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PostPosted: Sat Oct 03, 2020 6:18 pm 
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Joined: Sat Sep 12, 2020 2:46 pm
Posts: 2
Hi
Thanks for letting me ask about some challenges I have with my bowel program.
I live in a home for the physically handicapped and need help with any physical task, including going to the toilet. I can not sit on the toilet, so I lie on a couch in the bathroom.
I'm sorry if I'm too direct, but I've read some other topics in here, so I think I can ask about this. :)

For daily I use Peristeen anal plugs, from morning until I go to bed. They work really well for me. I have only very few accidents.
My regular caregives on site perform my bowel program.
Now they have changed my bowel program after the hospital I am affiliated with has changed their guidelines regarding my bowel program. so I have been hospitalized for a few days, to get my bowel program adjusted. Over the last six months, my bowel program has taken longer and longer and harder to get completed. I do not know what I think about it.

Since I was discharged from the hospital five years ago, I have been using the suppository for half an hour before my caregivers use digital stimulation for about half a minute up to three times. At the same time they give me abdominal massage which also has a good effect.

After giving one or two suppositories and waiting for it to work. Then they start with digital stimulation.
Now they need to insert the finger 2 to 2.5 inches and moving in circular motions about three minutes at the rate of approximately one second per turn.
i feel like it's a long time, sorry my language, they need to have a finger my anus, but that's what my caregivers were instructed in.

at the same time they have been instructed during or between doing digital stimulation, to do perianal massage / support, to relax my sphincters. They press two fingers on the area between the anus and scrotum in the direction of the anus, and continue pushing in pulses of 3 to 5 seconds each.

They have said that I and my caregivers should try the new method, for two months, to assess whether it is better and whether it helps me.

usually I am determined and persistent when the hospital suggests new ways to help me with different things, and although it is not too uncomfortable, it is a special feeling to have to be stimulated in the three places at the same time.

I'm going to continue and do as the hospital suggests some time, but I'm really in doubt about their suggestion to do so.

I need to hear from you what you think about it? I do not want to spend so much time on my bowel program, so I really want to give it a try. I hope you will share your thoughts on it

I apologize for my wording, but I needed to use Google translate to express myself accurately.

Thanks for letting me into the community. :D

Nikolaj


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PostPosted: Sat Oct 03, 2020 9:13 pm 
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Joined: Sat Mar 29, 2014 11:45 am
Posts: 1669
If you corresponded from a place that does not use English commonly, as your reference to Google suggests, you are doing great.

As for your bowel incontinence, much of what you wrote is common in the experience of folks who must deal with bowel control issues. Embarrassing? Yes indeed. Beyond the bounds of polite conversation? That too. But it is all too real. What you wrote seems fairly typical of pelvic floor physical therapy, in all its gory.

Thanks for your post; keep up the good work, and keep us informed.


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PostPosted: Fri Jul 30, 2021 7:55 am 
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Joined: Sun Oct 20, 2013 3:45 pm
Posts: 1771
Location: North Carolina - Raleigh area
Hello Nikolaj,

I am sorry to read about your difficulties with your bowel program. You are asking a very good questions.

I am both bladder and bowel incontinent. I use Peristeen anal plugs and find them to be effective. I only use them occasionally when I think I need extra protection.

I also use digital stimulation. What you describe is acceptable medical practice. I do something very similar. Please note that all doctors do not agree on the details of how to do digital stimulation. Some specify a shorter period. It will be different for each person and may require much experimentation.

Unfortunately, a good bowel program may require a long time. Some require as much as several hours. :(

I am treated by a spinal cord rehabilitation center and use daily enemas to control my incontinence.

Good luck,

--John
(double incontinent)


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PostPosted: Sat Aug 14, 2021 10:54 am 
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Joined: Sat Sep 12, 2020 2:46 pm
Posts: 2
Hello again

Thanks Patrick and John for your answers :)

Here is a update how it is going with my bowel program.
After several changes and training of my caregivers and follow-up of the hospital, I have found an bowelprogram that works really well.
But I still have a hard time accepting it, despite the fact that I have virtually no accidents anymore.

I get my bowel program done every morning,
They changed the suppositories to Enemeez Plus.
Now I get two Enemeez after my caregiver has removed the anal plug and stool from the rectum. Next, my second caregiver starts with abdominal massage. When they can feel and hear sounds from my stomach, they start the perineal massage to relax my sphincter muscles, pressing two fingers on the area between the anus and the scrotum in the direction of the anus and continuing to push in pulses of 3 seconds each.
When enemeez works, my other caregiver starts digital stimulation, inserts the finger 2.5 inches and moves in circular motions for three minutes at one second per turn.
While I have bowel movement, my caregiver takes over the perineal massage, and instead of pushing pulses in, they maintain a pressure on the area. They hold the pressure while the bowel movement is going on.
When they feel stool coming down, they move their finger to one side and wait for there is something. When that happens they continue the perineal massage. If it does not come by itself they perform manual evacuation of my bowel. Sometimes they add another finger to make it easier to dig it out. My caregivers starts with another three minutes of abdominal massage, perineal massage and digital stimulation after 10 minutes, up to five times if needed. Unfortunately as you say John, it's require a long time. And yes typically over an hour
After the last time, they perform a rectal check, and if the glove is clean, my caregivers know that my stool is done. They finish my bowel program with inserting a new plug.

During my evening routine, when I have gone to bed, I get the plug changed, and my caregiver does a rectal check and removes the stool that should have come during the day. They end up inserting a new plug that I sleep with during the night.

Both my caregivers and I can feel a great improvement in my bowel program. And I'm happy to no longer have accidents.

On one hand, I'm really happy to have had help adjusting my bowel program so I can once again have weeks between accidents. And thankful that my caregivers are involved in the changes. They can also see the improvements. And happy to have the opportunity to let the hospital help with optimizing my bowel program so I have almost no accidents.


On the other hand, it has been hard to accept my new bowel program because I can feel it all.
I'm surprised that it takes so much constant stimulation for me to have a bowel program that works well.
I lie and listen to music or reading during the bowel program, to think of something other than the bowel program. My caregivers have good contact with me and can see if I need a break.
But I still think it's a lot of simulation for a bowel program, and ind the first month, it feels wierd that the hospital was doing a program, with so much stimulation. But it has proven to work.

Thanks for your reply John
It eases me that you say it's acceptable medical practice. I have thought about that a lot.
The nurse at the hospital also told me, that my new bowel program would be a bit different, than it is described in many places on the internet. Especially the long digital stimulation along with the perineal massage was hard to get used to. And thought about why there should be two of my caregivers to do my bowel program. It seemed of a bit much. But as the nurses trained my caregivers, I could well see that two were needed.
For the first few months, my muscles tensed up in different places in the body due to all the stimulation, but over time try to relax more in the body and thought of something else.

I need some advice on how to get used to my new bowel program. If there are any of you who have or have had your caregivers to perform your bowel, which includes different types of stimulation. How do I get to the point where I accept that this method should be used now and in the future. And how do I accept all that stimulation?

I'm sorry if I'm too direct again, but it's something I've been thinking about for a long time.
Thank you for listening to me and hope you can make me a little clearer. :wink:

Thanks

Nikolaj


Last edited by NTBallerup on Sun Jan 02, 2022 4:57 pm, edited 6 times in total.

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PostPosted: Sat Aug 14, 2021 2:34 pm 
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Joined: Sat Mar 29, 2014 11:45 am
Posts: 1669
You post seems to indicate that your physicians are experimenting with different management protocols. I was glad to read that your latest protocol seems to be working. For folks who have GI issues, such as ours, embarrassment, both while enduring the treatment, and in describing it afterwards, is to be expected. I have had many of the procedures you describe, and unpleasant is too weak a word. Such descriptions are forbidden in polite company; however, this is the place to vent, among folks who understand, because they have endured, and survived.


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