Bowel Movements

[Brandy]

My dad as i posted on the other board has a new C5 injury... Yesterday was 4 weeks since the injury.  He has had bowel movements, diarrhea consistency a lot since the beginning.  My dad's situation is different becuase he has had colon cancer 3 times and has had so much of his colon removed.  Before the accident it was just the norm for him to have diarrhea all the time and go 4 or 5 times a day.   Since the accident he has continued having bm's not quite as frequent .. but now 4 weeks out the Dr has concerns wanting to test his stool saying he may have something causing this that people with C5 injuries can't have bm's without suppossitories and digging it out.  I dont understand why now after 4 weeks of him doing this they have just now said this.  Why are they acting like it is impossible for a bm to happen without a suppository?  I mean with such a short colon his stool doesn't have time to form like normal people so therefore it just leaks out without the muscle relaxing or whatever they think should restrict it?  Maybe i'm just too tired to understand why they are just now getting concerned about something that has been happening and why they think that only haveing 3 foot of colon left has nothign to do with it. 
Anybody have any insight? if not i guess that's ok i just am tryign to sort out my thoughts maybe...

[Jilly]

Hi Brandy,
Pretty much the only reason people with C5 injuries need to use supposotries and manual bowel evacuations is because they are less active. Anyone who isnt physically active can get constipated not just those with spinal injuries. It can of course be helped by diet but I guess it is unusual for someone with that level of spinal injury to go the other way.

I dont know why your dads doc has only just now decided to investigate your dads bowel habits. Maybe hes just being careful.
You mentioned in another post about the possibility of your dad having a colostomy. Maybe the doc has to make sure there arent any other problems with regard to assessing him for this.
As far as I can see, your dad having looser bowels than the norm because of his shorter colon can only be an advantage. It very much lowers the chance of him getting all blocked up. Like all people with spinal injuries your dad will have to set some sort of routine for bowel management, to do this they need to figure out his normal habits so they can work with them. I guess that might be a reason why they are concerned with any looseness now too.

[Gary Anderson]

Hey Jilly

What a damned good reply that was. I could not have put it better and I am a doctor!

[DavesMom]

Brandy,
When my son was in shock trauma in Baltimore, his aortic graft repair threw a clot down and killed off a large portion of his small bowel. He had been on TPN and tube feedings and had loose or runny bowel movements the whole time. I was told it was because of all the small bowel that was removed and he would always have problems.

He was removed from all tube feedings and TPN and was finally eating real food. They used to give him something so he would not go so much and then give him a suppository to go. Once I got him home, I stopped the pill they gave him so he wouldn't go and only used one suppository before I stopped. My son is a T5 paraplegic and his bowels have regulated on their own. I just let him go normally without all the added help. He does want to have a colostomy at some point but that is just so he has no accidents when he starts going out which he can have even if he was on a bowel program.

Is your dad eating a regular diet and is he on meds that could cause loose bowel movements? Sometimes they give them meds in rehab that can cause these problems. I agree, why did it just dawn on the doctor after 4 weeks?

DavesMom, Diane

[Brandy]

The colostomy idea has been put on hold for now.  The surgeon had come by to evaluate him and said if they did it, it would have to be permanent due to all the other surgeries he's had for the cancers and 2 hernia repairs where they had to place a mesh inside him.. there is so much scar tissue and the wound has been looking better for a couple of days so they said let's hold off on that and see if it will heal and the colostomy will be a last resort since it can't be reversed in his condition.


DavesMom.. you are right all their meds can get frustrating sometimes.  To start with they wanted to give him the stool softners and didn't take into account that he is different from normal people with regards to his bowels.  He only has 3 foot of his colon left..

Anyway they want to culture for C-diff and something else i can't remember waht the other was but I really think it's just that his body is different. 

tomorrow his therapist are following me home to do the home check and help us figure out what modifications need to be made.  That stresses me out I guess.  It's like saying this is really real.  I guess being here at the hospital is one thing i still tell myself he could just get better and go home normal..but in reality i dont think that's going to happen and changing the house will just make it real so i guess i wish we just could skip that tomorrow...

[Jilly]

Hi Brandy,
Im no expert on the matter but I tend to agree with you, I would say that his different bowel habits are because of his short colon rather than anything else but I also think its a good thing that the hospital are investigating to rule out anything else. It means they are being thorough.

I guess the therapists coming to your house to see what changes would make it all more real, I havent been in your postion thank goodness of having to have that done but I can imagine how it must feel. Yes it is real Im afraid and theres going to be a fair amount of time passing until any changes or improvement in him show up as far as what he can and cant do. In the meantime he cant stay in hospital forever and when he does come home its going to be a whole new ballgame!

Are you the one thats going to be caring for him? If/when that happens make sure you keep in touch with us all as we can offer you all sorts of tips and advice and support.

[Brandy]

Hi Jill
Yes i will be caring for him.  My mom will help some but she is disabled herself and is limited in what she can do.  They are gonna see what we can do about having home health come out on the days I work... i only work 3 days a week but 12 hour shifts... so hopefully between home health and his sister has been good to help out so between the 2 of us, someone will have to be around all the tiem to help mom out. 

We had a set back this weekend.  Friday he went in to have a filter put in because he's already had a history of blood clots in his legs and had one go to his lung about 3 years ago and now with him this way they said the risk was even greater ... so he of course was on his back for the surgery and for a while afterwords ... and his wound which we had gotten down to maybe a stage 1+  is now moved back up to a stage 2+
Also they kept him over night at the other hospital where they did the surgery and Yesterday his arm turned purple and was swollen.  They ended up having to take his picc line out and he has blood clots in his arm.... it's better now but it cuased him to have to stay there longer and miss therapy which has set him back a few steps from where we were he is a bit weaker..  He is beign discharged from there back to the rehab facility this evening though so i Hope we can get back on schedule.