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Thread: what is the big secret about bowel programs

  1. #51
    Quote Originally Posted by notsohotwheels View Post
    since this is my first post, let me first start by telling a little about myself. i'm a c7 injury 4 years post. i'm told i'm a complete injury, but i have recovered some function down to t1/t2, my hands function almost normal. i have been lurking here for a while. i registered, but haven't posted because i don't feel comfortable discussing personal issues with strangers, and most of my questions have been answered by searching. i'm only posting now because i'm desparate for help.

    the only bowel program i was taught in rehab was to use a supository. i was going every day for about a year after coming home. i lived with my parents during that time and the bathrooms in their house were not accessible, so a home nurse would come by every morning to help with the bowel program. she would put the supository in and i would lay in bed for about 10 minutes and then transfer to a commode chair next to my bed. i was going every day in the mornings, and i would be finished in 20-30 minutes tops. even then that didn't work very well because i still had quite a few accidents.

    i have since moved out into a small apartment alone. i quit having frequent accidents once i sarted doing my bowel program myself, but i have yet to find a bowel program that works consistantly. my apartment has an accessible bathroom with a roll in shower. i now do my bowel program by rolling over the toilet in the shower chair.

    i have tried so many thing, i can't even remember. when i first moved out on my own i stuck with my old program of using a supository every morning. i use a supository inserter and i tried inserting the supository in bed and laying for 10 minutes like before, but when i transfered to the shower chair i did not make it to the toilet in time. after that learning experience, i would roll over the toilet and insert the supository, hold it in place until it completely melted or it would fall out as stool passed by. i learned about the magic bullets from here and started using them. they do work a lot better, but with the supositories i would still have an accident either later that night or the next morning. it wouldn't be a large accident, usually just some mucus and liquid, but it is still a mess to clean up.

    i then started using just digital stimulation, and once i did that i quit having accidents and my bowel program still took me about 30 minutes every day. eventually my bowel program started taking longer and longer. it went from 30 minutes to 45 minutes to eventually about 2 hours. i then tried going to an every other day program, and that seemed to do the trick. it cut my bowel program back to about 30-45 minutes. once again that didn't last and eventually i was back to 2 hours.

    i went to see a gastro doctor, but he was unfamiliar with spinal cord injuries and just wanted to pump me full of laxitives. it was a total nightmare, i was having several accidents per day. i quit seeing this doctor and just went back to just digital stimulation. he did give me one good peice of advice, he said that when i make a change in my routine, to only make one change at a time and try to keep it up for two weeks before making another change.

    i began experimenting on my own and found that the longer i went between bowel programs the faster i would epmty out. i could skip 3, 4 or even 5 days without having accidents, but 5 days was pushing it. eventually i settled into a twice a week program, and switched to doing it at nights after dinner instead of in the morning. i kept that up until recently. my bowel program was still taking me an hour, but 1 hour twice a week was better than 1 or more hours every day or every other day.

    that worked for a while, but then once again my bowel program gradually started taking longer each time. i was creeping back up to two hours. this time i asked my spinal cord doctor for advice. he told me to try taking milk of magnesia. he said to start with 2 tablespoons 1 hour before my bowel program and adjust the time as needed. he made it sound so easy, but it turned into another bowel nightmare.

    the first night i took 2 tablespoons, waited an hour then did my usual bowel program. the milk of magnesia didn't seem to be helping at all. then about an hour into my routine the stuff kicked in. i ended up sitting on the toilet for over 3 hours that night, and then i had two bowel accident the next day.

    the next time, i took two tablespoons and this time i wated two hours. that worked ok, but it still took me an hour and 45 minutes to finish. each time i tried the milk of magnesia i waited a little longer before starting my bowel program. i even tried taking it before bed and going in the morning, but the milk of magnesia didn't seem to be making it go faster, all it seemed to do was turn my stool into liquid.

    at my follow up appointment when i told the doctor that the milk of magnesia didn't decrease the time, it only turned my stool into liquid, and he told me to increase the dosage to 4 tablespoons and try again. that was a big mistake. it didn't decrease my bowel program time, all it did was make me have several accidents later that day or the next day. the doctor said that the milk of magnesia shouldn't cause me to have accidents after doing my bowel program, but it does.

    i gave up experimenting with the milk of magnesia, and dicided to go give the supositories another try. i also switched to a three times per week bowel program. that seemed to be working, it cut my bowel program back to 30 minutes. i would sit on the toilet for a total of 45 minutes just to be sure, but 20 to 30 minutes after inserting the supository i was done. i would still have a small accident of mucus and liquid stuff either later that night or the next morning, but i kept it up for two weeks.

    after two weeks had passed, i had been getting consistant results each time, so i dicided to trust the time and after 30 minutes i got off the toilet. for two weeks, i had been finished after 30 minutes and i sat there for 45 minutes to be sure and nothing happened. but this time when i dicide to trust it and get off, i end up having a bowel accident about an hour later.

    it has now been three weeks since i started using supositories again, and i'm starting to have accidents on the off days again. nothing has changed, the only explanation i can think of is that whtever is in the supositories seems to linger in my sistem and cause me to have accidents later.

    i don't know what to do now. i've run out of ideas and no doctor has given me any advice that has helped. i'm desparate, and i can't live like this.

    the only medications i take are 80mg of baclofen for spasms and 10mg of ditripan xl. i also take one 250mg tablet of generic colace. this hasn't changed in over a year.

    i've had so many accidents recently that i have noticed a few things happen after i have an accident. first when i have an accident, i go to the toilet and use digital stimulation to make sure i empty out so i don't have another one later. when i do this, i get a lot of blood. i don't normally get blood when i do a bowel program using digital stimulation, this only happens after having an accident. second, after an accidet i seem to be dehydrated. i only drink water, but no matter how much water i drink, i hardly have any urine when i cath after an accident. the third thing i've noticed is that the spasticity in my legs completely goes away after a bowel accident. my legs become like limp noodles, and that doesn't happen after a normal bowel program. i have not noticed an increase in spasticity right before the accident either.

    because of the bowel accidents recently, i haven't been out of the apartment. i'm running out of food because i haven't been to the grocery store. lately about all i have eaten is soup because that is all i have left. could eating so much soup have anything to do with the increase in bowel accidents?
    Hello,
    I have the same problem and I too use the magic bullet. So after my bp i sit up for about 1 half to one whole hour, then I do the dig stimulation again for about five more minutes. That usually works for me
    good luck

  2. #52
    I am really not sure what you are asking. It would be helpful to have more information about you and your bowel program in order to help you. Can you tell me how long you have been injured, level of injury and what you do for your bowel program, besides the magic bullet. A rough idea of your diet and fluid intake would also be helpful.
    CKF

  3. #53
    Quote Originally Posted by SCI-Nurse View Post
    I am really not sure what you are asking. It would be helpful to have more information about you and your bowel program in order to help you. Can you tell me how long you have been injured, level of injury and what you do for your bowel program, besides the magic bullet. A rough idea of your diet and fluid intake would also be helpful.
    CKF

    I really never had a question. I was replying to the post above my last one. Thank you though.


    I'm a C5 complete with six and seven crashed. I've been paralyzed for 17 years now.
    My bowel program I take stool softener, drink a lot of water, take fiber con the day before. I use the magic bullet while laying sideways on my bed on the left side of my body. I lay there with the magic bullet for approximately one hour. My help at that time we do the digital simulation for 15 minutes straight. After that I set up for around 30 minutes to one hour on a Chuck. Then I attended does a digital simulation for an additional five minutes to try to get the mucous all out. That usually works but not always....

    Last year my doctor took me off diazepam because of all the dangers associated with the benzodiazepines. I've been having side effects associated with that ever since. Mainly affecting my gastrointestinal area. (Lots of cramping & pain.)

  4. #54
    I am a C-5/6 quadriplegic also struggling with bowel program. Take 3 stool softener's a day, and three seena about 6 PM and a magic bullet suppository 7 AM in the morning, in bed. lately my stomach has been going round and round, then having extreme spasms in my legs, if I didn't tie them down with ankle straps when in my power chair they would be going straight out. What is the difference between the flem/mucus accident or the stool accident? Don't know whether to add lactulose or not?

  5. #55
    Quote Originally Posted by Barb10 View Post
    I am a C-5/6 quadriplegic also struggling with bowel program. Take 3 stool softener's a day, and three seena about 6 PM and a magic bullet suppository 7 AM in the morning, in bed. lately my stomach has been going round and round, then having extreme spasms in my legs, if I didn't tie them down with ankle straps when in my power chair they would be going straight out. What is the difference between the flem/mucus accident or the stool accident? Don't know whether to add lactulose or not?
    In my experience the phlegm/mucus accident is cause by mucous membrane irritation, i.e., bisacodyl remaining in the rectal vault after a bowel program that continues to irritate the mucous membrane and results in "butt snot." The stool accident is usually caused by something you have eaten or stress, resulting in stool moving more quickly through the digestive tract.

  6. #56
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    its not for everyone but I was same way for 4 years heard about colostomy no accident quick change and go back to life u might look into it.. fyt I am a quad c6c7 it has let me go down the Colorado all kinds of things just a thought oh amd I stood eveyday for 15 years but I don?t anymore

  7. #57
    Hi. Sorry to hear about your troubles. My 2 cents - Milk of mag takes 8 -12 hours to work as a laxative. Says it right on the bottle. I take it the night before my Mon/wed/Fri AM routine. Further, as stated by others diet is important. High fiber and lots of H20 2L/day at least. Finally, the greatest impact (or equal at least to diet/water) I don't eat anything after 7pm the night before my AM routine.

  8. #58
    Daily standing in standing frame really helps
    Bike-on.com rep
    John@bike-on.com
    c4/5 inc funtioning c6. 28 yrs post.
    sponsored handcycle racer

  9. #59
    Senior Member air ohs's Avatar
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    Quote Originally Posted by fuentejps View Post
    Daily standing in standing frame really helps
    Absolutely

  10. #60
    Diet, fluids, exercise and consistency in your program are all important. Also the medications that you take - and not just the bowel ones can impact your program. Good advice given above.
    ckf
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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