Ever been constipated? I’m happy to say- I don’t have this problem. Not being able to go for days at a time…must be miserable. Narcotic pain medications can cause constipation. A patient who hadn’t had a bowl movement for seven days- reminded me of a case that had slipped away into the memory banks.
Once, on a slow day- a patient checked in for constipation. No big deal right…a few days without a bowl movement…no biggie. Try a few months. The patient had not had a bowl movement in over sixty days! No once could believe it- the x-ray looked like a volleyball of fecal matter trapped inside this poor person.
I’m walking down the hallway and one of the nurses asks another ER-Tech, if one of us can help the specialist with disimpaction. A momentary lapse in judgement saw me voluteering for the task. For some reason or another- when she said “disimpaction,” I pictured “I and D” (incision and drainage.) While cutting open an infected abscess and suctioning up the resulting puss is certainly disgusting- it doesn’t hold a candle to fecal disimpaction.
The procedure is rather simple- the specialist puts on some gloves (and gown and mask) and shoves a few finger up the bum of the affected patient and tries to loosen and remove the blocking feces. Talk about a bad day at work! Turns out that the patient had tried disimpacting themselves to no avail- really…?
“Looks like you’ve got a bit of a rash back here as well.”
“That’s probably from the diaper I’ve been wearing.”
Now, for the discretionary reasons, I won’t disclose the age of the patient but I will say this- there is no situation (that I could picture,) where this patient should have ever been wearing a diaper. Manual disimpaction? Wearing a diaper? Sixty days of no boom-boom? After three days, and failure of ex-lax to solve my problem- I would have scheduled a doctors appointment. Oh yeah- the patient had a regular doctor but never saw them for this problem- even when it got to the point that they could only have tiny sips of soup…
The mass of doo-doo was so bad inside of the patient that the disimpaction did nothing- no feces was removed…I was happy for that. The patient was admitted and other options were discussed- surgery was even tossed around as an idea to remove this colossal poo. I don’t know what became of the patient and there epic bowl movement…and I’d like to keep it that way.