Pain meds and constipation warning.....what I went through

[SandyRN]

I have always been a very, very big advocate of pain medication rights here on this board. No-one should be denied pain medicine when they are in pain. We must, as always, remember there are side effects to ALL medications and I'm going to give you my recent story...not so that you are afraid to take the meds, but so that you are aware of what untreated constipation can do.

On Thursday April 16th I was a normal woman, at least normal as I could be. I joked with my kids, read, had fun with my dog, and ate dinner with Tom and the kids. I was pretty normal.

On Friday April 17th I was no longer normal. I opened my eyes at 5:15 am to my screaming alarm so that I could get my daughter off to school. I was in agony, agony doesn't really fit but it's the closest word I can think of. My entire stomach hurt really badly, but it was ***quite*** enough to send the kids off to school and hop on the next ambulance....but I should have. By about 12 pm, after a nap, I woke again this time to a 103 degree fever, and worse than agonizing stomach pain. Tom flew home and we hit the big trauma center's ER.

Long story short, by midnight I was nearing a temp of 105 and had a medical team comprised of at least 10 doctors. One who was almost always in the room told me of my CT results and said I was very, very sick and if I didn't have this surgery I would die...period. Even with the surgery I might die, and if I didn't die I might wind up indefinitely on a ventilator til my body was strong enough to fight off the raging infection I had. I neglected to tell you, my bowel ruptured....I had fecal matter in my peritoneum and it made me sicker by the minute, practically literally. The surgery he was telling me I had no choice but to have was an exploratory lap with possible colostomy, either total or partial, reversible or irreversible. They found a "BRICK" of stool where my colon ruptured.....I had been very backed up for a very long time.

I woke up with an incision from midline, right below my breasts down to my pelvic bone, and a colostomy bag on my left side. Needless to say I was scared out of my mind, in pain, but that moment I felt like the luckiest person on the planet. I was alive when there was a VERY good chance I wouldn't live...I had my children, my fiance, my family, my animals, my friends.

I've had a very rough recovery. I was in ICU for 2 days then transferred to a surgical unit who were fantastic. I came home Friday April 24th only to hear that one of the kindest people I've ever known has died and left her angel here alone. I have learned another very kind person is stricken with cancer. I can tell you that I see, smell, hear and taste differently now because I KNOW how precious life is.

I didn't mean to preach but the best advice I can give you is to follow a strick bowel routine that you and your doctor have decided on together if you are experiencing constipation from pain meds or, for that matter, any constipation. Try not to let it get ahead of you because it is harder to treat that way. I'm not saying anything bad about pain meds, without them I wouldn't have had any life these years, but you have to be dilligent with bowel care.

I will wear this bag for about 6 months til my bowel heals and rests then they will put me back together.......it's not fun, it's not pleasant, but I'm alive. I ignored too many symptoms and even though I took something for constipation I wasn't going like I should have been.

Stay safe.

Sandy

ps....if you sent me a pm you may not get a reply for a while....it makes me tired to sit here long

[dyno]

Sandy, First off I am so glad you are ok!!! Wow what a year you have had. I can only hope that you are on the road to recovery and healing and that you have had the end of all the bad things you have went through. Sending healing hugs!

[ICNDonna]

I'm so glad you are recovering now. :grouphug:

Donna

[katie87]

WOW ! That is just horrible and so scary! I cannot believe your colon burst! I am so so sorry for the additional pain you are now having, and very greatful to hear you got treated, infections are so scary even worse to think you had a raging infection with the lose stool in your abdominal cavity! What a miracle I am so greatful you are alive! You have been through so much and your I admire your strength while handling all of this .

[vm]

Oh my gosh, Sandy! How scary. :( I am so glad you are OK. :kissing:

[SharonA]

Sandy...OMGosh, my friend!!! I can't believe you have been through this. I am so sorry. I thank God that you are recovering. (((Hugs)))

[missychan]

Wow! I knew how important bowel care was with pain meds especially, but until someone you know goes through something like this, ya' don't "really" do all that you should, ya' know?

I am SO sorry you had to go through that, but am SO greatfull that you're here to tell the story, and pass on the warning. Lordie- have you not had enough to deal with?

Please take care of yourself, get as much rest as you can, and keep us updated for sure!

~M~

[darlene]

Sandy, I am so glad that you are doing better! I just have one question for you to think about. I also have IC( for 40 years), and Crohn's disease (23 years). Is it possible that your Crohn's caused the impacted bowel? Pain meds do have a powerful constipating effect. could the combination of Crohn's and pain meds be the cause of such a severe blockage?

[bluetou]

Sandy that is a huge scare, I am sorry to hear of all your discomfort and pain. What an ordeal, very overwhelming all that you went through....
Glad you are home now recovering
Peace to you
Blue
:pray:

[Katrina]

I am thankful that you are ok!!!! Having faced a period of time where death was suspected for me I know how it changes you forever. :grouphug: Thank you for sharing the seriousness of this. You go through something horrifying and come here to teach. God Bless! :pray::grouphug:

[Breezy1218]

That is so scary, Sandy, I am so glad you are on the road to recovery. I have no words. I will pray for your continued healing.

This really opens my eyes; I don't talk to my docs (or anyone else!) about it but I deal with SEVERE, painful constipation due to my meds. REALLY bad, I don't think I can even bring myself to share the details with ya'll. This really gives me a whole new way to look at the situation; I tend to see it as annoying and embarrassing, and I SHOULD consider the consequences, being that I am a med/surg RN, but for some reason, I don't. Now, I sure will! Thank you for sharing your story.

God bless. :pray:

[jameson77]

Sandy....OMG!

I cannot believe you have gone through this! I am just glad you are okay and am sending lots of hugs and prayers your way. Please continue to rest and i wish you a very speedy recovery!

:pray::pray::pray:
Meredith

[prestwood16]

Sandy, I'm so sorry you had to go thru that, but I'm so glad you made it thru!!
Although my colon didn't rupture, after I had my apendix out in december I was taking more pain med's then I had!! Well, my new year's resolutions was to see less doctors in 2009!! I made it till 1/7/09, when I myself ended up in the ER!! The day before I could tell I was really constipated, but what started worrying me was I was having problems urinating, but I went on about my days!! Well, that night I woke up and it was awful, it wouldn't pass and then I couldn't urinate AT ALL!! I started freaking out, I was scared to death!! I finally got myself calm enough to remind myself, you have cathered to self cath w/ for your instillations!! So, I grabbed one of them to relieve my urine, bc I had to go!!
I finally went on to the ER and told my husband it was nothing not to worry go to work, bc I was embrassed!! I get to the ER and they establish right off I had and Impacted Bowel!! And, since this was my local ER and not where my urologist worked out of (BIG MISTAKE) I couldn't get anyone to understand why I couldn't urinate!! First, the hook me up to fluids...I'm freaking out telling the nurse please, I can urinate, I'm not dehydrated the impaction is blocking my flow!! Well, when I started having to go over and over they made my cath my self, bc I explained to them (i thought?) i did instillations!! Well, after the 5th time of self cathing and the hadnt done anything about the impaction, I asked for them to please put a foley in bs it would be more sanitary and I didn't want to get an infection!! The doctor refused and finally took me off the fluids!! They finally 3hrs later and 10 self caths later they finally gave me the med's in order to move the impaction!! I was so upset, bc it took about 30 minutes once i drank the stuff and finally did an enema!! when the doc was discharging me he looked at me and said OH YOU "self cath to med's in not take out"....My mom looked at me like please don't say anything!!
But, the sad thing is this isn't the end of my story!! Just as i thought I ended up with the worst bladder/ kidney infection of my life!! it took 6wks of antiboitics to clear it up and a threat from work I could lose my job!! I was running fevers of 101.8 it was horrible!! Amoxicillin and Cipro were resistant to it!! And, I took them the 1st month, then finally they gave me leviquin and I had to take it for 2 wks and it knocked it out of me!! And, the sad thing about work is I worked everyday except when I had to go to the ER and then when my creatatin level was high and they were afraid i had a kidney stone & wanted to do an IVP!!
But, as Sandy stated yes we need our pain med's, but you really have to be more aware of what your body is telling you, because pain med's can be EXTREMELY DANGEROUS when it comes to constipation!! I was so much more fortunate then Sandy and Sandy knows she more fortunate then others!! And, I'm so thankful Sandy made it thru and her story reminded me how I really have to pay attention to my body!!
Take fiber supplement, eat more fiber, just make sure you are getting ALOT of fiber from somewhere while on pain medication!!
And, Sandy I will pray daily for a fast recovery!!!:angel::angel::angel:

[SandyRN]

Thanks everyone. It's really been a rough time for me. Before I went in the hospital, about 2 weeks earlier, I found out I have a broken bone in my left foot and was walking around with a "boot" cast thingy on as well. That has been cast to the side right now because it makes it harder to walk than it already is with this huge incision and stoma.

I am having a lot of emotional issues with this, even though it IS temporary. I don't know what to do. I sleep on the couch with lights on and everything I need within arms length, like my phone to use like an intercom to contact Tom who IS in the bed at night.

I HAVE quite smoking, so I know lots of you will be proud of me for that. I chain smoked 3 or 4 on the way to the hospital April 17th and have not had one since. Tom has also quit. I can't possibly do that to myself when I've literally been given a second chance at life. So, I am a non-smoker!!!

I am already planning the surgery to fix me back up. I want the surgeon who did Tom's bowel resection almost 3 years ago. He was a great guy and I liked him very much....and I trust him as opposed to a room full of residents who all wanted a shot at examining me while I was screaming in pain...anyway, I stray......So, I will have the surgeon I want, I will have lost weight because it is inevitible with the stoma and absolutely NO appetite. And I will be a non smoker, so this surgery will work in my favor.

Thank you all for your posts...they mean the world to me. This is hard, very hard, but I will make it through this.

Hugs, Sandy

[Jessica12974]

OMG! Wow! I am shocked and so sorry that this has happened to you! You are one strong lady! Take it easy! And feel better soon! Wishing you a very quick recovery!Hugs!!!:angel:

Jessica

[c2miracle]

:flower: Sandy, what a nightmare! You are a strong lady and I know will get thru this horrific situation. The one positive thing out of all of this is, your not smoking! That's great! Hang in there, and know you are loved by all of us IC sisters! :smile tee

[IC SARAH-CPP]

OMG Sandy, I am so happy you are okay. That is so scary. You are a very lucky woman indeed.

Now i have a few questions about the bowel movements. How backed up were you? Like you only went 1-2 times a week or less than that? And what med do you take for constipation. I use Miralax but sometimes even that does not work and I have a very hard time staying on top of this. I eat a lot of fruit and try to monitor it but I will admit, it has gotten scary a few times. I have really bad hemroids that are so painful and they make me not want to go but I get so worried b/c sometimes I only go 1 time a week and I usually went every single day.

What did you and your doctor work out for the future? What are you going to use to prevent this from happening again? Did he have any guidelines? Please inform us if you can, I know many of us suffer from this problem!

My friend eats Activia yogurt and she said it really helps her. Even enimas do not help me.

sarah

[A-Thompson]

Wow Thank you for shareing this information with all of us! I am sorry that you had to deal with this on top of IC. I also have cronic constipation. I have a thyroid andIron problem ontop of the pain meds. I just thought it was my lot in life to have Horriable BMs. I will start taking something to soften my stools. Quick question though.....what is a"normal" ammount of BMs in a week? God bless and I will be wishing you a healthy quick recovery!
Thanks again for informing us. and shareing a rough patch in your own life. I has certinaly helped me.

[ICNDonna]

The number and amount of bowel movements in a week can vary from person to person. It depends on what and how much is eaten, how much of what we eat is fiber, and other factors as well. Some people have a BM daily, others only every two or three days, and some as often as two or three times in a day.

Donna

[LolaDoggie]

After my open abdominal hystorectomy in December, I refused the stool softeners and laxatives they offered me in the hospital. I have always leaned towards irritable bowel and I thought it would be a bad idea to take them.
Nobody explained to me what surgery does, it stops you completely. So I ended up impacted. I had to clear the impaction myself or else I had to go to the hospital. So, I did it myself. There I was, hunched over my incision, clearing the blockage. I cried. I never cried all through my whole ob/gyn ordeal, but that blockage brought me to my knees.

Even if you lean towards irritable bowel, you have to take precautions if you're on pain killers that stop you up. Also keep a bowel movement log. If you haven't had a poop today...consider something gentle like senakot or a food you know gets you going.

[SandyRN]

I was just released from home health today. I have had a slight problem, that hopefully can be resolved when I have my reversal surgery....but I was having blood from my vagina. I had a TAH/BSO, so I have no cervix. I went to the GYN yesterday and he thinks I have a fistula from one surgical site to the other that may be leaking some blood thru my vagina. What fun. I'm starting to get around more...cooked dinner for the first time since the middle of April yesterday! Little things wear me out and I'm learning to live with the colostomy.

I am already planning my reversal and talked to the home health RN today who said that with the surgeon I want (the best) that I need to get in there ASAP to make an appt so they can get my records and do what they need to pre op. I can't have this done for another 5 months or so because the stressed bowel needs to rest and if done too soon it could fail, which I don't want. I don't want to live like this forever, but if this is the choice I have over the possibility I faced that day my bowel ruptured I'll take the bag if I have to!!

As far as a bowel program now, I am missing over a foot of intestine that I had before, so the route is shorter, plus I have the colostomy! I DO still get constipated though and need to take stool softeners and miralax as needed. I don't have it all figured out yet because my bowels are tricky right now....I may go normally for 5-6 days, every day!!! Then I get backed up for a day or so and have to take something for it. It's crazy and the home health RN told me today that by the time I get it all figured out I'll be back in surgery for the reversal.

I WILL say this...IF Enemas don't work, you NEED to see your doctor ASAP! This means there is nothing far enough down to move with an enema.....it gets DANGEROUS from here...this is where I was. I can't stress it enough. If you don't go a couple times a week (this is a rough estimate, you need to talk to your DOCTOR to find out what is right for you) you should talk to your doctor and plan a bowel program. Not just a random "take this if you need it" but a plan to live by daily. I wrote that I had a literal "brick" of backed up stool in my abdomen. I could have died....I almost DID die and I am very lucky to be here.

I'm not going to tell you what is right for you because everyone is different. If you can't go with an enema you might ask a doctor if a round of Go 'Lightly is needed, or some other bowel prep....then you know you WILL go and you WILL probably empty...just a thought and something to ask your doc.

I alternate between miralax and stool softeners now....after the surgery I will have to put me back together again, I have no idea what will be right for me, but I can promise you I will never, EVER let constipation get that bad again. If I have to drink a bowel prep once a week I will!!! I don't recommend what I went through to anyone! It's scary, and I'm still afraid everyday that I'll have complications in my incision or something.

Who'da thought constipation could do so much harm?

[SandyRN]

I'm STILL not smoking. I don't really even want one now. I think about one every now and again, but when you face the chance of death like I did I think something just "clicks"...at least it did with me and I just can't smoke and do that to my body when I was given a 2nd chance. I'm sad it took this to make me quit, but at least I did and am still successful!

[Katrina]

:grouphug: Feel free to contact me if you want to talk. I had my bag for a year. Definately sounds like this path hasn't been easy for you! I hope things are figured out and easier soon!

[BrittanysDance]

Sandy,

I'm SO glad you're okay... I've been there and although mine didnt rupture, I did have an obstruction and a preforation, and I too..waited.

You will be in my prayers my friend - speedy recovery and many blessings to you.

Love,
Brittany

[A-Thompson]

Thanks for the advice Donna and Sandy. I am so glad your doing better. Keep on trucking!
God bless.
A T.

[kiffy313]

Hi
Just wanted to say I hope things are going better for you! It is very scary to think what can happen from constipation problems...While I used to tend towards the IBS-D, since I have been on the pain meds, I try to be very careful to make sure I don't go too long without "going"...I would rather have the diarrhea than have an impaction...sad thing to have to choose between constipation or diarrhea, eh?...:toilet:. I even have a pretty embarrassing tale of having to pull off the road and "share" the restroom with the cattle...EEK!! Thankfully it was early in the morning, and dark...but it was also winter and sleeting...oh well, "gotta do what you gotta do". But the thought of a bowel impaction way over-rides my story...anyways, thanks for the info...
Take Care all,
Kif