nancy_east Posted November 17, 2008 Share Posted November 17, 2008 Hello all, I found these boards about a week ago by chance, and I feel like I already know some of you by reading your posts. What a blessing a forum like this is. My name is Nancy, and my 58-year-old mother was diagnosed with stage IV adenocarcinoma of the lung a month ago today. It has metastasized to her brain, bones, and lymph nodes. Needless to say, it was a complete shock to all of us as she was not having any symptoms until she complained one week of left sided weakness that become dramatically worse over a couple of days. So far, she has had 14 treatments of whole brain radiation that helped the neuro signs dramatically and she had her first round of chemo 6 days ago. She has been doing fairly well with the chemo (slight nausea, fatigue) until this morning when she woke up with abdominal pain and is severly constipated. She has taken a Fleet enema, magnesium citrate,and she is currently giving herself a water enema, per the nurse at the oncologist's office, but with no relief yet. My mom is a very stoic person when she is pain and she is really, really hurting right now. She says she can feel everything "right there" wanting to come out and bulging at her rectum but she can't pass any stool. Is anyone out there who can share any tips or suggestions on what we can do? I'm feeling like this is warranting a trip to the ER but I don't want to overreact. the nurse is calling us back in an hour to check on her but I just keep getting more worried as I see her in so much pain. I'm a veterinarian, and I know when animals are in this much pain with constipation, we generally intervene to a greater degree to help them, but since my mom doesn't bark or meow, I kind of feel like I'm out of my league Any suggestions are most appreciated and sorry to start my postings with such a desparate email. Quote Link to comment Share on other sites More sharing options...
MsC1210 Posted November 17, 2008 Share Posted November 17, 2008 Hello Nancy and welcome to the site. I'm so sorry you had reason to find us but am glad you've joined us! I am sure the others will be along soon with some wonderful advice but until then the only thing I can offer is maybe getting Mom to go see the doctor rather than just talking to the nurse by phone? The poor thing, I am so sory she is in such discomfort. Please keep posting and let us know how things are going and of course let us know how we can help you and Mom out at anytime!! Warm hugs Chrisitne Quote Link to comment Share on other sites More sharing options...
recce101 Posted November 17, 2008 Share Posted November 17, 2008 Hi, Nancy, welcome to the group. I believe your instincts are right on target and that a trip to the ER is warranted, unless the onc nurse has gotten back to you with something that has resolved the problem. I also believe there is no such thing as overreacting when a person on chemo is having difficulty. This even extends to minor cuts which are showing signs of becoming infected, things we'd normally feel silly reporting to a doctor. During my chemo I was put on oral antibiotics three separate times — first for a port incision that had become inflamed, then for an open blister on my foot, and then again for the port incision. In each case I was surprised that my onc took these "minor" problems so seriously, but the upside is that I never needed any interruptions in treatment to deal with an infection or other complication. Constipation is a very common side effect of many chemo agents, and especially pain medications if and when those are required, and I think it's just as important to stay ahead of the constipation as it is to stay ahead of the pain. After this immediate situation is taken care of, there are plenty of preventive measures to take, and I'm sure you know them as well as anyone here. I think overall it's better to err on the side of keeping things a little loose, keeping up with the fluid intake at the same time. Looking for a good report soon! Aloha, Ned Quote Link to comment Share on other sites More sharing options...
Ry Posted November 17, 2008 Share Posted November 17, 2008 It's not overreacting-- a bowel impaction can be fatal very quickly. If the stool is impacted she's gong to need to go to the ER. The best thing to work quickly is a "mom bomb" which is milk of magnesia and warm prune juice. If the enemas are not working she should go get some help removing the stool. Once this is over make sure she starts using some natural means to keep her bowels moving like prune juice, apple juice, bran, and lots of fluids. Let us know how she does. Welcome to the board. Rochelle Quote Link to comment Share on other sites More sharing options...
nancy_east Posted November 17, 2008 Author Share Posted November 17, 2008 Thank you, thank you, thank you for all your responses. I truly can't tell you how much your quick replies mean and how I feel so welcomed to this forum after just one post. What a wonderful community to be a part of through this--I have found that the people who have dealt with cancer either themselves or by supporting a family member just "know" more than anyone what to say and do, and I can't thank you enough. My mom and I just arrived home from the hospital. We decided after I posted the question to just go on and go as she was in so much pain. She literally could not sit down properly in the car because of the pressure. Once we arrived, they quickly (at least quick for an ER), took her back and a very kind nurse and nurse practitioner manually extracted a lot of her fecal matter and then they gave her a soapy water enema to get rid of the rest. Instant relief and a much happier mother for sure. She has battled with constipation for years anyway, so I'm sure the chemo is just exacerbating it. She already does all the right preventive measures for constipation on a regular basis, so I'm thinking maybe we ought to make an appointment with a nutritionist to see if there's anything else they can recommend besides fiber, exercise, water, juices, etc. As she said, this just can't happen again and I'll definitely do everything in my power to prevent her from going through that again. Again, I appreciate your advice and support so very much. What a gift. Quote Link to comment Share on other sites More sharing options...
recce101 Posted November 17, 2008 Share Posted November 17, 2008 Thanks for the update, Nancy. I'm relieved too! If you haven't already, may I suggest that you visit cancergrace.org (the previous onctalk.com has been folded into GRACE, Global Resource for Advancing Cancer Education). There's a wealth of information there, especially on lung cancer, constantly updated by a Seattle oncologist who is an internationally-recognized expert on lung cancer and who gives high priority to promptly answering questions from people like you and me. A lot of us are "dual citizens" and have the same usernames there as here. Dr. West has written about constipation issues recently, and he is always interested in hearing others' experiences so he can be even more helpful to the next person with a similar problem. Please check out GRACE — I believe you'll be impressed. Ned Quote Link to comment Share on other sites More sharing options...
beatlemike Posted November 17, 2008 Share Posted November 17, 2008 Hi Nancy and welcome,I am so glad your mother got her problem taken care of. I hope she can keep ahead of it by taking stool softeners or other products so it doesnt return.I had no idea that constipation could be so painful until I was on hydrocodone(Pain med.). I too had to manually extract it. Its not a pleasant subject but it is something that I think should be forwarned of when on any kind of pain killers and chemo. I dont remember any one warning me of the severe constipation that can occur. And it will come back if you dont stay on top of it. I wish you and your mom the best. Quote Link to comment Share on other sites More sharing options...
SandraL Posted November 17, 2008 Share Posted November 17, 2008 Hi Nancy and welcome. I feel so badly for your mom. It does sound like right now she is in an emergency situation and needs help. I hope you get it resolved quickly. I have suffered signficantly from constipation. Chemo drugs do it to you as well as pain drugs like morphine. I just need to absolutely stay on top of it, and that's an always for me, as I am on a steady stream of morphine. I take Senokot plus stool softener a number of times throughout the day. I have also found that a product called Lactulose works well. It is a very very painful thing to get through. Quite frankly it is the worst pain I have been through in any of this and I would wish it on nobody. Prayers that your mom get relief quickly and that you get on a proactive plan to prevent it from happening in the future. Please keep posting and letting us know how you and your mom are doing. We are all here to answer any questions and support you in any way we can. Take care Sandra Quote Link to comment Share on other sites More sharing options...
Larry's Wife Posted November 17, 2008 Share Posted November 17, 2008 Nancy, my husband also suffered with chronic constipation. He was prescribed Senna-S. He took 1-3 tablets twice a day. We also monitored his "ins and outs" so we would know as soon as possible if we needed to adjust the dosage up or down. After we started this system, he only had a single occasion of needing an enema. And honestly, the only reason he needed it then was because he refused to take the senna for a couple of days - he really hated taking medication. Well, he never made that mistake again! Quote Link to comment Share on other sites More sharing options...
jaminkw Posted November 18, 2008 Share Posted November 18, 2008 Nancy, so glad your mom went to the ER. I had an episode like you described. It was excruciatingly painful. I'm a grin-and-bear it kind of gal so I went for hours and finally called my daughter who is an RN. She told me to take more vegetable laxative and stool softener. But the real key was while I was waiting for it to work, put a heating pad on my stomach. It was amazingly effective. So if mom has even a minor bout of painful constipation again, don't forget the heating pad. Welcome aboard. If you have to be in this situation, isn't this a great place to go with your stuff! Judy in Key West Quote Link to comment Share on other sites More sharing options...
Yorktown Linda Posted November 18, 2008 Share Posted November 18, 2008 Nancy, I too suffer from constipation. My internist told me to take Miralax 2 to 3 times a week on a regular basis. So far it seems to be working. Linda Quote Link to comment Share on other sites More sharing options...
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