constipation and buzzards flying over

Well, the nurse told her to take the lactulose every hour. Does this sound right? If that doesn't work, she said she would try something else. This was this morning and so far nothing. I guess my question is, while we are trying all this stuff, it is just getting worse. Do we just wait until it gets unbearable before we go to the doc or ER? Mama is drinking plenty of liquids (that hasn't been a problem). Problem is, she drinks so much and then her sodium goes low! Geeeez! We can't seem to win here. Thanks for all the advice. Keep it coming!

constipation and fecal impaction not the same thing. My father had fecal impaction twice and was hospitalized and it had to be manually removed.
www.articleclick.com/Article/Fecal-Impaction-vs--Constipation/280
Pat

My 82-year-old father has been battling constipation for years but seems to be having a particularly tough time since his R/C. He has tried various combinations of things such as senna and softener, milk of magnesia and mineral oil, Glycolax and fiber but still recently ended up in the ER with impacted bowels. He was in so much pain with this and the CT scan showed a mass of feces the size of a grapefruit!

A week or so ago, he went to a gastroenterologist who put him on that magnesium citrate stuff they use to clean you out before a colonoscopy AND 3 Dulcolax at the same time. This didn't even work! Then he prescribed this new drug called Amitiza. No luck there either. Now he is on Lactulose (generic) with the instructions to "take it until it works". I think he has had results one time so far. He drinks tons of liquids (water, gatorade, cranberry juice) and is not taking any pain meds. I was reading about Lactulose and the article said not to take it for more than one week. My understanding is that he is to take this on a long-term basis. I guess it doesn't help that he doesn't eat the best diet. We're from Texas and love the fried foods.

I think that peristolosis slows down as you age and the muscle contractions aren't as strong so the waste doesn't move through your system as quickly (or at all.) I hope your Mom and my Dad can find something that works for them as this is a painful problem.

Julieanne,

They didn't want Angelo to go more than 3 days without a BM. I don't know if this is different for everyone, but the nurse should be keeping track. If she is still eating she obviously needs to get rid of the waste. The problem with narcotics is that they need as much liquid as they can get to be effective. If they don't get it from added water to the diet, they will literally suck all moisture it needs out of the body, hence very hard stools, and without any moisture are very hard to pass (constipation). If she feels like she needs to go but can't that is a warning sign to either try the lactulose or enema. Once it gets to that point, the senna and stool softners are of little help because they are designed to help to softnen stool as it is formed not after. The bowels will start slowing and eventually shutting down, as she eats less and less. But fluids are still very important.

There is a SQ (sub qutanious) pump available that we found very helpful. It gives the medicine 2 ways...There is a basal rate which is a set amount of medicine that the patient gets every hour. and there is an option to get a Bolus rate for those times when they need a bit more they (or you)can press a button and get it.

It comes with a fanny pack which makes travelling alot easier, and the ups and downs of pain control are a thing of the past.

Here for you,
Karen

Hi, Julie....Doran is having the loose stool problem, too, but at least I've gotten him on the commode in time so far. Haven't had a full night's sleep yet, but I can dream.

Good luck with your mom, Julieanne. Getting the right combo is hard.

Stephany in Iowa

Thanks Stephany and Julie. When I was at Mama's earlier, I checked her medicine and it is Lactulose. It isn't helping. We will speak with the nurse in the morning. Mama is definitely not feeling well today. The constipation is getting the best of her. She said she isn't sure if the pain meds are worth it. I may mention the patch to the nurse and see what she says.