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Constipation after first mvac infusion

10 months 2 weeks ago #56661 by mjhs70
Jack,

Thanks for the additional info. The nurse mentioned Milk of Magnesia if I thought it was needed to more urgently clear things out but there is no specific plan, at least not yet. I hope to have a more detailed discussion at my next visit.

Wish you the best.

Regards,
Mike

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10 months 3 weeks ago #56658 by Jack R
Mike,

All of us are different and have to figure out what works for us. Prior to chemo I did not have a recurrent constipation problem, so going on the prescribed plan to avoid problems was new to me.

The first drug was the stool softener, along with fruit, fiber and lots of liquid - Goal to keep everything soft and "flowing".

If the softener did not produce, senokot (no added softener) was added. Keeping soft was a separate duty from producing a BM in the plan I was given.

My next step up was milk of magnesia if needed. MiraLax was the plan drug to follow senokot, but it was ruled out because of my kidney issues - only one and it is in remission for renal cancer.

It seemed that my constipation was most helped when the amount of softener was increased. I let the team figure out what I should use, in what quantities and when. Fortunately, they got me through it.

I hope your care team can offer more assistance.

Best
Jack

What's with this Bleeding ? 6/2015
DX: HG Papillary & CIS
3 Years and 30 BCG/BCG+Inf
Tis CIS comes back.
BC clear as of 5/17 !
RCC found in my one & only kidney 10/17
Begin Chemo; Cisplatin and Gemzar
8/18 begin Chemo# 3
Begin year 4 with cis
2/19 Chemo #4
9/19 NED again :)
Until next scope :) :)

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10 months 3 weeks ago #56657 by mjhs70
I appreciate your very informative reply. I am going to follow your example about keeping a better record of input and output. I do exercise some every day, mostly walking.

I have had chronic constipation over the years so this is making it a real challenge since the same meds haven't worked for this. I'll have to experiment some to get the right dosages. Senokot s contains both a laxative (sennoside) and softener (ducosate). I'll see how well it works. Do you mind telling me which laxative you have found works best for you?

Will start increasing the number of 'meals' a day but with much smaller portions. Also going to talk with the nutrition experts at the facility next week.

That is good if you get a response within a couple of hours, I usually don't get one before the next day unless I make it an urgent call.

Thanks again for sharing your experience.

Regards,
Mike

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10 months 3 weeks ago #56647 by Jack R
mjhs70

First, don't take anyone's word for a what to do without running it past your care team. Hopefully you have a number to call for support and get a reply with in a couple of hours.

From my regimen, you are missing the stool softener - ask about Colace - docusate.
Also missing is exercise - walk to encourage the bowels.

The hard lesson for me was learning to stay ahead of the constipation by taking the recommended drugs regularly, as recommended, and reporting any problems right away - before anything becomes an emergency.

I had a calendar to record BMs - date and time. At 48 hours without a movement, I was to call in for advice, and would be recommended to add additional of something or another. At 72 hours, it was time for an urgent visit.

Eventually, they had me on the boarder line of diarrhea. That was when it was time to back down a bit.

Hopefully, once the bowels start cooperating you can (if approved) move to a high fiber or other diet and get some weight back.

My biggest help was to record meds, food, liquid, activity and all problems on the calendar. That way I could call for advice with specifics and I could see what worked. Get all the help you need from your care team - they know this stuff.

Best,
Jack

What's with this Bleeding ? 6/2015
DX: HG Papillary & CIS
3 Years and 30 BCG/BCG+Inf
Tis CIS comes back.
BC clear as of 5/17 !
RCC found in my one & only kidney 10/17
Begin Chemo; Cisplatin and Gemzar
8/18 begin Chemo# 3
Begin year 4 with cis
2/19 Chemo #4
9/19 NED again :)
Until next scope :) :)

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10 months 3 weeks ago #56642 by mjhs70
Within one week I am getting hit with severe constipation and fatigue. Have been drinking tons of fluids, warm fruit juices, eating fruit and vegs, trying Miralax, Senokot s, Dulcolax without consistent success. My appetite is waning and I have lost a few pounds already.

Any suggestions on what might work?

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