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If you take pain meds, sleep meds, muscle relaxers, etc. please read this thread!

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  • If you take pain meds, sleep meds, muscle relaxers, etc. please read this thread!

    This is for everyone who has to take pain meds sleeping pills, or muscle relaxers, etc. on a daily or regular basis. This is just a friendly reminder to make sure that you have a good preventitive bowel care plan in place. It is well known that narcotics, sleeping pills, muscle relaxors, etc. really slow down our systems and also can cause serious constipation, hemmoroids, and even impaction, (among other things.) So this is a reminder to keep track of your bowel movements. You dont need to go very long without having a bowel movement (BM).

    I know a few people who only go once a week and have had major problems. I even read a thread here on the ICN a while back where someone had a serious impaction and had to be hospitalized and almost died because of it. She is now a serious bowel care prevention convert. (This is gross, I know, but her Dr. said it was as solid as a brick when he cut her open to remove it.) It was blocking other organs and cutting them off. That's why she almost died. She hadnt has a BM in 9 days, but hadnt noticed or kept track of it until she had the big problem.

    I also know someone else who has IC but doesnt have a computer so she isnt on this site, but she's had this problem too. She had two impactions. Both of them had to be surgically removed. The last time, she almost died too. But after that last time, she finally started seriouisly following the prevention plan that her Dr. put in place for her, consisting of a fiber supplement and eating a high fiber diet.

    Speaking of the diet, make sure you eat a well balanced, high fiber diet. It is also well known that pain meds sometimes cause a loss of appetite in many patients, causing them to skip meals. This makes it very difficult to get enough fiber, vitamins, minerals or other nutrients in the diet. (After all, it's pretty difficult to cram all the nutrition of 3 meals and 1 snack into just one meal or two per day!) Among alot of other things, skipping meals can also make you very sluggish, cause you to have a lack of energy and, poor concentration. It also causes a lack of focus and can cause you to be very forgetful and even very emotional. It can even make you very grumpy (even though YOU aren't hungry, YOUR BODY IS! So make sure you eat all 3 meals everyday, and get that extra fiber in there!

    Many patients who take daily pain meds also take a fiber supplement to help ensure they have regular, soft BMs. (Extremely large and/or very hard BMs that cause straining can also cause very painful hemmoroids.) If you take daily pain meds this might be something to discuss with your Dr. to consider as a preventitive measure for bowel care.

    Another reason alot of ICers have this problem is b/c so many of us are disabled due to the IC and the pain, and it hurts when we move around very much. Because of this, we tend to get up and try to do a few things that we have to do, (like clean the house), but then we have to lay back down after few minutes because of the pain. This makes us stop and start all day long due to the pain. But, on the really bad days (like when we are in a bad flare or have a UTI on top of everything else), we dont get up at all. Instead, we just stay in bed all day. When we have a few bad days in a row, we are in bed a few days in a row (or sometimes all week!) But, what alot of patients don't realize is that you have to move around to get your bowels moving. So, if we stay in bed and dont get up except when we absolutely have to, then our bowels become very sluggish and dont get started for the day either. Also, chances are, we wont have a bowel movement till we get moving again. So, if you find yourself in that situation, it is honestly best to try to push yourself to get up and move around some. That way your bowels will start to move. (A good time to do this is after you have taken your breakthru med and it has kicked in.)

    (Ever notice how alot of times when you have been hospitalized for something, or just had surgery, they usually want to make sure you have had a bowel movement before they let you leave the hospital? When they make this request, they also usually encourage you to get up and walk around. One reason they often want you to walk around is to help you expel the gas (carbon dioxide) that they pumped into you during the surgery to help them look around. Anyway, the gas pretty much stays put (often in your back or shoulder area, until you start moving around. That gets the gas going so you can "expel" it. But, they also request this because it gets your bowels moving.

    Taking the appropriate precautions and preventative measures can go a long way to keep you from having serious problems.

    If you get in trouble because you havent gone in several days, act swiftly to prevent impaction. This can be VERY DANGEROUS and even LETHAL! So make sure you take the problem seriously and take care of the problem immediately.

    I realize that there are several of us who have been forced to rely on these kinds of meds in order to have any semblence of a life. I am very grateful to my IC Dr who referred me to my Pain Dr, and of course I am also very grateful that my Pain Dr. is willing to treat me. I realize that we have so many IC sisters (and brothers), who are being denied this very basic compassionate care. BUT, as great as my pain Dr. has been about prescribing these meds, I do think he has been irresponsible and negligent in one area...... that is by not mentioning the importance of practicing prevention in regards to bowel care. Hopefully, other Doctors out there are more responsible about this. But, I wanted to write this thread just in case there are others out there like me who have not been cautioned about this.

    If this thread reaches just one person and helps them to realize the importance of this, then I would consider my time writing this to be "well spent". But, I truly hope that everyone reading this who takes these kinds of meds will heed my words of caution and (if they aren't doing so already), will just do the following:

    1) Make an appt with your Dr. to discuss this and to get a plan in place for prevention and to discuss the items listed below.

    2) Start following a high fiber diet. (IF you are just starting this, it is important to start slowly and gradually increase your fiber intake, instead of doing this abruptly.) (Increasing too much too fast can cause stomach pain, so it would be a good idea to talk to your Dr. about this and get his/her advice as to how to go about this in a responsible way.)

    3) Dont skip meals, (for the reasons explained above). (Also, skipping meals causes your metabolism to slow down EXTREMELY LOW. So, if you are overweight and want to lose a few pounds and think skipping some meals like b-fast is a good way to lose some weight, then you better think again! Instead, it has the opposite effect by lowering your metabolism, your body really wants to cling to those extra pounds!)

    4) Start moving around more to get your bowels moving. (Again, if you are just starting this, get advice from your Dr. to get this tailored to your particular needs. Don't try to increase your activity too quickly. It is best to increase it gradually, unless your Dr. advises you otherwise, of course.) They can advise you as to how much activity to start out with and how much to increase to in order to get your bowels moving and also for your optimal fitness/excersize. ( Some ICers can excersize with no problem. However it is very problematic/painful for others.) However, you dont have to actually excersize to get your bowels moving. Just getting out of bed and moving around throughout the day will do the trick for that.) (In this instance, I am primarily talking to the ICers who are in bed all day long when they are feeling really bad, (except to go pee), and sometimes stay there all week or even longer.)

    5) Moniter your bowel movements and stay on top of them. (Don't go too long or too many days without a BM.) (Again, talk to your Dr. about what is normal for you in terms of frequency and your current texture. Then, he/she can tell you how often you should be going and can advise you if you need a fiber supplement to have softer BMs if your meds have been having a constipating side effect.

    6)If you get in trouble and really need to go but are very constipated, your Dr might recommend something you can try at home like drinking prune juice, milk of magnesia, black strap molasses (or even all 3 mixed together.) OTC Stool Softners (like Glycerin suppositories) are also very helpful for constipation. However, they are certainly not a "quick fix". They generally take several hours to work. So, it is best to take them as soon as you realize you have missed a bowel movement. For example, if you usually go every day or even every other day, but miss a day, then it would be a good idea to insert a few of these. But, if those things would cause your IC to flare, they might recommend something else. You never know unless you ask!

    7) They can also advise you as to whether or not you should keep a few enemas on hand and if so, when it's time to use them. If they advise you to use them, they can also recommend which kind is best for your situation and the qty (ie: dose) you should use: mineral oil/ water/ hot soapy water like baby shampoo/ etc.


    My Mom is an RN and she said that when she worked in the nursing home, the patients often had this problem since they were heavily medicated and extremely sedentary. So she said the Drs. had a standing order of this concotion for constipated patients to drink. (served hot in a coffee cup): 1 part Milk of Magnesia mixed with 1 part Prune Juice and 2 tablespoons of black strap molasses all mixed together. (She said it is important to drink it hot because the heat also helps loosen and soften the stool.) She said it worked within about an hour almost every time! She says on those rare occasions that didnt work then they did a 3H enema. (That stands for High, Hot and a Heck of a lot! She said they used very warm (almost hot) mineral oil first, then after the patient expelled that mixture, they chased it with a mixture of a little baby shampoo and a lot of hot water and each time they were told to hold it in as long as they could (while laying on their left side because the bowel, colon, etc, is mainly on that side, so more of the liquid would go there if you lay on the left side.) She said between the oral concoction and/or the enemas, they worked in every case except in cases of impaction that were severe that they had to be surgically removed. So, those are things you also might discuss with your Dr as options for you to try as home care if things get really bad. Of course, you shouldnt try anything without talking it over with your Dr. first. That's why I put "talking to your Dr. and getting a care plan down" as the very first thing on the list. It is the single most important thing to do.

    I truly hope this thread reaches someone out there that I can help. So many chronic pain patients on heavy duty meds seem to suffer needlessly simply because their Drs. forgot to counsel them about good bowel care while on those kinds of meds. So, if you get nothing else out of this thread, please, make an appt with your Dr. and get a plan together for good bowel care.

    Hope this helps someone!

    Hugs,
    Amaranthe
    Last edited by amaranthe; 02-19-2011, 12:06 AM. Reason: added something
    I am not a medical professional. I do not give medical advice. In all cases, I urge you to talk to your Dr. about your treatment options.

    D/Xed 2003 with IC. Also have the co-existing condtions of VV, Vulvadynia, Lupus, Fibro, GERD, CPP, Endo, & Adhesions, and Depression

    Meds: Estrogel (due to total Hyster)
    The meds r/xed by my Pain Dr. from the Pain Clinic are as follows: Morphine ER and IR, Baclofen, and Lyrica and Seroquel (used off-label as a sleeping pill, but it also helps with depression)


    (I listed my meds in case someone reading this has been told like so many ICers that Drs dont r/x pain meds for IC.) I want you to know that there ARE tons of us who are also dealing w/this disease and the pain and many of us ARE on pain meds.)


    John 3:16 For God so loved the world that he gave his only begotten son, that whoever believes in him shall not perish but have everlasting life.

  • #2
    WOW...thank you for all the info! It is sooo true how important it is to really take care of that part of our body since it is also closesly related to our bladders. I know when I am constipated, my IC flares up even more! I am a big fan of Benefiber...it just mixes in with anything to drink & really works! Thanks for this!
    Karen
    Currently Taking:
    20 mg Celexa
    fentanyl patch 12.5 mcg chgd every 3 days
    morphine IR 15 MG, up to 3x daily
    Xanax 1mg as needed (not taken daily)
    900 MG Oxycarbizine (mood disorder)
    300 MG Welbutrin
    Tizanidine 4 mg up to 20 mg daily as need
    Prevacid 30 mg
    Ambien as needed

    my heating pad is my best friend, use daily on my lower back & pelvic area
    blessed to be able to receive massage & Amma , along with Avazzia therapy 3x weekly

    Been diagnosed for 10 years now, consider myself pretty well versed in this disease & would love to help out with new IC sisters or brothers, feel free to message me.

    Comment


    • #3
      Thanks for posting that!! My PM has told me to keep Fleet enemas on hand for when this happens. Also, he told me to take Miralax every other day which seems to help. Although right now I am SUFFERING with horrible hemmoroids, I believe due to straining. SO painful!! WOW!!! So if you have any hints about THAT (other than not straining, that part I know). I'm ALL ears!!!

      Thanks so much for the info!!!
      Katie-46 yr old female dx'd with IC after 15 years of symptoms off and on long term antibiotic use, GERD,IBS and now IC diet, gallbladder removed, endometrial ablation w/tubes tied
      Lexapro-20 mg
      Aciphex
      Ambien-as needed
      Percocet-7.5 up to 3 per day as needed
      Valium-10 mg x2 per day
      Phenergan-1 at night
      Prelief w/everything
      Now recovering from acute pancreatitis

      Currents treatments that help somewhat:
      Heating pad
      Hot baths
      Ice
      Being VERY still while lying down with legs elevated

      Comment


      • #4
        Hi Katie,

        I was just curious as to whether or not you've ever had pelvic physical therapy? I am lucky to live by Isa Herrera's practice, so I go to her but the #1 thing they told me NOT to do was strain with bowel movements as it makes IC so much worse! We spent awhile talking about 'potty posture'. Anyway I just wanted to let you know that PT has helped a lot.

        Rachael

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        • #5
          I tried the fiber but it did not work, I have to use womens gentle laxative and sometimes stool softeners and fleet supositorys. I have to go at least every other day or I have problems.
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          • #6
            As per my doctor's orders I take Lactulose Syrup (prescription), a dose of Miralax, and a tablespoon of mineral oil every day, plus follow a very high fiber diet.

            Comment


            • #7
              This is the link to the thread that I was telling you all about where the IC patient almost died. She was taking pain meds and they really slowed things down and she hadnt paid attn to how long it had been since she'd had a bowel movement until it was too late. By that time, around 9 days had passed and she had a serious impaction and bowel obstruction and had to have surgery to remove it. Here is the link: http://www.ic-network.com/forum/show...highlight=died The thread was written by SandyRN. She is a registered nurse and even a volunteer moderator here at the ICN (before she got too busy and resigned.) So, it just goes to show you that this could truly happen to any of us!
              Last edited by amaranthe; 02-19-2011, 12:18 AM. Reason: added something
              I am not a medical professional. I do not give medical advice. In all cases, I urge you to talk to your Dr. about your treatment options.

              D/Xed 2003 with IC. Also have the co-existing condtions of VV, Vulvadynia, Lupus, Fibro, GERD, CPP, Endo, & Adhesions, and Depression

              Meds: Estrogel (due to total Hyster)
              The meds r/xed by my Pain Dr. from the Pain Clinic are as follows: Morphine ER and IR, Baclofen, and Lyrica and Seroquel (used off-label as a sleeping pill, but it also helps with depression)


              (I listed my meds in case someone reading this has been told like so many ICers that Drs dont r/x pain meds for IC.) I want you to know that there ARE tons of us who are also dealing w/this disease and the pain and many of us ARE on pain meds.)


              John 3:16 For God so loved the world that he gave his only begotten son, that whoever believes in him shall not perish but have everlasting life.

              Comment


              • #8
                It's NEVER a good idea to strain. It can even cause a rectocele --- and definitely can cause hemmorhoids, as well as an IC flare.

                Donna
                Stay safe


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                Click on ICN Shop at the top of this page. You'll find Bladder Builder and Bladder Rest, both of which we are finding have excellent results.

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                I am not a medical authority nor do I offer medical advice. In all cases, I strongly encourage you to discuss your medical treatment with your personal medical care provider. Only they can, and should, give medical recommendations to you.
                [3MG]

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                • #9
                  Originally posted by KatieB View Post
                  Thanks for posting that!! My PM has told me to keep Fleet enemas on hand for when this happens. Also, he told me to take Miralax every other day which seems to help. Although right now I am SUFFERING with horrible hemmoroids, I believe due to straining. SO painful!! WOW!!! So if you have any hints about THAT (other than not straining, that part I know). I'm ALL ears!!!

                  Thanks so much for the info!!!
                  Those can be SOOOO painful! And it's not like you can just quit using that part of your body until the hemmoroids are gone. You poor thing!

                  The last time I had them, everytime I went to the bathroom, I used Preparation H on them to shrink them. It also had some sort of numbing agent in it that seemed to help alot. I also had a r/x of Lidocaine 2% jelly that I applied to them topically. (I always applied the Lidocaine about 20-30 minutes prior to a bowel movement to make it less painful.) However, I am pretty sure that using Lidocaine prior to a bowel movement will only work if you external hemmoroids, because if you try to use them on the internal ones prior to a BM, it can cause you to be too numb, making it difficult to expel the bowel movement.

                  I definately think you should give your Dr. a call and ask him what he recommends using and if he doesnt mention it (or if you dont have an r/x for it already), then ask him if he will call in some Lidocaine 2 % jelly. It really does work wonders for external hemmoroids! It also helps with the pain of the internal kind, as long as you give it time to wear off before you have a bowel movement.

                  Good luck! I hope your Dr. will call in something to help and that they go away soon.

                  Hugs,
                  Amaranthe
                  I am not a medical professional. I do not give medical advice. In all cases, I urge you to talk to your Dr. about your treatment options.

                  D/Xed 2003 with IC. Also have the co-existing condtions of VV, Vulvadynia, Lupus, Fibro, GERD, CPP, Endo, & Adhesions, and Depression

                  Meds: Estrogel (due to total Hyster)
                  The meds r/xed by my Pain Dr. from the Pain Clinic are as follows: Morphine ER and IR, Baclofen, and Lyrica and Seroquel (used off-label as a sleeping pill, but it also helps with depression)


                  (I listed my meds in case someone reading this has been told like so many ICers that Drs dont r/x pain meds for IC.) I want you to know that there ARE tons of us who are also dealing w/this disease and the pain and many of us ARE on pain meds.)


                  John 3:16 For God so loved the world that he gave his only begotten son, that whoever believes in him shall not perish but have everlasting life.

                  Comment


                  • #10
                    Thank you for this post. You're more knowledgeable than my pain management doctor, who handed me a leaflet from Senoket and said, "Here read this." The prune juice, milk of magnesia, and black strap molasses concoction seems like it might be gentler on the bowels. Thanks!

                    Comment


                    • #11
                      Warning- Prune Juice causes flares! I was doing really well, didn't even think I was diet sensitive. Not so. Prune Juice is dangerous.

                      Comment


                      • #12
                        Originally posted by ICNDonna View Post
                        It's NEVER a good idea to strain. It can even cause a rectocele --- and definitely can cause hemmorhoids, as well as an IC flare.

                        Donna
                        yes i had a rectocele repair about 5 months ago got hemmorhoids, had constipation the other day. i did an enema and i am still flaring, i am sticking with womens laxitive for now on.
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                        <a href="http://s1086.photobucket.com/albums/j441/linda5552/?action=view&amp;current=Picture005.jpg" target="_blank"><img src="http://i1086.photobucket.com/albums/j441/linda5552/th_Picture005.jpg" border="0" alt="Photobucket" ></a>
                        </center>

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                        • #13
                          Prune juice = flare

                          I have found one thing that has made it so I can have a BM = Apricot Nectar.

                          Miralax and other fiber or fiber type mix I have tried flared me.
                          -Jennifer
                          jenjen05

                          __________________

                          25 years young. Diagnosed with IBS-C May 16, 2007. Diagnosed with moderate IC February 26, 2009. Severe anxiety and moderate depression since middle school.

                          Current Meds: 60mg Oxycontin 3x daily (every 8 hours), 30mg Oxycodone 4x daily as needed, 350mg Soma as needed (twice a day), 10mg Valium Vaginal Suppositories as needed (after sex usually, what I call "the nuke" is two of these, and two oxycodone by mouth and one soma by mouth and I can usually prevent a flare if this is done RIGHT AFTER sex along with a cold pack right over my bladder), and Prelief as needed. Heparin 10,000 units installs as needed for rescue needs, usually makes it worse after about 8 hours for the next day or so but then the pain goes away for a few days at least. By following the IC diet I have lost 35lbs and I love the IC diet because it has made me a much healthier person!

                          Past meds: 60mg Opana ER 9am and 80mg Opana ER at 9pm, 15mg Oxycodone as needed for breakthrough pain or flares, 350mg Soma as needed (twice a day usually). Hydrocodone 5/500 (two at night with 350mg Soma would get me 6 hours of sleep). Tramadol 50 mg (didn't touch my pain). Elavil 25mg (did nothing). Various installations made me worse every time. Cytotec (don't remember dosage, didn't work).

                          Photo below is of myself and my Golden Retriever/German Shepherd/Chow, Daisy May.

                          Message me if you'd like to be added to my Facebook!
                          Skype- jennifer.jericho

                          PLEASE read about antibiotic resistance. It is a growing problem, especially in the United States. We are running out of antibiotics that work effectively before scientists can develop new ones! http://www.fda.gov/oc/opacom/hottopics/anti_resist.html

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