Started trying independent bowel program but..

[underthesun]

So after 16 years post-injury, I've decided to try my hand at becoming independent with my bowel program as a c6/c7 complete quadriplegic. I never knew if was possible until I came here and found others with the same level of injury having bowel programs with little to no assistance.

Today, I got my start but can already see that this is going to be a tough one. I have a few questions:

1) Can the bowel program be done independently lying on one's side (as opposed to transferring to the commode)? Based on what I've read, everybody gets into the commode after inserting the suppository but are there any who stay lying on their side?

2) I am having trouble getting the inserter in...as hard as I push, it barely budges. Is there a trick to applying the right pressure? Also, should KY jelly be applied the digital stimulator?

3) I've got a long handle mirror and it certainly helps but it isn't getting the job done. What's the longest these mirrors come in and where can I get one?

Thanks in advance.

[Stormycoon]

well gravity helps so sittin n twistin err in would work better..

[underthesun]

well gravity helps so sittin n twistin err in would work better..

You're right..I should have explained better. I need to know if the bowel program can be done just on the bed (whether lying down or sitting).

I've always had trouble transferring into/out of a commode....there's just not enough for me to grab on to or push off of without keeling over. Not to mention, I literally get stuck in the opening.

[wtf]

You're right..I should have explained better. I need to know if the bowel program can be done just on the bed (whether lying down or sitting).

I've always had trouble transferring into/out of a commode....there's just not enough for me to grab on to or push off of without keeling over. Not to mention, I literally get stuck in the opening.

I know people who do their bp in bed, but I think it takes a little longer. I prefer getting up, because I think I empty better that way. If you have feeling you may not need the mirror, because you'll know when your in the area. I can feel when I have my homemade suppository inserter in my butt. I'm a quad too and do my bp independantly. Keep trying, it doesn't happen the first time, it takes practice.

[dnvrdave]

I haven't tried insertion, but have you considered using a hoyer lift or ceiling lift to transfer. I know one C5 quad who goes to bed and gets up that way himself.

I'm C5/6 complete and use a sliding board to go to bed myself. But I get help for getting up and for bowel care.

To the point... I want to try a ceiling lift myself to do the bowel program at night on my own. I don't use suppositories or anything, so I only need to figure out the transfer (to/from a commode chair) and wiping. I'm pretty sure I could do it. My next step is to try someone else's lift before I buy my own.

So if you don't figure out the insertion, maybe you can figure out how to go without, as I did.

Good luck! We can learn a lot from each other.

[underthesun]

I know people who do their bp in bed, but I think it takes a little longer. I prefer getting up, because I think I empty better that way. If you have feeling you may not need the mirror, because you'll know when your in the area. I can feel when I have my homemade suppository inserter in my butt. I'm a quad too and do my bp independantly. Keep trying, it doesn't happen the first time, it takes practice.

You don't have any trouble transferring into a commode?

It's really encouraging to see others with quadraplegia are independent with their bowel program. I'll definitely continue trying and figure some way to get this done.

[underthesun]

I haven't tried insertion, but have you considered using a hoyer lift or ceiling lift to transfer. I know one C5 quad who goes to bed and gets up that way himself.

I'm C5/6 complete and use a sliding board to go to bed myself. But I get help for getting up and for bowel care.

To the point... I want to try a ceiling lift myself to do the bowel program at night on my own. I don't use suppositories or anything, so I only need to figure out the transfer (to/from a commode chair) and wiping. I'm pretty sure I could do it. My next step is to try someone else's lift before I buy my own.

So if you don't figure out the insertion, maybe you can figure out how to go without, as I did.

Good luck! We can learn a lot from each other.

I use a sliding board for transferring too. I'm definitely going to consider getting a Hoyer Lift...but that also means I can only be independent at home (would be too difficult to haul this around for travel).

You're considering going independent with your bp too? I hope whatever you come up with works.

A "electric" lift seems like a good idea, but in my case, I doubt Medicaid will think it's medically necessary.

[underthesun]

I'm racking my brain trying to come up with something that works. What I'm doing now is sitting(in my wheelchair) immediately following the suppository insertion (done by attendant), then hopping right back into bed when I know I'm about to go. I "go" while on my side in between clean-up, I sit upright to get rid of the rest.

It doesn't seem practical in terms of clean up to continue lying on my side so I'm trying to find something like a bedpan that will allow me to sit up and make clean-up much easier. I know regular bedpans won't work since they're likely to cause pressure sores and well, they look difficult to sit on.

I'm wondering if there are any bedpans that'll work for a person with a spinal cord injury. Or, if I need to get creative and build my own with foam and lining...

[SCI-Nurse]

I don't recommend bed pans for anyone with SCI. Have seen too many bed pan shaped pressure ulcers. If you must do bowel care in bed, best to put Chux or newspapers under you, and lay on your side. It is much better to do bowel care on a toilet or commode as this helps with 1) more complete emptying, and 2) less time for bowel care.

If you are working on doing it yourself, most insert the suppository in bed, then transfer to the commode/toilet and do any digital stimulation there, as well as clean up. Of course a padded seat is strongly recommended.

As far as mirror use, I try to use that only when teaching the technique, and not for long term use. We put the commode chair over a chux on the floor (no pan, not over the toilet) and prop a large mirror on the floor so you can look down into the mirror and see the anal area. Practice this way until you can reliably get the dig stimmer or suppository inserted into the right place, then move to having the commode over the toilet with no mirror at all.

Both the suppository inserter and the digital stimulator should be lubricated for use.

(KLD)

[underthesun]

I don't recommend bed pans for anyone with SCI. Have seen too many bed pan shaped pressure ulcers. If you must do bowel care in bed, best to put Chux or newspapers under you, and lay on your side. It is much better to do bowel care on a toilet or commode as this helps with 1) more complete emptying, and 2) less time for bowel care.

If you are working on doing it yourself, most insert the suppository in bed, then transfer to the commode/toilet and do any digital stimulation there, as well as clean up. Of course a padded seat is strongly recommended.

As far as mirror use, I try to use that only when teaching the technique, and not for long term use. We put the commode chair over a chux on the floor (no pan, not over the toilet) and prop a large mirror on the floor so you can look down into the mirror and see the anal area. Practice this way until you can reliably get the dig stimmer or suppository inserted into the right place, then move to having the commode over the toilet with no mirror at all.

Both the suppository inserter and the digital stimulator should be lubricated for use.

(KLD)

Thanks for the warning about bedpans..last thing I need is a pressure sore.

I guess what seems impossible now will get easier with experience. So, both the inserter and the stimulator are meant to be used with lubricant..that explains why I was struggling.^^

[wtf]

As far as mirror use, I try to use that only when teaching the technique, and not for long term use. We put the commode chair over a chux on the floor (no pan, not over the toilet) and prop a large mirror on the floor so you can look down into the mirror and see the anal area. Practice this way until you can reliably get the dig stimmer or suppository inserted into the right place, then move to having the commode over the toilet with no mirror at all.

Both the suppository inserter and the digital stimulator should be lubricated for use.

(KLD)

I didn't know most sci put the suppository in while up in commode chair. I put mine in while in bed, wait for 15 mins and then get into showerchair.

[SCI-Nurse]

No, see my message above. Most insert in bed, but some prefer it to while on the commode, esp. if you lack triceps.

(KLD)

[wtf]

No, see my message above. Most insert in bed, but some prefer it to while on the commode, esp. if you lack triceps.

(KLD)

Ah I see. I have some triceps probably why I think its easier to do in bed.

[dnvrdave]

...As far as mirror use, I try to use that only when teaching the technique, and not for long term use. We put the commode chair over a chux on the floor (no pan, not over the toilet) and prop a large mirror on the floor so you can look down into the mirror and see the anal area...
(KLD)

A webcam works well for me. Easier to look at the monitor (up close, and zoomed in) than a mirror (further away).

[underthesun]

A webcam works well for me. Easier to look at the monitor (up close, and zoomed in) than a mirror (further away).

I've figured out how to make do with a mirror but thanks for all the suggestions Dave.