Problems with Bowel Program Days

I met my Fiance 10 years post injury and so am coming into this late in the game. We've been together 2.5 years, so I'm all over the nitty gritty of SCI-Life. He's a C5 (mostly complete) Quad and can't do his own bowel care. One of our biggest problems involves the aide that does his bowel care. He's on a 3x/week program and she's been doing his bowel care for 5 years. She works with an agency and is the only one in his small town that will do his bowel care. So we are kind of stuck with her. Unfortunately it seems he's been letting her run all over him and she's been getting lazy.

His program is a mess and I'm looking for suggestions. Currently, she's arriving at 5am, clearing out the lower tract and inserting suppositories in the bed. She's sitting around for over an hour before she comes back to do any stimulation. Stimulation goes on for about 45 minutes before he's in his shower/commode chair (7:20am approx). He then sits in the commode chair for another 45mins while she stimulates and tries to get him to "finish". She then does the shower and dressing and helps get him up. This whole routine is taking 4 hours and she's complaining that she doesn't have enough time to get him dressed, run the laundry and throw something quick together for breakfast and wants ANOTHER HOUR to do it, starting at 4am.

She did this today and we had the nastiest accident we've had in the past couple years. Yes, accidents happen but is the 3 hours of suppositories and stimulation contributing to them?

I've done his program on trips, with a bed bath and a rickety commode chair without an accessible bathroom in less than 4 hours and not had any accidents yet.

What should we expect? I don't know what the best practices are for doing bowel care. He's been letting her run the show here for so long, I think laziness has taken hold and he's just used to it going this way. However, it just doesn't seem like everyone else is doing it this way.

Thanks for your help,
Tracy

Oh, and I'm still a little weird about urine soaked laundry or stool in laundry. (We're having SP catheter issues too, as it's leaking from around the site quite a bit and we are having trouble getting in to the doctor in a timely fashion.) I feel like it's never clean.

What do you guys usually do? Is once through the laundry good enough for urine? Clean the stool as best as possible and then run it through the washer too?

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Originally Posted by SoCalGal77

Oh, and I'm still a little weird about urine soaked laundry or stool in laundry. (We're having SP catheter issues too, as it's leaking from around the site quite a bit and we are having trouble getting in to the doctor in a timely fashion.) I feel like it's never clean.

What do you guys usually do? Is once through the laundry good enough for urine? Clean the stool as best as possible and then run it through the washer too?

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Hi SoCal,

Of course I never have bowel accidents but I have a friend who knows a guy who's the cousin of a fellow who....

Anyway, stool is a 3 washer load process. You need to get the "heavy stuff" off the sheets, towels and clothes etc. in the toilet and shower first. You don't want to make soup or stew in the washing machine. Maybe just a light broth! Hahaha. Use plenty of gloves and hopefully nothing will "sneak" down into them. My friend says he hates when that happens. :) Then with just detergent, run them through a full washer cycle once. On the second run, add detergent as you normally would but when it's halfway through the heavy wash cycle, add a cup of bleach. When this is halfway done, let it soak for about 15 minutes and then let it finish through to the spin cycle. Then do it a 3rd time but replace the bleach with OxyClean and let it wash through to the end. This usually gets things clean and hopefully disinfected as well. Dry things really well in the dryer as this should kill off any bacteria that the washer didn't get to.

Either that or just throw the soiled stuff out and hope the sanitation worker doesn't smell it through the plastic garbage bag!

Bob.

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Originally Posted by bob clark

Of course I never have bowel accidents but I have a friend who knows a guy who's the cousin of a fellow who....

My friend says he hates when that happens. :)
Bob.

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Ha ha Bob, you really made me laugh with that since I also know a friend whose cousin is a reative of an uncle ... :D :applaud:

Outside and sprayed with the garden hose or in the toilet to sink if its manageable. Never straight into the wash. Extra rinse, extra wash.

Fortunately my friends cousins sisters boyfriend hasn't ever had a huge problem with bowel issues on the sheets. They do use a lot of chux just in case something should ever happen. With regard to the urine, regular laundry soap, borax, and wash on hot. White sheets and towels are the preference, so if bleach is necessary you don't end up with tie-dyed linens. The borax leaves the laundry smelling fresh and clean rather than bleach trying to cover the urine smell. Plus the bleach was eating holes in all my sheets.

Imo waiting that long for the suppository is an accident waiting to happen. Same thing happened to "that guy" before. I use the magic bullet and wait about 15min before I sit up, so I give it time to dissolve.

I sympathize with your situation regarding only having one choice as to who can do the bp. I don't know what she's doing in the 1.5hrs she MIA waiting for him to produce. Maybe write a list of what he would like to have done at what time. Let the aide know you're (he's) hoping you won't have to add another hour, and are hoping some new ideas could help speed things up. It's ok for him to be assertive, it's his body. Hopefully any information you share with her will be well received.

There are tons of threads here on different bp's, I'm sure you'll find some great suggestions. Best wishes

We talked to his case manager and she finally had a chat with her. She's been spending the 1.5 hours out in her car, smoking and drinking coffee cuz he's usually sleeping. :mad:

Today we did suppositories in at 5, stimulated at 5:30, 6:00 and got him up at 6:30. He did most of the work in bed and was up, complete and out of the shower by 7:30. :) At least an hour improvement on the other days. Guess we'll see how that works and whether we can get moved up even earlier. Or, get some more sleep.

As far as laundry, we can't use bleach on his clothes. Bowel accidents in jeans is the worst! I'm just washing them as well as I can, sometimes twice.

Thanks guys

Are you still having any problems with his bowel routine?

If so, you should rubbing his lower back going down just on either of the spine. Rubbing down will help stimulate the intestines and push "it" down towards the colon. My fiance does this to me when I can't go and it works like magic.

I can't add too much to this thread, but one of my nurses was literally taking FIVE HOURS to do my routine. Fortunately, she's super nice and didn't mind coming to watch one of my other nurses, and now her time is a SPEEDY 3.5 hours. :D

- Bill :-)

What kind of suppositories are you using? MGs tend to get things moving in 15 minutes and done by one hour. Maybe time to sleep until 6. :)

As for clothes? After rinsing what you can down the toilet try Oxyclean or google adding hydrogen peroxide to your detergent and go through two heavy cycles.

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Originally Posted by SoCalGal77

We talked to his case manager and she finally had a chat with her. She's been spending the 1.5 hours out in her car, smoking and drinking coffee cuz he's usually sleeping. :mad:

Today we did suppositories in at 5, stimulated at 5:30, 6:00 and got him up at 6:30. He did most of the work in bed and was up, complete and out of the shower by 7:30. :) At least an hour improvement on the other days. Guess we'll see how that works and whether we can get moved up even earlier. Or, get some more sleep.

As far as laundry, we can't use bleach on his clothes. Bowel accidents in jeans is the worst! I'm just washing them as well as I can, sometimes twice.

Thanks guys

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