Health Organization for Pudendal Education

Hi Kathi
I sent you an email.

Blossum

Hi Blossum
I got it...
I'll respond on my Iphone... my computer is down so I borrowed my daughters but don't know how to access email on her computer..so Ill write you back from my my Iphone..
But just wanted to let you know I so understand how you feel!
Hugs..
Kathy

Hi Blossun
Found ur post!
You suggested a combo of senna and colace which here in the US, is a called Peri -colace ...a stool softener with a softener.
theres also a generic store brand sold at the pharmacy..etc.
Its a bit less strong than Dulcolax so haven't gone back to it yet.
Had used it in the past before these issues were as bad over a year ago and it worked etc.
Maybe I need to switch off the Dulcolax to "trick' my system?/
so afraid of this back-up feeling again the rectal pain,,which it sounds like you understand!
PT says its my muscles fooling me into 'feeling the pressure'...most folks can walk around with stool in rectum, and the stool comes out when ready. The person doesn't notice. With pain like ours we are aware of the pressure of the stool.
Yesterday I was able to get some out, but had to push hard ... it was almost impossible to get any out ...tho its all soft. yucky experience sorry for TMI!
Thx!
Kathy

kathyd wrote:Hi Everyone
Does anyone here live in NJ or even In the NYC Metro area, and know of a decent gastro-enterologist?
I continue to feel constipated regularly from my pain suppss and my pump meds...

The gastro doc I saw put me on a program during the winter which required a lot of senna plus a laxative supp daily.
This worked for awhile but my pain doc didn't like the idea of s stimulant laxative suppository put in area of my Nerve pain daily (anus). I agreed.

So I stopped it
But lately the feeling of painful rectal pressure ...as if I l always need to go , comes daily...before my bowels are ready to empty. It hurts and I feel like I must go now..
I still have usual rectal pan and IC bladder issues as the pump med combo is not right...Im with a new doc for a couple months but he's taking things very slowly, and not making major changes yet. Most Docs are new to managing pumps for PN.
I do "go" at least every other day,and have soft stools. I am not bloated etc. Just that awful feeling.

No on gets it My infusion nurse just suggests another gastro docs..Hubby looks at me like Im from Mars...or "What next"? (sick of the $$ spent on useless
specialists. This is so hard. God I want my normal life back!
Please help!

Any docs names or other suggestions would be appreciated!
Thx!
Kathy

Dr ann Swedland in Princeton nj is fantastic. Before I moved to NC I used her.

To Sic
Thx very much for the reference!
Did Dr Swedland helped u prevent/control constipation from the pain meds taken for pelvic pain issues?
Just confirming as I've seen a few gastro docs who did not understand that constipation for pelvic pain patients is extra complicated as it tightens things--irritates muscles nerves, etc.and is very painful etc.
Their advice was wrong, and given without consideration to my pain condition. so just being extra careful!
Thx, again, just checking.
Kathy

Hi Everyone,
Just checking in. Hope all are doing well.
I was -re-reading all your suggestions for the 'constipation' feeing I get almost daily.
Thx for all the ideas folks.. I have tried various things out but am still struggling.. I will explain what Ive tried in another email as soon as I can.

As mentioned,my feeling of urge to poop is from anal/rectal spasms found by my PT, I've been seeing her since December
Also the opiates in pain pump are Im sure causing some real constipation, tho I am vigilant with laxatives. supplements, and now even prune juice daily.
I go almost daily, but instead of just one normal BM daily,it's several visits all day with limited output and a feeling of stool stuck there..
So sorry for the TMI! I occasionally have to use laxative suppositories which usually work if Ive taken enough laxative the night before
Based on what I've learned from the Pt the anal spasm is causing both the 'feeling', and maybe even not allowing the stool to release all at once due to the muscles.

My Pt seems very knowledgeable --best Ive had in years,,
butI want to ensure she is all is doing all that is necessary to help, as time is going by..
She does external massage first on my abdomen for awhile, then goes intern ally and works on the parts of the anal area,,( the external sphincter,the gutter and the internal)..she usually finds lots of trigger pts there. which feel like sharp "fingernails when she touches.. tho she of course. does not have long nails.
This week she couldn't find trigger pts in that anal area.but instead some in the vaginal area. - I felt the "sharp" feeling there this time.
Regardless of the PT work, my anal pain, ( severe throbbing- unable to sit, and bowel issues described above continue..I also can't stand in place for long without pain but can walk ok.. I know it takes awhile.
Is there anything she isn't doing that we should try? Is there anything I myself can be doing at home?
She doesn't do biofeedback...she does not believe in it in my case, as her hands (her best tool!) we can obviously tell how tight I am..
I can vouch for that. I ve had it with other PTs ---- for me it was just a measure of how tight the muscles were.
Also what about trigger pt injections? I don't think she does those either, as I see no evidence of needles, nor does she speak of it. It seems that various PTs have different schools of thought as to what helps.
I will say that about a month ago i felt a small bit of progress ..she agreed!
and then a slight medicine change in my pain pump meds set me back again....
I tend to get very nervous whenever the meds are adjusted so the pain spike could have been caused by that,,,knowing how my brain works..
Thanks for any info as always!
Have a good weekend everyone.
I had one question but will write later..
Thx so much for being there!
Kathy

Hi Kathy,

Glad to hear you have found a PT you like. I hope over time the therapy will help your pain to ease off. I'm sure it must be hard to be patient. If you can achieve relief without trigger point injections that would be great. No need to add that extra risk of something more invasive, right?

Take care,

Violet

Thanks so much Violet!
i have been staying off the boards for a long time and just saw ur post.
Thankfully my Pt does seem to know her stuff. For Every question I ask she has an intelligent and educated answer...Some PTs in the past would go right to work on me, but never explained why ,or the causes of the pain..this one seems to be so much better. God-willing!
She is not a big believer in trigger pt injections..
As you said, I agree , why take that extra risk ...I have done too many invasive treatments, in the past.
Thx for checking in!
Kathy