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    Changing bowel program method

    Hi all. For the 28 years that I've been a quadriplegic, I've done my bowel program in bed. For the past 10+ years I've lived in an apartment that did not have a roll-in shower, so I received bed baths. I just bought a Nuprodx tub slider system to allow me to shower once again, but I am also considering trying to do my bowel program sitting up. At this stage, will there be any issues with switching from in bed to in chair? I haven't had an issues with accidents (knocks wood), but am hoping switching to in chair will be faster and a better clean out. So if I do switch, I have some questions:

    1. Currently I use a magic bullet, but am waiting for a sample of Enemeez. Do I first get in bed, insert the suppository, and wait x amount of time before getting in the chair? Or is the suppository inserted once in the chair? Right now, I have the suppository inserted, wait 30 minutes, and then do a dig stim. If the suppository is first inserted in bed before transferring, how do you avoid releasing the suppository/stool during the transfer process?

    2. Once in the chair is positioned over the toilet, how does the aide perform a dig stim? Seems like a difficult angle with the chair in the way. Do they do the stim while the chair is positioned over the toilet, or do they pull the chair away from the toilet for better access (and then how to avoid a mess on the floor?).

    Thanks for your feedback.

    #2
    My Dad's bowels work differently than yours (he has a low injury and suppositories don't work for him, unfortunately), but he does his bowels sitting up on a padded elevated toilet seat. So I'll let others give you the practical advice.

    The one thing I recommend is being extremely vigilant about monitoring your skin. It is so easy to get pressure injuries from the toilet/padded toilet seats. My Dad got one, and even though it was extremely small/shallow it lead to a lot of long term skin problems. He used the Activaid elevated toilet seat when he got the sore, and now places a ROHO commode cushion on top of it, but he still has a precarious set-up.

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      #3
      I have a C7 injury and complete my bowel program independently but the steps are pretty much the same. I used magic bullet for several years before switching to Enemeez. I use a self propelled shower/commode chair (Activeaid 624SS) and transfer myself to it before I do anything, even get undressed. After undressing, I'll squirt in the Enemeez. My bowel movements generally start within 5 minutes, though sometimes longer. With that timing I never considered it safe to try to work over a toilet, rolling back and forth for access. I poop in a plastic bucket lined with a plastic bag that I dispose of after the routine. So much easier than cleaning a bucket or pan.
      My chair over the bucket offers plenty of access for dig stem if that's what you want to do. I quit dig stem after dealing with bleeding hemorrhoids. Instead, I use a hand shower with a hard spray of hot shower water for stimulation. No problems with hemorrhoids these days.

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        #4
        You can start your bowel program in bed first, insert the suppository, and wait x amount of time.
        How soon before dig stim do you have results?
        That is the key to your decision.

        You can get dig stim done while sitting up in a chair. It is a difficult position for sure.

        pbr

        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
          You need to remove any stool in the rectum so that the Enemeez is able to be absorbed. Enemeez can work very fast so we recommend sitting up or the ability to do so right away. You need to discuss this with your bowel provider to ensure no falls or injuries. Also Enemeez is not a chemical irritant so you should not have the rectal discharge afterwards seen with Bisacodyl-after 2-3 uses. CWO
          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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