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    #1

    changing bowel routine

    I have been doing dig stimulation for 14 years.... The past year I can not get it right, I am almost scared to leave the house out of fear of having accidents! I have been doing dig stimulation everytime I catheterize which is 3 to 4 times a day.... From reading some posts on hear this is doing me no good!!! I am wondering how I go about training my bowels to go everyday in the morning or something? Any help would be so apreciated
    thanks
    Tags: None
    #2
    Originally posted by kloe82 View Post
    I have been doing dig stimulation for 14 years.... The past year I can not get it right, I am almost scared to leave the house out of fear of having accidents! I have been doing dig stimulation everytime I catheterize which is 3 to 4 times a day.... From reading some posts on hear this is doing me no good!!! I am wondering how I go about training my bowels to go everyday in the morning or something? Any help would be so apreciated
    thanks
    just don't dig the rest of today, do it first thing in the am
    then only first thing in the am from now on

    if you have a accident, clean it up, then dig the next morning again
    We must reject the idea that every time a law's broken, society is guilty rather than the lawbreaker. It is time to restore the American precept that each individual is accountable for his actions.
    Ronald Reagan

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      #3
      The more that you do the dig stim, the more your bowel is stimulated. That means that you will go more-

      To get into a pattern, do the pattern the way that you want it to turn out. FOr example, if you want a morning program, then do it everyday in the morning around the same time. Only do it then. Make sure that any medications, food and fluids are about the same. For example, if you are taking Colace three times a day, take thme around the same time for each dose. Make sure that your meal times stay about the same and the same for the amount of fluids that you drink.

      If you have an accident, clean it up, make sure that your rectum is empty by inserting your finger and seeing if you can feel anything. If you can't let it be - if you can, do enough dig stim to get that out - but don't redo your bowel program.

      It might help for you to keep a diary of what exactly you are doing. You might be able to see if a certain food sets off an accident.

      If you ahve other questions- let us know.

      CKF
      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

      Comment

        #4
        kloe, sorry you're having problems.

        To start "training" your bowels to a more regular schedule, try this.

        Pick the time of day that best fits your schedule. Be sure you allow at least an hour for emptying your bowels -- you may need more time or less, but an hour seems to be about average and is a good place to start.

        Eat a meal 30 minutes to an hour before you try to empty your bowels. This helps increases peristalsis, the muscular contractions that help move stool through your body.

        Drink a hot beverage before, or even during, your bowel care. Like having a meal, the hot liquids help stimulate activity.

        Do dig stim every 10-15 minutes -- repeat up to four times total.

        Don't rush -- allow yourself plenty of time so you can be sure you've emptied out as completely as possible.

        Because you likely have a flaccid/lower motor neuron bowel, you may need to empty your bowels twice a day, and could need to rely more on manual evac than people with higher level SC damage.

        Here's some detailed info on bowel programs that may be helpful to you. Hopefully you'll be able to find a routine that works for you.
        It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.

        ~Julius Caesar

        Comment

          #5
          Thank you very much for your replies! I need to make some adjustments on my routine and I definately need to give myself more time! I am going to keep a little journal until I get it all under control......
          And for medication, I just went out and got myself some cranberry pills and some vitamin c maybe I can give my immune system a bit of a boost as well...... I used to take sulfur pills everyday, until my kidney stopped functioning and I had it removed, I stopped taking the antibiotics and hope that the cranberry will help do the trick!

          Comment

            #6
            high vit c can act as a laxative, so be careful, and cranberry juice or any acidic juice can irritate the bladder sphincter , like coffee does.little things that can add to the confusion
            cauda equina

            Comment

              #7
              Digi-stim bowel care

              A head nurse in my community assistance program recently told me that their policy prohibits caregivers from doing digi-stim because there is a large nerve that could be ruptured even causing death.

              I have had 6-7 SCI for 25 years and never was told that was true. I've had numerous attendants thru the years without incident. Many times pain pills have hardened the stools, or skipping a day makes a lot to collect. I have eliminated those problems for the most part, and have been having it done every morning. I would hate to have to change to a suppository because I stay in bed to do bowel care. The stuff then leaks out later in my jeans.

              It seems a few years back such nonsense was resolved in Texas by a statement that a CBA nurse could delegate this task to attendants, but I'm still looking for that in print.

              Has anyone heard that argument?

              Comment

                #8
                I read from other website that frequent use of ducolax suppository can lead to reliance on it. Is this true? I have been using it 6 years every other day.

                Comment

                  #9
                  Dig stim needs to be done carefully, but I am not sure how doing it correctly would lead to death unless you cause ad by doing it. Yes, there are nerves in the anal canal - they are what helps the rectum to open and close. The only thing I can think of that she might be talking about is a vagal response. Thia can come from pushing down to hard and causing your heart to skip some beats. But dig stim doesn't usually go in the area where this can happen. Maybe one of the other nurses has heard of something that I don't know about.

                  It is not uncommon for caregivers to not be able to do bowel programs, because the suppositories that are used are medication. In PA, only licensed personnel can do BP's because of that.

                  Using suppositories can lead to your bowel becoming dependent on them. The longer you use them, the more likely that this is the stimulation that your bowel will need to get going. That is why we try to wean people off of them. However, if that is what it takes to keep the bowel program working, it is not the worst thing in the world. You might want to try weaning yourself off of them by first cutting them in half and then going to no suppository - just the dig stim. Give your bowel time to adjust.....
                  before you go changing to nothing.

                  Make sure that you keep the rest of your routine the way that you had it . It is important that you only change one thing at a time.
                  CKF
                  The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                  Comment

                    #10
                    Thank you for the info. I quit trying suppositories many years ago, as it would cause accidents hours after in my jeans and would smell all up to when my eve attendant would arrive. Digi-stim only takes two minutes on me and that's it, never any bleeding nor disreflexia reaction. The agency is calling it a skilled nurse task, yet no nurse would come out every day just for that.

                    The only thing I can think of is to try to get a Dr. prescription for daily digi-stim that always works for me and take it to the agency.

                    Thanks for any further ideas.

                    BTW, I learned that taking a chlorophyll capsule daily takes the smell away.

                    Comment

                      #11
                      Originally posted by XAviatrix View Post
                      A head nurse in my community assistance program recently told me that their policy prohibits caregivers from doing digi-stim because there is a large nerve that could be ruptured even causing death.

                      It seems a few years back such nonsense was resolved in Texas by a statement that a CBA nurse could delegate this task to attendants, but I'm still looking for that in print.

                      Has anyone heard that argument?
                      This is totally bogus. If you have a complete SCI, you cannot get vagal nerve stimulation from bowel care. The vagus does not innervate the distal bowel (rectum) at all, and you would have to have an intact spinal cord for sensory information from dig stim to go up your cord to your brain to cause the vagus to slow your heart. The vagus is a cranial nerve.

                      I would strongly recommend that you download the clinical practice guidelines (both consumer and professional) on SCI bowel management which you can find here, and give this to the director of nurses at this agency. They are uninformed and providing you below the standard of care for SCI bowel management. Change agencies if you need to, but stand firm on doing your bowel care the way that works for you, not according to some unscientific and non-evidence based method that they are pushing onto you. Get your physician to write an order for them to do it with the digital stimulation for good measure.

                      http://www.pva.org/site/PageServer?pagename=pubs_main

                      (KLD)
                      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                      Comment

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