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Posts Tagged ‘enema’

This second post concludes that posted on January 9th [link]. WARNING – this post is much longer!

Following my consultation I began the usual wait for things to happen at my local healthcare authority. During the waiting time, Nexium seemed to have worked, lower-bowel discomfort was reduced and I’d begun to forget all about the procedure discussed. Then just before Christmas (which I survived without any digestive distress) the appointment dropped on the mat for January 6th 2011.

The preparation
Instructions provided by the hospital are full and sufficient. They required me to eat a particular diet on day one, a mainly liquid diet on day two and to undertake the procedure on day three. The instructions comprehensively explain how the procedure will work and what to expect before, during and after the x-ray. So a rare well done to Calderdale and Huddersfield NHS Healthcare Trust.

Basically, the bowel has to be as clean as possible for the procedure to work. For whatever reason, I had to have 2 slices of white bread toast for breakfast ‘with a scrape of butter’ on both days one and two. I could have had egg instead, but the toast wasn’t far off of my normal routine. However, I usually have a dark, rich artisan-baked bread – and rarely eat the sticks-to-the-roof-of-your-mouth soft and pappy stuff.

Day one
For lunch on day one I could have any lean meat and mashed potatoes (there was a slightly wider choice, but given the fact the my evening meal could only be a lean meat, white pappy bread sandwich I opted to pop out to the local butcher and buy some calves’ liver). As I was forbidden to drink anything other than ‘clear’ drinks now, I had a cup of oxo with my dinner, which also became the gravy for my calves’ liver and mashed potatoes. Actually? Lovely!

The clear drinks included orange juice without bits, tea without milk – although ‘a dash of milk’ was allowed with breakfast on days one and two; marmite, oxo, Bovril or water. I also had to drink approximately half a pint (250ml) of such liquid every hour. EVERY HOUR! I know that we should all drink about 2ltrs of water per day but who does that? Who can? Most of my daily liquid intake is tea and I couldn’t drink much of that as I like milk in my tea (I did get a taste for Rooibos with honey though). So the odd cup of oxo and Rooibos had to suffice as hot drinks.

Coffee might also have been on the list but as coffee is a major contributor to Gastro-oesophageal reflux disease (GORD), I thought it best to avoid. I do enjoy coffee though and am usually prepared to put up with any resulting discomfort provided it’s a good brew – see: http://eduvel.wordpress.com/2010/06/04/good-coffee/. But not at this time.

The sheer quantity of liquid I had to drink affected my voice for a few days and although my throat wasn’t sore, it was distinctly ‘unusual’. However, I dared not drink less than advised, as I knew what was to come on day two.

Day two
On day two there are two very important drinks to have: the first at 8.00am and the second at 2.00pm. The packet says that the drinks are ‘powerful laxatives’ and well, they are POWERFUL LAXATIVES! By now the reduced diet on day one and liquid-only diet of day two made so much sense. The frequency of toilet visits was not unlike having severe bouts of diarrhea but without the pain and discomfort. Also, because this was enforced evacuation, rather than the result of any illness, my urinary system continued to work too. So although I’d dreaded this middle day, it wasn’t half as bad as I’d imagined. By bedtime I felt that I had enough control of my bodily functions to sleep soundly – which I did.

Day three
Come the day, I had what I could manage of drinks and still contrived to be the first in line at the hospital’s x-ray department. I changed into a hospital gown and was taken into the x-ray room. Here, I met three people. The lady in charge, a young male radiographer and a young female nurse training I think to be a radiographer. They were as polite and respectful as you would hope to expect when faced with a patient about to undergo a series of indignities.

The first indignity is the gown itself. I know why there’s no backside in it, but it doesn’t help you to stand up straight and proud.

The next indignity comes when the senior radiographer (the lady in charge – SR) asks the others, just after you have laid on the x-ray bed and bared your backside “has anyone seen the KY Jelly?” (That made me giggle). The whole procedure was actually made more relaxing by SR’s comments: “I’m just going to apply a little gel, it might be cold” and “I’m just going to insert the tube, it might be a little uncomfortable” etc. In fact none of that was too traumatic at all, certainly much easier than a doctor’s probings! Neither was it uncomfortable as the liquid was run into my bowel. At each stage, I was told what was going to happen and what it might feel like. So far, nothing was disturbing at all.

She then said that she would start to add the air and that this “might give me tummy ache, but it was unavoidable and it wouldn’t last long” – which was reassuring. The first injections of air were no trouble at all but as the procedure went along it did get a little uncomfortable. Despite having a tube up my bum (“I’m just going to tape this in place”) I was asked to turn this way and that for about ten to fifteen minutes as SR took the various x-rays of my bowel. At one point, the table I was laid on was tilted upright and I was hanging on to the bed in much the same way as I used to hang on to roller coaster cars! At each turn more air is pumped in and only when I thought that I couldn’t possibly take any more did the procedure finish. The most uncomfortable time on the table was at that point, as the procedure finished – because of the amount of air that I was holding inside me.

Nevertheless, nothing had been half as bad as I had thought it might be.

I was escorted out of the room now for the final indignity of being shown to the toilet and being told to spend 5-10 minutes getting rid of as much liquid and air as I could. The first flush (sorry – not intended as a pun) is a big one, but there is still plenty of barium liquid and air trapped around folds and bends of the bowel. As the bowel wall begins to work again (I had been given an injection of Buscopan – http://www.patient.co.uk/medicine/Hyoscine-butylbromide.htm – to relax the bowel wall as the air was added to it) the air’s journey is inexorable as it attempts to find a way out. This led to the only real discomfort I experienced during the entire day.

I was now allowed to eat and drink normally, so my starved stomach was able to pass the omelette through to my small intestine pretty quickly. I left the hospital about 11.20am and by 2.00pm I was in agony. The air was now being compressed between my lunchtime food as peristalsis pushed it down into the bends and folds which were preventing any urgent or worthwhile exit strategy (although there were one or two occasions). Basically, I had to go to bed and lie down for almost four hours to allow the discomfort (gurgling etc.) to pass. And it did pass. By 6.00pm I was fine – and have been since.

So that’s it. Don’t worry about the procedure, lie back and think of England – but don’t plan on going back to work afterwards, you’ll need to relax your tummy! 🙂

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I’ve written this post in the hope that its content can help others. This piece and the next (part 2) refer to my personal experience of the title procedure. Anyone not interested in understanding the process should back off now. It is fairly graphic (in as polite a way as the subject allows)!

First of all, this was not an urgent or emergency procedure for me.

Background
Once you get past fifty, your body begins to play tricks on you. Bits you’ve always sworn by, relied upon and learned to trust, begin to let you down. It’s a very slow process, which even though expected (and remorseless) tends to creep up on you. It could start with your eyesight – just small changes reported at each visit to the optician or it could be your memory. You don’t worry too much about this because your friends and peers say that they are just the same: Things like ‘I’d forget my own head if it wasn’t screwed on’! But these things don’t come in series, the come in parallel (old school physics!).

I still consider myself to be reasonably fit, maybe not as fit as some contemporaries, but far fitter than many others. Nevertheless, one of the things to change over time has been the way in which my digestive system has worked. Whereas at one time I could and would eat anything, I now have to be quite careful about many foodstuffs. For example, raw onions at an Indian restaurant used to be a delight, as were the many curry flavours – but now raw onions are ‘out’ along with all take-aways and most Indian restaurants. Some restaurants seem to be ok and all home-cooked curries are ok but there has to be a little thought about what I eat these days.

The problem
It seems that I’ve suffered from acid reflux for a number of years. Initially, I’d thought it was a persistent sore throat and I have had all the tests (just the beginning of a long series of indignities that await folks who have gone fifty). But I’d resisted that label because my symptoms didn’t fit the norm. Basic Message here: beware of ‘the norm’. The doctor eventually put me on Lansoprazole http://en.wikipedia.org/wiki/Lansoprazole and told me I’d have to take those for the rest of my life. I’ve therefore tried hard to find ways NOT to take those for the rest of my life! As time went by I began to develop what I thought was IBS (Irritable Bowel Syndrome – http://en.wikipedia.org/wiki/Irritable_bowel_syndrome) – this remains unconfirmed, currently. I eventually visited a (second) consultant who suggested that I was both blessed and beggared. Blessed, because I understood the workings of my body (I’d enjoyed all of my school biology lessons and taught Digestion for many years) and beggared because I was more aware of my body than most. He also said that the Lansoprazole could be partly responsible for the discomfort and therefore prescribed Nexium http://en.wikipedia.org/wiki/Esomeprazole.

After a long consultation he suggested that there was noting seriously wrong with me but if he were to offer more in-depth investigation of either the top half of my digestive system or the bottom (pun not intended) – which would I have. I elected to have further investigation of my bowel for two reasons: 1) it was a relatively new complaint for me and 2) everyone over fifty should have their colon inspected as a preventative measure. I’d previously avoided it and decided now to take up the offer.

The next post will look at the procedure itself.

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