Post by makemycordgreatagain on Sept 17, 2017 19:26:42 GMT -8
Im now 13 months Post SCI. Im a T7 incomplete and one of the lucky few that had regained enough function in legs and trunk to walk functionally in the community. I have been doing some type of physio every day pretty much since being injuried. I regained function in my right very quickly and it is almost normal how every my left is still severally impaired and had no feeling or movement for months after the injury.
Although i have had amazing recovery physically, my bowels are still a huge problem (bladder is fine). It seems that i either only have a slight urge to poop(but most of the time not at all). I find that i can sometimes go "normally" but it usually takes a ton of concentration and after words i can feel that i have not evacuated all of it. im trying to practice going normally as much as i can too hopefully wake up that function in my spinal cord but the incomplete/full feeling is very uncomfortable and gives me anxiety as i fear having an accident as i have also experienced having to very urgently go when i don't have a bowel movement regularly.
I have been seeing a pelvic floor physiotherapist who essentially puts her finger in my but and assess how tight it is, and has given me a number of breathing to do to relax the area. She tells me to try when i have the urge to go and if i cant after 5min to get up and try the next time i get the urge. She has told me to stay away from practices like digital stimulation as she believe this is training my body to only respond to that type of stimulation. On the other hand i have had Nurses tell me to stick to a bowel program and use Digital Stim when needed.
Aside from all that i have scene a nutritionist to sort out my diet. (my poops are ideal according to the bristol scale). Because im still early into the recovery im hoping that my bowel function will still improve and i want to do what i can to maximize that potential improvement. does anyone have any experience with this or experience a similar situation as mine and could possible give me a few more suggestions or put me on the right path?
I suspect that your physiotherapist doesn't really understand the problem. In my opinion, keeping your bowels regularly cleaned out is crucial to good health. Also, in my opinion, when I hear non-SCI people talking about "training" your bowels to do anything, they are living in a separate reality to ours. Digital stimulation is how I stay alive, and it minimizes the amount of laxatives I have to take. Yet, my physical therapist at the hospital never once even mentioned it to me. I suffered for six months with nothing but laxatives and suppositories (and twice enemas). I remembered reading a book twenty years earlier that mentioned that paralyzed people have to digitally remove their feces,...gloved hand, lubricant. So, I got one of the latex gloves from the box the nursing home had for aides, and I figured out all-by-myself how to dig out my feces. When I told the administrator that this was what I needed, he threatened to expel me from that nursing home! I transferred to a different nursing home about a month later. Yes, keep your bowels moving. Don't let the physiotherapist stop you.
Regardless of what I try, I usually hit 1 or 2 on the stool chart, I can go, but it usually requires a glycerin supp to jumpstart things. taking Lactulose every other day helps soften things up a bit, but gives me really bad wind - I have a hole in the ozone layer named after me. been like this 7 years now
Hobbit, you might try rotating into your diet some other natural things, in order to reduce the amout of Lactulose that you have to take. Boiled okra with cooked corn and tomato (3 minutes, add butter) tastes good. Prunes, the old standby. A pod (often from Mexico and sold in Mexican supermarkets) called tamarind (tamarindo). An herbal remedy that can be purchased already in capsules called cascara sagrada. Each one of these remedies has its own "personality", so taking them isn't so boring as taking the chemically harsh remedy. Yes, results do vary, but the okra, prunes, and tamarind also have nutritional value.
Excerpt from a nice article: "Cascara Sagrada, also called Sacred bark and Chittem bark, is an herb derived from the year old bark of Rhamnus purshiana. Native American Indians commonly used Cascara sagrada to treat constipation and upset stomachs.
Taken as an extremely bitter tasting tonic, or in tablet or capsule form, Cascara sagrada is regarded to be a safe laxative that is often employed as a remedy for mild and chronic constipation. Modern herbalists also recommend it as a tonic for the digestive system and to stimulate the liver, pancreas, gallbladder and stomach. It is also considered to be useful in the treatment of jaundice, hemorrhoids and colic...." nutritionreview.org/2013/10/cascara-sagrada/
Oh, and look! I didn't know this-- "Cascara sagrada can also be used in small doses as a liver tonic and a chelating agent to prevent the occurrence of calcium-based urinary stones."
The pelvic floor physio has great experience with normal neurologically functioning people but SCI is a different universe. I think digital stimulation is a necessary tool.
Thank you for your response.
Just to clarify, my pelvic floor physio specializes in neurological injury (brain and SCI). She believe that allowing my bowels to work normally when i get the urge will wake up/possible make the connection between my cord and brain to go normally. I already can go normally a bit (and pass stool everyday).
The trouble i see which this is that unlike making a new connection with say a limb where the message just has to travel to the limb in question, a BM requires a feeling from the rectum up to the brain via cord and then back to the rectum to release. That extra travel of signal is what i believe to be the issue.
I have had lots of motor function return in the affected area however there is still quite a bit of sensory/feeling loss in my legs (particularly the left). I believe that the feeling is what is stoping me from having a "normal" BM and less so the muscle strength.