Don’t read this post if you’re eating, if you’re planning to eat, or if there is any possibility you may have undigested food in your stomach. Now I know what CrankyProf feels like.
A physician once told me during my training that the plumbing and the sewage system are two body functions that no one appreciates until they stop working.
To get the “sewage system” working when it is “backed up,” one of the more unappealing things a doctor has to do is to “disimpact” someone.
Some docs just flat out refuse to do it. They admit the patients and make someone else do it or they send the patient home with an enema and tell them to do it themselves. The problem is that then the patients suffer.
I won’t understand why someone waits two weeks without a bowel movement before deciding there’s a problem, but I do know that once the problem is there, being unable to have a bowel movement is an agonizing thing. Sometimes an enema will relieve the impaction, but the longer the stool sits in the colon, the more fluid the colon absorbs from the stool. Eventually, the stool sitting in the rectum turns into almost a clay consistency. The body adapts to some degree by liquefying the stool so it can pass around the impaction – called “paradoxical diarrhea.” Once the stool turns to clay, the only way it is coming out is for someone to stick their multiply-gloved fingers up there and to dig it out. For those of you who took my advice, are not eating anything, have not vomicked, and are now totally enthralled with the topic of constipation, see this link for more exciting information.
The start of a long shift was a man who had no bowel movement in 8 days. He felt the urge to defecate, but was unable to do so and was very uncomfortable. And he just happened to have paradoxical diarrhea. Not high on my list of enjoyable things to do, but we’re in the business to help people, right?
Well, when I walked into the room, it looked like a couple of monkeys had been in a poo fight. He had stool all over his clothes. He had placed his clothes on the chairs and the counter, so there was collateral contamination all over the furniture, too. Even though one of the nurses had placed a commode in the room, the patient was standing up and straining so that liquid poo was dripping onto the floor. I did a survey of the room. There was poo on the bed frame, on the handles of most drawers, on the curtain, on the front of the sink, on the otoscope (why would someone with constipation mess with an otoscope – never mind, I don’t want to know), on the nurse’s call light, and on the doorknob leading out of the room.
For a good ten seconds I stood there dumbfounded. It was me standing in back of a door I had just closed, mouth ajar, staring at a man half-squatting over the floor in a soiled gown who stared back at me with an equally dumbfounded look.
Then I seriously thought that I was the subject of a practical joke. I looked for an uncontaminated part of the linen drawer, opened it without touching its handle, grabbed a towel inside, and used the towel to pull the handle on the door out of the room. Fresh air hit me in the face. When hospital air smells like Liquid Downy, you know something stinks.
I was half expecting to see everyone laughing at me when I walked out of the room, but the scrunched up faces of the staff, their demands to “hurry up and shut the door”, and the strong smell of deodorizing spray proved me wrong.
I got the stool out of this poor guy’s bottom, but the odor lingered in the room for hours to come. I kept smelling stool on my clothes to the point that I had to change my shirt.
And I thought the lice were bad.