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  • Quad suppository in commode?

    I'm a C5/6 no hands trying to reach independence in my daily morning bowel program. I've gotten pretty good at using the dil stick in my commode, but I haven't yet started to insert my own suppository (the inserter just arrived). In line with advice I read here, I want to eat a small warm breakfast and have coffee about 30 minutes before I start the bowel program. Right now somebody else is feeding me while I am still in bed and then she inserts the suppository before I transfer to achieve this end, and the bowel program seems to be working well enough. My plan for independence is to transfer from bed into the commode (Raz SP), head to the kitchen to make and eat breakfast, go into the bathroom, insert the suppository, and then administer the program.

    I've read that the suppository is best inserted while in the bed, but if I do that I won't have ample time to get breakfast before things start, or I'll have to do another set of transfers to do the suppository after breakfast. Obviously I'd like to avoid that. In order to do this kind of process, are others successful inserting the suppository while on the commode? Or does it simply fall out too often to be a good routine? Just hoping to gain some confidence that others have been able to do this before I waste time trying to learn a new skill!
    C5/6 complete (maybe) circa June 2018

  • #2
    While I can appreciate the motivation to achieve as much independence as possible, in my opinion there's a lot more to the bowel routine than simply popping it in. There are multiple digitals to be done in most cases and then there is the god-awful mess of cleaning yourself up and even more importantly cleaning up the whole bathroom afterwards. It's no joke when you have potential fecal bacteria, visible or invisible, scattered in the area, such as the toilet, the rim, the cover, and then let's not forget that the commode chair needs a very thorough disinfection.

    My aides mix up about 2 gallons of water with Lysol and go to town on the chair and the toilet, then finishing up with the sink area.

    At C5/C6 one has to ask if it's really worthwhile, especially if you don't do a good job and wind up having accidents on a regular basis.

    Just my two cents.

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    • #3
      Bowel program independence is one of those important self-esteem milestones. I have some hand function, C6/C7, and I used one of the tools for magic bullet suppository insertion for several years. I did it sitting on the commode chair because I really wasn't confident that I'd make the transfers in time. I found that I had to poke around quite a bit to get it on location, enough that it irritated my hemorrhoids. After a few years I switched to using something called a Lubricant Launcher. It's readily available online from sex shops. I put my little finger through the loop on the end of the plunger and cradle the syringe body in the crook of my thumb. It is quite secure and gives me much better control and tactile feedback to know that I'm in the right spot. For a while, I squeezed the Enemeez liquid into little cups and then sucked it up into the Lubricant Launcher. Now I have a pharmacy compounder make up some similar liquid a liter at a time so it's much more convenient for use. Works great.

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      • #4
        I think that you can do this and do it safely. That being said, you might want to give some thought to whether this is how you want to expend your energy. That is a decision that only you can make. My two cents worth is try it for a bit and see what works. At least that way, you know you can do it and in an emergency, you could do it. If it takes too much time or energy - then you have to make a decision if this is how you want to spend your time. Nothing to lose by trying it.
        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.

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        • #5
          Originally posted by crags View Post
          While I can appreciate the motivation to achieve as much independence as possible, in my opinion there's a lot more to the bowel routine than simply popping it in. There are multiple digitals to be done in most cases and then there is the god-awful mess of cleaning yourself up and even more importantly cleaning up the whole bathroom afterwards. It's no joke when you have potential fecal bacteria, visible or invisible, scattered in the area, such as the toilet, the rim, the cover, and then let's not forget that the commode chair needs a very thorough disinfection.

          My aides mix up about 2 gallons of water with Lysol and go to town on the chair and the toilet, then finishing up with the sink area.

          At C5/C6 one has to ask if it's really worthwhile, especially if you don't do a good job and wind up having accidents on a regular basis.

          Just my two cents.
          Thanks for your perspective, crags. The good news is that I'm pretty successful already with dig stim using the dil stick. Admittedly, I'm still perfecting the art, but I'm lucky enough to have sufficient sensation that I can do a pretty good job. As for the mess, I've been able to keep it largely under control, though it helps to have caretakers come in reasonably often and clean the bathroom. That way, at least, I might put myself in a position to do a bowel program at 6 a.m. so that I can get to work on my day, and allow my caretakers to come by at a more reasonable hour to do the cleanup routine.
          C5/6 complete (maybe) circa June 2018

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          • #6
            Originally posted by endo_aftermath View Post
            Bowel program independence is one of those important self-esteem milestones. I have some hand function, C6/C7, and I used one of the tools for magic bullet suppository insertion for several years. I did it sitting on the commode chair because I really wasn't confident that I'd make the transfers in time. I found that I had to poke around quite a bit to get it on location, enough that it irritated my hemorrhoids. After a few years I switched to using something called a Lubricant Launcher. It's readily available online from sex shops. I put my little finger through the loop on the end of the plunger and cradle the syringe body in the crook of my thumb. It is quite secure and gives me much better control and tactile feedback to know that I'm in the right spot. For a while, I squeezed the Enemeez liquid into little cups and then sucked it up into the Lubricant Launcher. Now I have a pharmacy compounder make up some similar liquid a liter at a time so it's much more convenient for use. Works great.
            Very cool, endo. I hadn't heard about the Lubricant Launcher before, but with a name like that it's got to be one heck of a tool! I'm doing pretty well with the dil stick, but I admit that sometimes my aim isn't perfect and I worry about doing damage. Sounds like this is a neat alternative.
            C5/6 complete (maybe) circa June 2018

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            • #7
              Originally posted by SCI-Nurse View Post
              I think that you can do this and do it safely. That being said, you might want to give some thought to whether this is how you want to expend your energy. That is a decision that only you can make. My two cents worth is try it for a bit and see what works. At least that way, you know you can do it and in an emergency, you could do it. If it takes too much time or energy - then you have to make a decision if this is how you want to spend your time. Nothing to lose by trying it.
              ckf
              That is some sage advice, ckf. This all came about when my last remaining caretaker called up one morning and said she wasn't feeling well and wasn't going to come. Due to the enormous shower buddy that I was using, my routine was to transfer out of bed in the morning using a hoyer lift. Essentially, this meant I was trapped in bed that day, and it didn't feel good. I called my sister for help, and escaped to her house 3 hours away, and have been imposing myself on her ever since. But I've decided that before I return home, I'm going to figure out how to be independent. At least, as you suggest, on an emergency basis. That said, I've found that caretakers don't have much interest in coming by at 6 a.m. everyday, and therefore after a late start bowel program, shower, dressing, etc. I'm generally looking at a very late morning before I'm in my chair. I'm quite interested in improving that part of my schedule if this all works out!
              C5/6 complete (maybe) circa June 2018

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              • #8
                I believe, and would be interested in what other folks who work (or worked) think, that most folks with jobs do their bowel routine after work, though obviously more tiring after day of work. Bowel routines aren't always consistent in how long they take, but getting to work on time consistently requires getting out of the house at the same time consistently.

                Not to mention unintended "expulsions" of missed/undescended stool or the notorious "afterburn" of the magic bullet. Not always large in volume, but nasty in stink. Just enough to raise eyebrows in the office.

                Plus, when I was working I had a condom cath and leg bag, which required bending over at the waist to pull up my pant leg, get the tube in the toilet and open the drain. Bending over to waist generated a lot pelvic pressure, just like the kind you want when taking a crap. This was more than enough force out whatever is left and causing a premature departure from work, leading to the inevitable psychological stress that entails, especially if one is in the middle of a meeting, project, deadline etc.

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                • #9
                  Really good points, crags. For years prior to my injury I had a lot of flexibility in my job, and a lot of control over the hours and way that I got work done. I live in Boston, but my employer is in Washington DC, so I'm accustomed to working from home much of the time when I'm not traveling. I guess my mindset is kind of locked around that model, but certainly there's no reason to believe it will be like that for me in the future.

                  I guess the one thing I've got going for me is that I haven't had problems with incontinence, even when bending over. But still, certainly worth trying to minimize any potential embarrassment.
                  C5/6 complete (maybe) circa June 2018

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