severe diarrhea means you may have to re-think activities.

    • Delay Potty Training. If your child was potty trained they may go backwards and if they aren’t potty trained you may not be able to do it while on the medicine.  They do well with pee but they never see the diarrhea coming.
    • No swimming.  We can’t take Mr T to the pool or enroll him in swim classes with his brother.  Since it can’t be controlled he can’t go in.  And there is no swim diaper on earth that will contain this.
    • Delay Schooling/Day Care/Child Activities.  We are struggling with this one now.  Mr T is supposed to start a Mother’s Day Out program this fall and we are still not sure if we should send him.  How do we make a teacher or other care taker deal with this?

We have to think about the diarrhea situation any time we let someone else look after Mr T.  We will arrange things around the last bout of diarrhea.  If he had it that morning we can drop him off at Grandma’s for the afternoon.  If he hasn’t gone in a day we stay close to home because we know it is going to be bad.

A very important word about diapers.  We have tried many and…

    • Luv’s with Ultra Leakguards will save you!! We have never had a leak and since it is all liquid this is saying something.  There are times we know we have to take them off in the shower because the volume is too much to stay in one place (nice visual isn’t it?) but there has never been a speck to get on his clothes.

Luvs Leak Gaurd Diapers

    • STAY AWAY FROM PULL UPS.  This is the worst option of all of them. Pull ups are meant to help with potty training.  With diarrhea they will leak instantly.  This is another reason potty training is harder.

As I write this we are about half way through our 9 months.  The good news is that there our hurdles are just two fold: 1) getting the medicine in him and 2) dealing with the diarrhea.  Unfortunately both of these are something we battle each day and have had serious impact upon us all.

The worst part is where it holds Mr T back.  We have had to put some what I would call normal activities (potty training, swimming, etc.) on hold for 9 months.  That’s a long time and he does feel like he is being picked upon. I just keep reminding myself this is not permanent.

I hope for those that stumble upon this it makes you feel less alone.  I by no means have any answers other than to say I have been there.

So please feel free to comment or contact me privately.  Happy to talk.