Potty Talk

For the past year and a half, I’ve struggled with constipation. I haven't talked much about it to many people (since it's not really the greatest conversation piece!), but I feel like I've learned so much that someone who has a similar trial might be able to gain something from my experience. The following is a detailed account of my struggles. Please don’t read it if you're uncomfortable with poop talk. 'Cause there's lots of it. Poop talk. Not poop. ☺

May 2008 - baby #3 weighed in at 10+ pounds after both an 18-hour failed induction (where I recognized afterwards that I was really constipated, which may have contributed to it failing) and an 8 hour successful, though hellishly painful (even with an epidural), induced labor.

July 2008 until June 2009 - Within a couple of months of having Evy, I began experiencing severe constipation. If I didn’t use glycolax every day, plus another laxative once a week or so, everything would stop completely and my abdomen would feel hard and achy. I would go days and days without a b.m. During this time, I was exercising regularly, eating relatively well, only whole grains, lots of fruits and veggies (I discovered green drinks during this time), for fluids I drank only water (and lots of it!), and I even took supplemental fiber, and probiotics. I was losing a lot of baby weight during this time, but it was interesting to watch the pounds literally fall off whenever my bowels would finally move. There are a couple more obvious ones: 8/02/08, 9/05/08, and 11/13/08 where I lost several pounds within just a few days. I was being smart about losing weight, but while I was losing weight, I was also getting backed up and then finally eliminating it all at once.

Fall 2008 - visited my PCP - he counseled me to drink more water, eat more fiber, exercise... So, the 13 glasses of water and 35 grams of fiber a day, and the 3 hours of exercise a week aren’t enough? Ya gotta love it when doctors ignore what you’re already doing to self-treat.

January 2009 - went back to my PCP: he counseled me to double my glycolax, and he also gave me a referral to go see a gastroenterologist, who was booked out for two months.

March 2009 - first visit to the gastro. He ordered a colonic transit study.

April 2009 - Colonic transit study: basically, I swallowed a pill with little, tiny rings inside the pill that were visible on an x-ray, and then I went in every morning for a week to be x-rayed to see how they’re moving along. No glycolax through the whole test. Ouch! This is where I gained four pounds in a week (4/21/09) (though it didn’t help that my sisters and mom were in town and we visited the almond roca factory. twice.)

April 2009 - Gastro called - he said my colon transit is normal, until the end of the large intestine, where all the pills had gathered by the end of the week. He recommended pelvic floor rehabilitation to strengthen those muscles, which can help with regularity. Pelvic floor rehab specialist: booked out two months.

June to August 2009 - Rehab Kristi. These appointments were so interesting and educational. She gave me some foot exercises, which are supposed to stimulate the nerves and muscles in the pelvic floor. She cited a study that showed them to be more effective than Kegels. You can find them here. She also showed me a toileting “technique” and had me do some pelvic floor awareness exercises that were interesting. She helped correct a diastasis recti (common pregnancy-induced separation of the abdominal wall) and gave me a “morning bowel routine”: warm drink first thing in the morning, then eat breakfast, plus set a time each day to sit on the toilet for 5-10 minutes. All these exercises helped only very slightly. The only improvement I saw was that I was able to decrease the amount of glycolax I’d been taking.

August 2009 - Went back to the gastro. Said it was possible I had a rectocele. He sent me to a colo-rectal specialist. Never even knew those existed.

September 2009 - Colo-rectal specialist: Confirmed that I do have a minor rectocele. Not likely the cause of all the struggles. Invited me to come back in 3 weeks to be tortured. Until then, he told me to add caffeine to my morning routine. He suggested coffee or green tea. I went with Vivarin. The combination of the caffeine (which acts as a stimulant on the bowels), the warm beverage (which warms your body/intestines up), and the food (gastro-colic reflex (like you see in babies: eat, poop, eat, poop) -- it’s not as strong or as noticeable in adults, but it tends to be strongest in the morning, when you haven’t eaten all night) has helped quite a bit, but hasn’t completely solved the problem.

Yesterday 2009 - a day which will live in infamy, much like the labors of my three children, the difference being I didn’t get a sweet bundle to take home with me. The torture he scheduled me for was a test called Ano-rectal Manometry test. It was invasive and painful and miserable and unkind. And I am so grateful for it. He actually found something wrong with me! Thanks to the labor and delivery of my third child (remember the glass in rectum post?), the involuntary muscles in my rectum were traumatized, causing them to contract when I try to poop instead of relax.

It’s been a really long, really annoying struggle, but I’m very optimistic about it all right now.

What’s next? I have an appointment with the Pelvic floor rehab specialist in two weeks. She and the colo-rectal guy are working to get me a pelvic floor stimulation system. Sounds like a party.

I’ve thought a lot about all these kind, knowledgable people who have done their best to help me. These random, undesirable occupations such as a colo-rectal specialist, a pelvic floor specialist, a gastroenterologist: it seems like you’d have to have a really good attitude to be able to talk about your profession, not to mention that you have to have a really kind heart to even go there in the first place! I suppose you could argue the kind heart for many other health care professions, but there’s something special (at least to me!) about someone who chooses butts. Heart docs? Eh. Three cheers for the butt docs.