As Tijani’s illness progressed, her stomach got bigger. The additional weight in her abdomen caused her pain and she started getting cramps/pain in her stomach. She needed to take more medicine. As it was, she could barely eat because she hardly had space in her stomach, and she already had a few types of medicine to take. Initially, she took another pill that had to be taken 3 times a day. Eventually, it came to a time when she had to sacrifice eating food because taking the pill with water took up any available space left in her stomach. Also, the cramps/pain started happening more frequently. The nurse and doctor from Hospis Malaysia prescribed for the medicine to be administered with a syringe driver.

As simply and clearly explained by Medicines Learning Portal, a syringe driver is a small portable battery-operated pump that administers drugs subcutaneously by continuous infusion. It is not something that is used by every patient in palliative care, but it can be very useful when other routes become inappropriate or difficult. They are generally programmed to deliver their contents over 24 hours to maintain symptom control. 

At this point, this was the perfect solution for Tijani. She did not need to take the medicine orally, and the pain came at random times, each time with different intensity. I learned how to change the syringe as it needed to be replaced every 24 hours. For me, it was one more item I had to ensure was done for Tijani’s comfort as her primary caregiver. For her, it meant that now she has a tube sticking out of her body. As it is, she already has one tube attached to her abdomen to drain out the ascites fluids.

Looking back in retrospect, this would’ve been another thing she had to deal with. I will never know for sure what she thought about it. Sweet and strong till the end, she never really complained. She just endured.