My mom is on morphine and hasn't had a bowel movement in a week. She is in pain trying to go. The doctor prescribed Colace on Monday and she's been on it for 2 days. The nurse in the memory care gave her a suppository on Saturday and one today. After about 30 min she was ready to go but only a small amount (I know TMI). She cries out in pain when she is trying to go. Well, long story short and this is where I need your advice/experience - when I went to wipe it feels like a huge ball (like the size of a lemon) is there. How is she going to get that out?? I hate seeing her in pain. What should I do?
Apply Vaseline just before she eliminates. Give coffee just before.
Support the surrounding tissue on the painful side with some tissue/gloved hand.
Cwillie had once suggested wiggling back and forth while sitting on the toilet, but I'm not sure if it was advice for urine or a b.m.
Can she do this by herself without hurting herself? The nurses should be doing this.
Try not to irritate the delicate tissues. Does she have hemorrhoids? Gently clean and pat dry the area. Apply a hemorrhoid preparation to decrease the irritation and pain .
Take 2-4 prunes daily from now on.
I went through this with my Mother too and what worked for us was first I'd give her a mineral oil enema and if that didn't work,I'd give her a saline enema.The doctor prescribed Miralax which I gave her I believe 17 grams a night she'd chug down mixed with a small amount of water every single night and every single morning,first thing I'd put in a suppository,It was a project and it took some time to get Mom working better in that area,but we figured out what would help her and I let Mom have all the time she needed in the bathroom every morning.She also took a small dose of Senna,but the Colace didn't work for her and she took the Senna everynight too.
I think the Vaseline idea is probably a good idea too.
I'm really sorry you are dealing with this.I feel bad for you and your Mother.Hopefully,you'll find your recipe that works for you all too.Take care~
I hope this helps the 1st night, if not by the 2nd night, she has an impaction and should go to the ER.
Vaseline or castor oil will help with pain and clean up :-)
If those don't work, you may have to take her to the ER so they can manually remove it.
Hugs, I hope your poor mom gets things moving better. I know it is miserable :(
She was impacted. They told me to take her home and give her a fleet enema. I called her HH nurse and they came the next morning, gave her the enema and she felt better. Lost several pounds. By afternoon she felt bad again. The next morning she felt really bad. I took her to a second ER. Another X-ray. Still impacted. They recommended miralax and to see a gastro specialist. Said it would take a little time. Turned out it was her thyroid causing the problem. Too much medication onboard. He advised she take miralax everyday. She does. (polyethylene glycol 350 through pharmacy. Ask dr for script)
Along with a probiotic daily with her breakfast. She has not had another problem with her bowels since starting the miralax and getting the thyroid levels corrected. The dr said no stool softener.
I would be very careful about loading your mother up with things like Miralax, coffee, laxative type pills and/or potions.
Why? If there is a significant impact type situation increasing the need to go by stimulating, irritating the bowels - it can put too much pressure on the lower intestine prior to the blockage and cause a tear or even a rupture. Think along the line of what happens when you continue to flush a toilet that is already plugged up... sorry, not a pretty visual or comparison, I know.
The enema suggestions are good - but not too many as at some point that liquid too causes a build-up situation if nothing is coming out - and if the intestines are beginning to shut down nothing will be absorbed by the body - you’ll just have a huge internal puddle causing more pain and discomfort.
Talk to the hospice folk. What do they intend to do to help? This happened to my dad once towards the very end - he wanted to use the toilet but was to weak to apply any “push”. Could that be an issue with your mom? With my dad - since it was weakness over impact the TRAINED nurse was able to help with gloved finger tips and lotion. Kids - do not try this at home!!! If you don’t know what you’re doing you can make things worse- a lot worse.
Anyhoo - if it were me, I think I’d be asking for an X-ray long about now - or an ultrasound. Either should be able to identify if impacted stool is the issue.
But never mind being livid, be polite but also be persistent and unapologetic until someone gets their ass over to the house and, um, gets things moving. Poor mother! :(
I second (third) the fleet enema, I had difficulty administering these until our nurse demonstrated how to do it, so don't let them push the task on to you. Then, only after it has worked!, you can look at her daily laxative variety and dosages.
get production. It must not be allowed to close shut again. Drinking water
seems to be an important ingredient. We were doing miralax but it caused too loose stool, so we switched to senna. Finding the right combination is the challenge. One time I gave her a foot massage and that got a production. I
applied a series of 3 impressions at each point on the ball of the foot from the
big toe to the little toe and continuing on down that side of the foot to the heel.
I do not always get results but a foot reflexologist should be able to do it. We have had to resort to an enema. This is a very serious thing. A perforated bowel is not what you want to risk. If they can get up and walk, walk as much as possible. Any kind of exercise would be good unless there is more to the story and that would compromise the situation.
Am praying you find the right answer.
1/4 Cup prune juice
1/4 Cup Milk of Magnesia
1/4 Cup Orange Juice
Heat this gently until it is about body temperature then drink.
(I tasted a bit it really does not taste as bad as it all sounds)
One of the prescriptions I did end up getting, through the VA, was Lactulose it is a more gentle product on the kidneys than something like Magnesium Citrate. Magnesium Citrate works great, works fast pretty much like the product you take to prep for a colonoscopy. You can get Magnesium Citrate at any store, I got mine at Walmart, think it was less than $1.00 a bottle and there are flavors now not just lemon.
Is she being given a stool softener daily?
One of the products I used to give my Husband was Smooth Move Tea that is Senna based so it also is gentle.
I looked up some of the "cleanses" that are sold over the counter and most contained Pineapple and Papaya so I purchased a pineapple and a papaya and pureed them and froze them in 1/2 Cup portions and I would give him one of those if I though we were going to need a little help.
Side question for you..Is your Mom on Hospice? If so there should be a nurse assigned to her and the nurse should be consulted, they can aid in a fecal impaction.
If she is not on Hospice the nurse at the facility should be doing more they can manually aid in an impaction.
The last resort would be a surgical intervention and that should be avoided at all costs as it is possible that your Mom may not survive the surgery or the recovery process.
I wanted to share what had worked with my mom EVERY time, as last resort.
Sauer Kraut Juice.
Yep. Warm it a little and drink. This had NEVER failed us.
"Bulk-formers—Bulk-forming laxatives are not digested but absorb liquid in the intestines and swell to form a soft, bulky stool. The bowel is then stimulated normally by the presence of the bulky mass. Some bulk-forming laxatives, like psyllium and polycarbophil, may be prescribed by your doctor to treat diarrhea."
I use Traditional Medicinal "Smooth Move" tea (health food store) for my dad. Even for the challenging BMs.
All the best!!
If no movement, then on day for another dose of Milk of Magnesia . Day 5, I set up everything, KY gel, a box of gloves, lots of chucks, to physically disempact her. Thr aide helps by holdong her and lubricating the glove. I only go in woth the glove one time and then throw it out and put on another one. I am extremely gentle with her. When Mom was hospitalised,at one time for something else, she got disempacted. The doctors tried everything but nothing worked. They were going to disempact her but I would not let them because it would've been too much for her. So they "let me do it and assisted me".
After I clean the canal somewhat , I give her an enema. Wait about 15 minutes and put her on the porto-potty. At that point every thing comes "down " with the help of gravity. It takes a tender touch and a big heart. If you cannot do it for her, seek out someone (nurse) that can.
PS: Guess I meant short story LONG..LOL