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View Full Version : Gretchen's surgery, constipation,HELP



tennisplayer
11-22-2012, 08:37 PM
This is Gretchen's husband. She had the anterior approach surgery done on 11/12. After surgery she developed a heart rhythm disturbance and the next morning had her heart shocked back to a normal rhythm but couldn't maintain her blood pressure. Spent 2 days in cardiac ICU. Gained 25 lbs of fluid weight from the efforts and some fluid in her lungs and abdomen. The second stage has been delayed. After 8 days in the hospital she was discharged on 11/19. She looked good on 11/20 but things have gone downhill since. Actually has had no bm since surgery except for a very little bit from a suppository in the hospital. I should have made sure that they did something about that before they discharged her but assumed part of it was because she wasn't eating much. She has had the urge to go frequently but not much happening and of course it is painful. She has been on laxatives right along, tried an enema, went to ER this morning where they tried a water enema but that didn't help. The doctor checked and said the stool was soft and thought magnesium citrate would do it. We elected to come home to do that as she was so uncomfortable waiting in the ER. It is now almost 9 hours since taking the mag citrate and the picture hasn't changed. She did get some sleep earlier in the day but now the urge is starting more frequently like last night. I thought it was because the mag citrate might be working but it doesn't appear that is the case. The surgeon's office is not any help. She can't follow the postop positioning instructions with this going on. don't see that taking her back to the ER is going to help. We are just feeling hopeless.
Dick

susancook
11-22-2012, 08:56 PM
This is Gretchen's husband. She had the anterior approach surgery done on 11/12. After surgery she developed a heart rhythm disturbance and the next morning had her heart shocked back to a normal rhythm but couldn't maintain her blood pressure. Spent 2 days in cardiac ICU. Gained 25 lbs of fluid weight from the efforts and some fluid in her lungs and abdomen. The second stage has been delayed. After 8 days in the hospital she was discharged on 11/19. She looked good on 11/20 but things have gone downhill since. Actually has had no bm since surgery except for a very little bit from a suppository in the hospital. I should have made sure that they did something about that before they discharged her but assumed part of it was because she wasn't eating much. She has had the urge to go frequently but not much happening and of course it is painful. She has been on laxatives right along, tried an enema, went to ER this morning where they tried a water enema but that didn't help. The doctor checked and said the stool was soft and thought magnesium citrate would do it. We elected to come home to do that as she was so uncomfortable waiting in the ER. It is now almost 9 hours since taking the mag citrate and the picture hasn't changed. She did get some sleep earlier in the day but now the urge is starting more frequently like last night. I thought it was because the mag citrate might be working but it doesn't appear that is the case. The surgeon's office is not any help. She can't follow the postop positioning instructions with this going on. don't see that taking her back to the ER is going to help. We are just feeling hopeless.
Dick

Did you try a Fleet's enema? It has some stimulating substances that a warm water enema doesn't have. Have her lie on her Left side, grease up the tip a little with vaseline. She should stay on her side as long as she can. Probably best to do it with her lying on the bathroom rug if that is possible for her to get up from that position to get on the toilet. If you have a sideside commode, then she can lie on bed. If the doctor said that the stool was soft, then it must mean that it is sitting there waiting to come out....constipated stools are hard.
I would call the surgeon's office again.
So sorry....good luck!
Susan

With all of the stuff she's taking, I imagine that when it starts to come out, she will have LOTS of stool.

tennisplayer
11-22-2012, 09:24 PM
Was afraid she was impacted so tried a mineral oil enema last night- it just came right back out, didn't penetrate. She is so weak getting up from the floor is a problem. I'm not sure she can hold any of the enema in. I wish there was a way to do it while she was sitting on the raised toilet seat. This is really setting her back. Thank you for your suggestion, we may try it yet tonight if I can convince her. She is so sore there now it will be difficult. Dick

JenniferG
11-22-2012, 09:43 PM
I really feel for Gretchen, this constipation really is a difficult thing to deal with, many of us say it's the worst part of recovery.

The fact she's getting urges, sounds to me like a good sign, as though it's going to happen soon. I wasn't getting any urges whatsoever. I went 9 days and despite taking everything the hospital threw at me, nothing happened. My friend arrived at the hospital with this:

http://www.nu-lax.com/history/intro.htm

It worked for me within three hours. I took far too much of course, and I nearly exploded but it certainly cheered me up.

I'm sorry to hear Gretchen's had such a difficult time so far. Once she's emptied her tummy though, things will look a lot more positive for you both. Truly, you will cheer! ;)

Good luck!

susancook
11-22-2012, 09:55 PM
Is she eating now? Eating stimulates the bowels to move. Fruit [not fresh apples or any apples], liquids [not apple juice] are esp good.
I know that this sounds gross, but if the doctor could feel the stool, maybe you could grease up a gloved finger and stimulate the lower rectal area a little and actually scoop out some poop.
Good luck! It has to be tough for your wife. Whatever you do make sure that she is safe and won't fall.
Susan

tennisplayer
11-22-2012, 10:56 PM
She is eating a little. I did actually try to pull some out with a lubricated gloved finger before we went to the ER but it just rolled around, not hard enough to grab and pull. I could try to spread the opening a little I guess and try to "deliver" some stool. Just not sure she is up to it.
Dick

titaniumed
11-22-2012, 11:32 PM
It might not be a bad idea to keep in touch with the hospital by phone right now.....call them and explain the situation just in case they want you (or an ambulance) to bring her back down there. Make sure the doctors are aware of the current situation as it is right now.

Ileus is a common problem with anterior surgery and basically shuts the plumbing down...they have drugs to help with this problem.

This is an incredibly painful situation......the worst I have EVER felt.

Ed

tennisplayer
11-23-2012, 12:01 AM
Thank you Ed, before I took her to the ER this morning I called the hospital and they told me they no longer can give medical advice over the phone so they didn't connect me to the ER. Very frustrating. One of the problems is that there were a number of doctors (surgeon, cardiologist, hospitalist) involved but once discharged they seem to want her to see her personal internist who doesn't even go to that hospital and who does not know all the details. I think she is going to try to stick it out tonight but I will certainly see that she gets in if she has ongoing abdominal pain ( her internist's nurse said 2 hours of abdominal pain, not just cramps). Likewise if she starts vomiting she will go in.
Thanks, Dick

tennisplayer
11-23-2012, 01:03 AM
I think the dam is breaking, she passed alot of liquid with stool in it so it isn't just the little bit that was leaking before. She is starting to feel better. It looks like the mag citrate did the job- has just taken 14 hours or so. Now to prevent it from happening again. It may still be a long night as I doubt she is through but the light can be seen at the end of the tunnel. Now, hopefully, she can concentrate on getting her strength back for the second surgery which is scheduled for Dec. 7.
Thank you, Dick

LindaRacine
11-23-2012, 01:27 AM
One thing that worked for me was just sitting on the toilet, reading, and trying to ignore the urge to push. Sometimes it took as long as half an hour, but it always worked.

Hope things are still improving.

titaniumed
11-23-2012, 01:48 AM
Dick

Good news.

After the event is over, she will be totally drained of electrolytes and dehydrated.

I sipped on pedialyte and sipped water, it helped put the fire out. I also slept around 12 hours after, as I was hammered.

I am interested in her anterior procedure but its time for you guys to rest. Tomorrow is another day.

Ed

susancook
11-23-2012, 01:53 AM
I think the dam is breaking, she passed alot of liquid with stool in it so it isn't just the little bit that was leaking before. She is starting to feel better. It looks like the mag citrate did the job- has just taken 14 hours or so. Now to prevent it from happening again. It may still be a long night as I doubt she is through but the light can be seen at the end of the tunnel. Now, hopefully, she can concentrate on getting her strength back for the second surgery which is scheduled for Dec. 7.
Thank you, Dick

Love your comment...light [or whatever] at the end of the tunnel.
Glad that she is doing better. Sometimes the liquid just goes around the stool, so make sure that she passes a bowel movement and not just liquid. Put your ear on her area between her belly button and public hair. Can you hear grumbling? That's a good sign that she probably does not have an ileus and that things are moving. Don't hesitate to call the ER and go back.
Good luck! When I have my surgery, maybe my husband can call you for advice. He's an electrical-nuclear engineer, so he knows little about patient caretaking!
Start the Colace, lots of liquids, Miralax if needed to keep things going when she does clear up. Look up "constipation" on the upper right corner and others have given sage and helpful advice.
Susan

tae_tap
11-23-2012, 05:54 AM
I too just recently had the anterior surgery and the same problem. Went the first two weeks trying everything, but mag cit is the way to go and I hate to say it, but almost a mont out it still is the only thing keeping the body working. The docs blamed the narcotics but I took myself of narcs by week three. Before that I only took them at night. Hope she continues to improve. Prayers from Missouri!

Tamena