Yes this is not one of my introspective posts on living with Autism. If you are looking for those please scroll down. This post is an in the trenches, hard core guide describing a very unpleasant issue and how to treat it.
Sophie has dealt with constant constipation, like many children with Autism. At this time I have also been giving her large amounts of biotin to combat intestinal yeast and this adds to the constipation as does yeast. This culminated into a major impaction.
Sophie normally only has bowel movements every few days, many times up to 5 days. I give her magnesium regularly to try to help this situation, unfortunately this did not help this time. She became impacted.
She had not gone in a week. I had already increased her magnesium greatly, with no results. She was pushing on her stomach and straining every few hours with no results. I tried a children’s glycerin suppository, we have used these every once in a while when needed. This was they little bullet type, not the liquid, they seem to work a little better with Sophie. The result this time was Sophie pushing until she vomited with no results in her diaper.
I went to the pharmacy and picked up some stool softeners/laxitives, a few different brands, some for children and Dulcolax which I read about being given to children in this situation. The only form of Dulcolax they had was a pill, which Sophie doesn’t swallow and these can’t be crushed. I figured I would cross that bridge when I came to it. I started with a children’s formula that was a liquid and said it would produce in 6 to 12 hours so I gave it and we went to sleep.
The next morning, nothing. I decided it was time to move to the big gun, Dulcolax. The pills are really small so I came up with the strategy of giving it with a bowl of ice cream. The ice cream was pretty soft and I gave her a couple of bites close together so she didn’t have much time to chew, just swallow. Then I put the pill on the spoon with another good sized bit before she had totally gotten rid of what was in her mouth and sure enough she swallowed it with out chewing it up! Yeah, one victory!
The Dulcolax also had a 6-12 hour wait. So another day passed. Still nothing.
We made a late night call to her doctor and she sat miserably crying and straining for somewhere around 10 days now. I told him all of the things I had tried and here are his instructions.
The next thing to try was an adult size glycerin suppository. If that doesn’t work try a children’s fleet enema. The last option was to try to manually break up the mass with a lubricated finger in a glove. I had already read about this online and have quoted below:
Precautions
This digital breaking up and removal of impacted stool can potentially damage the mucous membrane linings in the bowel, and the stimulation to the vagus nerve that has endings in the rectum can cause heart irregularities. It is therefore a procedure that is undertaken only with extreme caution. Most often, nurses remove fecal impactions upon receiving a physician’s order, or under a physician’s supervision.
Description
As gently as possible, the nurse inserts a gloved, lubricated index finger and massages around the edges of the impaction, gradually working the gloved finger into the mass to break it up. The broken-up pieces of stool are dislodged by carefully working them downward toward the end of the rectum. During this procedure, the patient should be checked regularly to assure that there are no untoward effects such as weakness, diaphoresis or clamminess, or changes in pulse rate.
This scared me I really did not want to attempt this on my own. My doctor said that what I would do is go around the edge and break off a little at a time.
I tried the adult suppository and the next morning the enema with no results. I decided to take my daughter in to the doctor for the final step. Unfortunately after an hour wait, he told us to take her to an emergency room to treat her. When we arrived there we found it packed and her 2 people talking who had been waiting for more than 6 hours. We decided we would try the final step at home.
We picked up latex gloves and KY Jelly. We laid down some towels and my husband held her as she leaned against his lap. I inserted a gloved finger and found the mass and followed the instructions of going around the edge. She was also pushing. I made sure that everything was out that I could feel. The whole thing took about 5-10 minutes, It was horribly uncomfortable for her. She was exhausted and needed a bath at the end, but what a relief.
3 days later I had to give her a children’s suppository to get her to go again. I have put her on miralax and after the last suppository she is going by herself again.
I now have a technique for getting things into a fighting child’s rectum. Never thought I would be able to say that. I will share it with you now.
Don a cowboy hat. Lay your child on there left side, some of the suppositories call for the left side I am not sure why. Climb on top of your child facing their rear, on your kness, trap their stomach or hip between your legs, not really tightly, but so they don’t have enough room to roll. grab their top leg and that is as good of access that you are going to get. YEEE HAW!
Remember to be gentle when inserting anything, you can cause damage if you are not. Also remember I am not a medical professional, just a mom. Consult your doctor.
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Sophie was having more yeast problems. I notice her symptoms getting worse even though I was giving her probiotics with no fenol enzymes. With her chelating, that just wasn’t enough to keep the yeast monster at bay. She was spacey, spinning in circles, giggling, stimming and just not her normal self.
I have been giving her a drop or 2 of GSE with the ALA I use to chelate, but I just can’t stomach giving her more than that anymore, the taste is soooo awful. Well I posted on the gfcf yahoo group and a member mentioned giving more biotin. I was giving around 3000mcg (3mg) already, but this member pointed out that a b-50 has 50mg of biotin. Well I increased the biotin to around 15mg and that has made a huge difference.
She seems also to be constipated, probably impacted right now. I am increasing the magnesium which I would always do with biotin, because it can also be constipating. I have been using magnesium glycinate because the citrate form seems a bit rough on her system, and would cause diarrhea, I am thinking this might be welcomed right now so I may try the citrate for the next couple of days. I will update on how this works.