HElp me please.

[kathyd]

Could someone answer this question for me pls. I NEED help badly!
I feel like a freak of nature...
I currently have a pain pump which continuously drips i opiate drug and bupivicane (at only moderate levels) into my system.
I was told when I first began taking opiate meds 3 years ago that I must always take a laxative with an opiate drug.
( At the time I took Amitiza, for an opiate -methadone in 2012. - that laxative worked great at first and then ---almost too much pooping --almost had an "accident" ..so eventually switched to the over the counter ones.

AsI said I am now on pain pump... these meds have not alleviated my pain... I can function but I do need to lie down a lot during the day.

Each night I have been taking a stimulant laxative to get things moving. For over a yearnow (at least) I have feel the sensation of incomplete emptying of my bowels) so I have 2 scenarios in my mind:
Either these laxatives are actually making the situation worse by making my body lose its ability to "get things started"

Or it's simply the anal spasm my PT has found ...that makes me "feel" terribly full bowelsless than 24 hours after I pooped like a horse (sorry for TMI). This is what is happening
today..this time yesterday I was empty..Now I feel stuffed with poop. how can that be? Ive only eaten 2 modreate meals since all that emptying...

I need to there for my family and can't be consumed with this bowel issue so much, but Im going out of my mind!
At LEAST every other day, somertimes more I feel like Im carrying a small football around in my anal canal.
Mu pain pump nurse and PT say my belly is soft and normal so they don't feel impaction etc.
Do I need to take a laxative at bedtime if I pooped a lot that day? I was originally told by a doc that if you have an opiate on board then you must a take laxative daily.
Was she wrong?
Everything I read online says to avoid laxatives.. By the way I all do the natural lifestyle change etc too, but am still trying to drink more... i am a small 115lb girl-- all this water I have to drink issickening at times. i also take colace stool softener but maybe not enough (about 100 mg or sometimes more daily.. however softeners don't cause peristalsis only make things softer. Walking for exercise is hard with this heaviness urge to poop feeling all the time.

My hubby just tells me to calm down as he cannot understand what he cant' feel. He cannot posssibly fathom the level of pain.

Could I be causing this myself by taking laxatives/ (stimulants like senna) I had been taking Dulcolax, but stopped a couple months ago. Now its mostly Senna and am trying other things. Most over the counter laxatives have been tried with these above results.
Pls help me.somebody.
I am deseperate! I don; know what to do....My doc and have I been playing phone tag this week and he is clear that does not want to be called on his cell phone... Great huh!
Please help me. I really need it!
Thank you!

[stephanies]

Kathy,

Are you sure the sensation means you actually need to go vs. it being an incorrect firing of the PN due to irritation or muscle spasm? I probably have mentioned other places that sometimes I get odd sensations, including rectal pressure, though it doesn't mean I need to go.

[Patty]

It thnk it is just the PN givng you that sensation. I feel like I have a basketball shoved up there on and off but if I have had a normal bowel movement recently I try as hard as it may be to ignore it. You don't need to have a bowel daily contrary to what people tell you.

[Violet M]

Do I need to take a laxative at bedtime if I pooped a lot that day? I was originally told by a doc that if you have an opiate on board then you must a take laxative daily.
Was she wrong?

Kathy, I don't know if it's the PN or if you are actually full but just from my own experience, I have to take a lot of magnesium daily or I get into trouble and I am not on opiates.

My doctor said I can take magnesium daily. I take 1000 mg of magnesium malate daily and some mag citrate. I know you can't take the citrate because of the bladder irritation but you could try mag malate and mag chelate. You can get magnesium toxicity but you would have to have bad kidneys or be taking a huge amount. http://ods.od.nih.gov/factsheets/Magnes ... fessional/

Have you tried miralax yet?

Violet

[kathyd]

Hi Ladies
Thx for all ur replies..
Violet I have been taking Magnesium Malate, but maybe not often enough. My brand has approx 460 mgs (not sure) and I take it once or twice daily as my meal schedule is a bit off ... I eat a late breakfast/ brunch ( as I sleep late and rest in bed in am awhile to stave off pain/pressure,, so Im prb'ly just eating "brunch" and dinner each day So thus a max of 2 magnesium daily -- sometimes I do forget to take it, so it could be just one dose, on some days.
What is the highest amt I could safely take? I'm thinking of adding magnesium chelate... if this worked it would be so much better than taking laxatives!
Stephanie and Patty, I agree with you that at times it must be just the sensation I that have to go when I really don't..
As mentioned, this Friday I had a very large BM (with use of my whole arsenal of laxative and magnesium etc).
But yesterday, (Saturday) I felt that large golf ball in anus/ rectum feeling again, less than 24 hours later.
This happened at least twice this week and has been happening a lot over the past few months according to the bowel and medicine journals I keep.
I hate this awful feeling.There are times I know I need to go... ( sometimes I can tell the difference) but if you recently "went" ..then it is the sensation I assume. How do we ignore this feeling? Its awful pressure!

My PT is smart and has been very helpful but has no thoughts on how to deal with this, other than its just another manifestation of my anal area being in spasm. I get very scared, ( I fear ending up in ER with impaction).. The thought of anyone having to manually touch my painful anal area freaks me out)
But fear is only tightening things more! ---adding to the problem.
My pain pump nurse feels my belly as does my Pt and assures me I'm not impacted, so they told me not to worry about that.
(I have read and am concerned that regular laxative use can affect the body's normal ability to "push things out" .
But I was told by doc andmy PT that this applies to other patients, and that taking a laxative is a must for opiate patients, due to the constipating effects of pain meds .
Am I over thinking this issue? (I have done too much research!)
It is very hard to ignore that backed up feeling, but we all have lives to lead, families to take care of etc, How do you ignore this painful feeling and live your life? Im hoping it will gradually just pass.
BTW , Violet I have tried Miralax--it worked well on Friday, but I doubled the dose and took it in the AM after taking my bedtime laxative the night before.
I have heard that if you take just Miralax alone, it may take a few days to work,, but after that then it is a good med for constipation. I had taken it in the past, but moved on to something else when the single dose didn' t work.
Doc has told me doubling or tripling the dose is safe also.
What do you guys think of all this?
Thx again so much for any thought and your support!!
Xo
Kathy

[stephanies]

I agree the pressure sensation is difficult to ignore. I don't have it all the time, but it is awful when
I do. I get some relief from the pressure when lying down, but I know that is hard to do when you have to make dinner, help with homework, etc. I wish I had an answer.

Stephanies

[kathyd]

Thank Stephanie!
I also get some relief lying down, thankfully. My PT said it's because our pelvic floors are not "engaged "and nothing is pulling on them.
But yep .as a Mom it's hard for the family to understand this stuff, and we have much to accomplish daily. At the moment they are waiting for me to go out to dinner,and Im waiting for stomach to calm down!

Last Night I tried the max dose of Milk of Magnesia, and when I got up for breakfast drank a double dose of Miralax, and took a Magnesium tablet just to be sure. Yikes ..overdid it , but that back-up feeling makes me desperate to get things out.
So I' ve been "running" all day. (feast or famine! ) Ironically this could all be from anal spasm and not true constipation. But if you take an opiate you know that constipation will happen without preventive measures.
It would be so great to find a good med that would do the job and be done for the day!
My friend gave men the name of a gastro doc she likes ...hope to get in to see him soon and that he can help.

One question to anyone who reads this:
If you have had "the runs" all day from a laxative, what do you take that at bedtime that night to prevent constipation the next day..You are essentially empty, but (as a patient who takes opiate pain medicine, you know that back-up will start again soon.

I have a opiate and bupivicane (which I would think could slow bowel emptying) --dripping in constantly from my pain pain so I have to be proactive, but I would love a break from the laxatives! Does anyone else have a pain pump.? I cannot even go up to a therapeutic dose due to this bowel issue.
How do you prevent constipation?
Thx Stephanie and everyone!
Have a good evening.

[Violet M]

Kathy, I can't say what is the right dose for you. With miralax, some doctors recommend keeping your stool the consistency of applesauce. I have done that myself with magnesium and it works better than getting backed up and then swinging back and forth between constipation and diarrhea. I have figured out what dose works best for me but I don't know what would work best for you. If your kidneys are compromised then you would definitely need to proceed with caution.

Violet

[kathyd]

Thx Violet.
Im wishing that maybe taking the magnesium malate supplement woud be enough for tonight? But I hear they need to be taken with meals for proper absorbtion
I was still " running" to the bathroom earlier today (Thursday) from Tuesday night's 4 oz dosage of Milk of Magn. No cramps, just constant pooping, small amts all day! I has to stop in the store bathrooms as well!
Today it seemed to have calmed down, so for maintenance (due to my opiate pain pump) I took a magnesium pill with dinner...Boom, I was in back the bathroom within minutes! But it then I felt done... I guess!

For anyone who needs help it seems the Milk of magnesia laxative works -(once it gets into your system,)
but itjust keeps on working in my caseI Ive read reviews online and some folks had a similar experience.
It may take a while,but as my story shows, once it starts working it takes awhile to stop! Now I feel de-hydrated...Imagine all the water that was lost. But with each sip I got more "runs" etc. So I must take a break from it,for a little while.

I forget if mentioned but I also take Movantik ( a new drug that I hope will be very helpful for those of us who take opiates. This drug is supposed to prevent opiate constipation. You take it in the AM and eat an hour later No laxatives are allowed.
Then if after 3 days or so you find you are still not getting optimal "results" , you are allowed to add in a laxative. I had luck with it for about 5 days ,then not as well,and started adding in a laxative.. eventually switching from stimulants to the safer old standard Milk of Magn.
The combo of my Movantik may be why it worked like a 'bomb', once my system got used to it!

Just for tonight I may try Miralax (maybe a dose and a half or less ?) with water? Does that make sense?. I don't want to be taking laxatives.
But theres' nothing worse than opiate constipation.. and you must prevent before "build up. What do you think Violet, .As a nurse?
I know its hard to say.

Hoping to see a GI doc who will help, but it's a crap shoot ..the best one in our area is booked out for awhile and some others in his group got some negative reviews online.
My son -- age 23 has constipation and upset stomach issues too,so praying for a good GI doc.

I live in North Cental NJ... about 20 minutes from Newark, and on the Morristown border.If anyone lives fairly near here and has a GI doc they like,, could you please post? That would be great.Must stay fairly local for now, if possible.
Violet thx again. and by the way, thx for the warning about kidney issues ..to my knowledge, Im okay there.
Have a good night!

[Violet M]

What do you think Violet, .As a nurse?

OK, at this point I figure anyone who is sick of reading about constipation and BM's has probably tuned out, so with the intent of providing information I will just be forthright.

Keeping your stool the consistency of applesauce is something that a physician wrote as a recommendation to one of my patients who was prone to constipation. (Not the consistency of peanut butter but applesauce.) I decided to try it myself and it has definitely improved my quality of life. But I'm not really speaking as a nurse on this topic because most of what I've learned has been through experience or from my oriental medicine doctor who recommended magnesium, and my GP (who said it's OK to use magnesium long term). I do a bunch of other things like exercise regularly, drink lots of water, eat a plant based diet, eat flax seed, etc. but those are not enough for me. Magnesium is not a perfect solution and there are cautions associated with it but it's the best solution I've found....for maybe 8 years now. That's my story and I'm sticking to it.

Good luck, Kathy.

Violet