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Mar 18, 2016

They Call Me Doctor Poop

One of the biggest dementia care problems we face is problems with bowel movements.


One of the biggest dementia care problems we face is problems with bowel movements.
By Bob DeMarco
Alzheimer's Reading Room

Yesterday was a crappy day. More succinctly, a poop agita day.

It started with Dotty repeatedly telling me she had to poop.


A few minutes after I got Dotty out of bed she kept saying, I want to get back in bed. Why? She had to poop and couldn't do it. Six times in a little over an hour up down - no poop.


Keep in mind this entails: getting Dotty out of bed and into the wheelchair, out of the wheelchair and on to the toilet, off the toilet and into the wheelchair, out of the wheelchair and into the bed.

Six round trip rides. I wonder if I lost any weight yesterday? Hmm.

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Each time I checked after Dotty gets off the toilet -- No POOP - E.

Now for a confession. This entire problem was caused by lax caregiving on my part. Starting in early December our daily scheduled started to get disrupted. As a result, there were many days when Dotty did not get daily prune juice injection. Prune juice is the magic POOP - E elixir.

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As it turns out, I stopped giving Dotty the daily prune juice injection back on December 31, the first day she was sick. Big mistake.

Things were so hectic that I just forgot. Has this every happened to you? Things get so hectic while caring that you forget to do something?

We were no longer on our regular schedule because of Dotty's illness, and I suffered a case of total Alzheimer's caregiver dis-com-bob-u-lation. My head was spinning.

If you read this far -- it is time for a warning.

Warning.

If you find the discussion of poop in any way offensive click out of this article now. If you find a graphic description of poop a problem, click out.

Okay, I warned you.

So anyway, after repeatedly taking Dotty to and from the bathroom with no end result, I decided it was time for the magic. A large double strength dose of prune juice.

Of course Dotty tried to resist. She held her nose, told me it was poison, said no I won't drink it, and so much more. Keep in mind, there was no potential solution here like linking the pruce juice to potato chips or ice cream -- Dotty isn't hungry. Yep, you read that right.


Finally, I get Dotty to drink the prune juice. I put her back in bed. I have the same smile at this point as the Cheshire cat. I AM FEELING VERY CONFIDENT THAT OUR Problem IS GOING TO BE SOLVED IN 30 - 40 MINUTES.

Sure enough Dotty says, I have to go to the bathroom. She gets on the pot. I see it, the look. She is going to POOP - E. She makes the face, the noise and then she says the dreaded words -- it won't come out.

This called for an inspection. Sure enough, the poop is coming out but it is stuck. I inspect further. The POOP - E is not like concrete. But, it might be impacted.

Meanwhile, Dotty is getting weaker and weaker and I just went from being the happiest person in the world, to one of the most dejected. And, stressed.

I put Dotty back in bed. I think. I decide. We just can't do this all day long and hope Dotty squeezes out enough poop to break the log jam.


I decided this calls for drastic measures.


Its time for the Atomic bomb. MAGNESIUM CITRATE (MC).

During a previous episode of this type, I actually used the magnesium citrate on Dotty. The previous time this happened, I had three choices: enema, magnesium citrate, or the hospital.

I gave Dotty the magnesium citrate, laid her down in bed right near the bathroom, and waited.

All of a sudden I heard Dotty moaning and crying. I ran into the room and well lets just say there was POOP - E everywhere.

Poor Dotty, she was crying and all embarrassed. I gave her a shower and cleaned up every last drop of POOP.


Later that night I told my sister what happened. She was aghast and said it must have been horrific. I told her quite the contrary. It was one of the happiest moments of my life. The poop problem was solved and Dotty was bright eyed and bushy tailed.

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I looked myself in mirror that night and said --

YOU ARE an Alzheimer's caregiver.


The previous episode occurred 4 years ago. Since then

I beat the poop and the dreaded bowl movement syndrome that is suffered by many Alzheimer's caregivers.


I am also a lot smarter than I was way back then (2006).

Okay, now back to the current Poop - E episode.

The first thing I did was put a nice thick diaper (for those of you that get hung up on semantics, this means adult incontinence wear) on Dotty. I learn fast when it comes to Poop - E.

Next, I convinced Dotty to drink the MC. This took some time and effort.


After Dotty drank the MC, I started watching the clock. Twenty minutes, Dotty is sleeping like a baby. Forty minutes, Sixty minutes, Eighty minutes, same thing. Time to wake Dotty up.

I get Dotty to the bathroom. Take off her now full of liquid poop diaper. Next thing I know, here comes the POOP-E. More Poop - E. And, more Poop - E.

Now for the cliffs notes version of this story.

The Poop - E continues to flow for the next 8 hours. Check the diaper every 30 minutes, more liquid poop. Finally it starts to look like maybe we are getting some old poop that has been in there for a long time. Seemed to me like like this is a good sign.

Finally, at 8 PM it looks like we are in the clear.

Then I do the dumbest thing in history. 

I give Dotty a tiny burger, some french fries and later on some rice pudding.

I put her in bed at 10 PM but not before I check the diaper. Walla, good news. No POOP - E.

Around 1 30 AM I hear this racket. I go and see that Dotty is in the bathroom. I say let me check that diaper. Hmm, it has some POOP-E in it. I think no problem. I get the diaper off.

AND THEN IT HAPPENED.

The POOP - E explosion. Like an atom bomb the liquid poop flies and explodes to the floor and then expands every where -- like a mushroom cloud. Not only do we have the big POOP - E , its drops of POOP - E everywhere. Think floor, walls, everywhere.

I get Dotty cleaned up and back in bed.

By now you might be thinking I am ready to hit myself in the head with a frying pan. I am not.

I did mess up. I got confused. I forgot the POOP - E war is never ending.

It will be another 4 years before I forget to give Dotty her daily prune juice injection.

After this problem we never had a major Poop - E problem again.

What is the morale to this story?

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Solving problems that come with effective Alzheimer's caregiving can be treacherous, difficult, and all consuming. You name the word.

But at the end of the day, once accomplished, success brings with it a tremendous feeling of accomplishment.

Somehow we just do it. Day in and day out. And this is why I believe, regardless of circumstance, you should hold you head high.

In my opinion, you are operating at a very high station in life.



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