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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
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
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