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This is really just a vent, I'm pulling my hair out with frustration! Mom is chronically constipated and every time I think I have a handle on things it returns worse than ever. Last week when she developed diarrhea I was reluctant to give her anything due to her history, but the the doc told me to use imodium and days of constant clean up I was ready to try anything.
Nurse popped in on Wednesday and said everything sounded good, no tenderness, return to business as usual. Well now it's been 5 days, rectum full but no pooping. Last time I dragged mom to the hospital about this after a painful digital exam they set her on the commode (like that was going to work) and after several hours sent us home with instructions to go buy some Miralax (which, btw, is not even sold under that brand name in Canada). I vowed I would never put her though that again.
I understand nobody WANTS to deal with a possible dis-impaction, but why am I supposed to sit here stressed with worry and frustration and NO HELP. It seems everyone I turn to for help just lobs problem back to me like a hot potato. Well my hands are on fire! :(

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Okay, ya'all are likely to think I'm crazy, but try a Potty Squatty. Can't hurt. Might help. Not that expensive: bedbathandbeyond/1/1/201634-squatty-potty-7-inch-toilet-stool-white
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I woke up and mentally prepared myself to go to war today, but Mom was soiled when I got her up this morning, yeah!!! ?
I will continue to keep her on a liquid diet today and do some more research about her diet in the future, something has GOT to change.
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The enema causes pain in my mom, so severe, caused significant agitation. They were going to administer ativan in ER, but thank goodness, she was able to go before that. Had she had the ativan she would have been in for psych evaluation. We have found out since that my mom is one of those that has the completely opposite reaction to ativan than what is intended.
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Cwillie, a search brought up the IFFGD website, which described the alarm symptoms: Acute abdominal pain and swelling, fever, nausea, and vomiting. They also explain about how long between bm is ok or not. In the elderly, the alarm sx. listed can indicate a bowel obstruction. If she vomits, don't wait to get help. You stated the enemas cause pain? Or discomfort. The website advises that giving fiber (flax & chia ) has not been shown to help (you should read this) I would listen to the ladies who have already gone through this with their moms. Hoping there is some relief and an answer for you soon.
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My mom gets 2 stools softeners twice a day. And prune lax to get her pooping ...it's hard to get things moving I hope it works out ok
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CWillie, After the administratin of immodium, anything could happen days later, or not. It seems if someone is chronically constipated that immodium would be contraindicated. That would be basic nursing. The diarrhea should have been properly treated, even if inpatient hospital. The nurse that came by was listening for bowel sounds. That is a good sign there is no impaction. We have learned from Falcon, that even if a dnr exists, or a patient is in hospice, or terminally ill, that doesn't mean do not treat. You would know if mom is uncomfortable or in pain, right? Falcon went through quite a time with her mom and diarrhea; was then hospitalized and there was improvement. The not knowing what to do is distressful for you. Maybe if you private message Falcon, she could walk you through this. She had to call 911 to take her mom to the hospital.
Have you tried simple things like, coffee? Unless you get more information and call doctor or nurse Monday morning, over-the-counter meds should be limited to what you have routinely given her. This is not medical advice, just a discussion to give you ideas. Move her around in the bed by turning her more often. Can she be ambulated/walked around? I will read more of her condition, but from what you have said, waiting is zen.
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Sharing is always a good policy in caregiving.
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The nurse only comes once a month unless I call her. Mom is really only registered for nursing care because I fought for it and in order to have the paperwork in place for an expected death in the home, at 96 that's a likely possibility. She has long outlived her original less than 6 months prognosis. It is also supposed to relieve me of the burden of dragging mom out of the house when we encounter a problem, but somehow I've hit a roadblock with this issue. We keep playing around with different laxatives and yet it only keeps getting more complicated. Mom is only distressed because I am and because the suppositories and enema cause her pain.
I'm going to step back and play a waiting game, let go and let god as they say. Things will either resolve themselves soon or progress to a degree that can't continue to be ignored. (A little of mom's ativan has helped me be a little more zen about this)
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When is the nurse due to pop in again? It sounds as though she needs to be looked at sooner, rather than later. She's not on Hospice, is she ? In which case I would call THEM. So sorry that you're both going through this. ((((((((Hugs)))))))
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Stool softeners? Hahaha. Mom is on a daily dose of colace a.m. and p.m., and MofM every 3rd day. And a fiber rich diet. And occasionally I throw in chia or flax seeds and PEG. I know she should drink more, but I've been really pishing extra fluids the last 2 days. And the bisacodyl laxative is what started the diarrhea last week, usually we just use the glycerin ones. See, I really HAVE tried it all.

And you both nailed it, she has absolutely no sense of having to go, no ability to push, no idea if she has gone. If only I get a health care provider to LISTEN to my concerns and actually offer to do something about it,or at least offer some reassurance, but it seems I can't.
I am still hopeful something will happen soon, thanks for letting me vent to you all, no one else will try to understand.
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cwillie,
So sorry your having awful bathroom problems.My Mother does too on and off.Our recipe is a half dose of polyethylene glycol 3350,NF which is like Miralax,and 2 senna pills at bedtime and then when shes on the toilet the first time of the day,I give her a suppository everyday.when were having no luck,I give her a saline enema and if that doesnt work,a mineral enema,one after another.I also try to make her as comfortable as i can with a blanket and heating pad and something to read and give her lots of time and kkeep checking on her and offering drinks.Impaction is awful to go through.Fortunately,it hasnt happened in a while.I hope you find a recipe that works for you.Take care!!!
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Is mom on a stool softener? That really won't help now, but for future, mom's doctor recommended Senna-S. I would ask the doc about putting her on a schedule of laxatives...like, I don't know, once every four days or something.

Toward the end mom had no sense of needing or HAVING a bowel movement. It was scary, so I know what you mean. I used to mark the calendar. The nurse finally gave me an suppository laxative. What a mess is all I can say about that.

If mom gets uncomfortable, it's probably ER time again...or one of those super suppository laxatives. I have no doubt in my mind THAT will solve the problem.
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Willie, did they do an ultrasound or MRI? If she has dementia she may foget how to go, the signals are not being sent. It has happened to my mom, she has been in ER four times for bowel related issues. Three times was what to mom is constipation, but due to consistency resulting after two enemas, it was not constipation. My mom just does not know what to do. The remaining time was a bowel obstruction that was discovered either my mri or ultrasound, just don't remember now. But, an obstruction is serious and required stomach pumping to relieve pressure causing the restriction. Thankfully relieving the pressure got things flowing again, as mom would not be a candidate for surgery. She was hospialized for three days.
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