Thursday, August 22, 2013

The Scoop on the Poop and the Goop

It's been very frustrating for me that two weeks after treatment, where I should be shedding problems and focusing on recovery, I still have these two lingering issues that are making things worse instead of better: constipation and yet another sinus infection (number four since diagnosis for those keeping score at home).

Wonderful Wife and I felt like we had come to a dead end trying to address the constipation issue with our team at Dana Farber. They've been a fantastic cancer fighting team and I'm very grateful to them for saving my life but this issue felt like it had people befuddled and out of ideas.

Essentially it has been a story of too many cooks in the kitchen. Both of my doctors, the nurse practitioners and many nurses have all put forth ideas and suggestions but we tried everything suggested in various combinations and no one was able to provide us with a consistent plan to follow.

What we had arrived at was using a colon cleansing routine (homemade GoLyghtly) that would produce more output than anything else we had tried. The main problem with the constipation was that it would eventually compress my stomach so much that I could no longer feed or take medicine. The cleansings removed some material from my bowels, though clearly not everything. But it made room to get food and medicine in again for a few days. We sensed, however that we were falling behind and not making enough total room.

Monday night I was expressing frustration with the process to my mother when she had the brilliant idea of getting a different opinion elsewhere. So we called my primary care doctor to ask for referrals to gastroenterologists. After a couple tries, we had a next day appointment (which was today at 1:00) with young Doctor Stoole.

We got the impression Doctor Stoole is a fairly new addition to the practice - he doesn't have a photo on the web site yet - but we felt very comfortable with his knowledge. Yesterday I spent time documenting on a single page the entire experience since July 27, which is the last day I produced anything solid in the intestinal department. He found the documentation very helpful.

He performed a physical exam and rectal exam. His manipulation of my abdomen from the outside was fairly aggressive. I've actually had a lot of burbling this evening and it feels like just that manipulation may have had some beneficial effect.

In the end he came up with a very simple three-component regimen to follow for the next week at least.

  • Colace (stool softener) 3 times per day
  • Miralax (laxative) 2 times per day
  • Senna (herbal laxative) 1 full dose once per day at bedtime

We have used all of those medications but not in this specific combination or this consistently.

Time to update the Tracker Keeper again.

I'm very happy that we reached out for additional, specialized help. I'm optimistic about the plan. The fact I'm still taking opioids for pain could throw a wrench in things but I'm hoping for the best. And I'm also hoping that I'm not going to need those opioids much longer; for that we progress to the Goop portion of the story.

Welcome to the extended team, Doctor Stoole.

I wrote last week that I suspected either the previous sinus infection was returning or a new one had arrived. Doctor Chemo had already prescribed Levofloxacin in case the infection came to fruition. I started taking it last week but was interrupted by another "full stomach" episode.

It became a little more critical in the past two days as the radiation-induced mucous actually has started to diminish. That would be a great thing, except it leaves the sinusitis mucous, which is thicker and sticker, without the diluting effects of the radiation mucous.

Messed up, eh? That I wish I still had the radiation mucous?

We went to see my ENT, Doctor B, on Monday and, as he always does, he confirmed in two seconds that I do in fact have another infection. For some reason at the Farber my doctors never seem to want to look that closely for pus in the throat and not to make definitive statements about whether an infection is present or not. That's been frustrating.

Anyway, I do have a sinus infection and Doctor B was fine with the antibiotic I already have on hand. It's only a one-week course and could show results in just a few days. That would be most welcome.

I may be being my usually overly optimistic self, but it feels like getting rid of these two annoyances would really let me focus on recovery proper - regaining weight and strength and energy.

1 comment:

  1. You'd think that Big Pharma would find a way of putting laxatives with the opoids - I am sure many patients would gladly pay the extra Premium for having fewer pills to swallow.