"delicate" question......(Bowel regimen after spine surgery)

**Kimberly** · 06-09-2011, 11:23 AM

I know we all have experience with this, but I am still a little embarassed to be asking this......

After my last surgery I had severe problems with the plumbing getting backed up. At the time, my Dr. had said this 'might be a concern' so I should remember to 'take a stool softener.' So I did. And....that's....ALL....I.....did. And, of course, what happened next? Nothing. For a long time. We finally got our heads together and just before I was ready to head to the ER, we "worked it out."

Part of it was that, I was feeling so awful about this issue, I stopped taking the painkillers on the 3rd day to see if I could alleviate the problem. Part of it was that we realized we were trying to fight with BB guns when we needed an AK-47. But, unfortunately that one awful thing tops the list as the worst thing I remember about my surgery....by far.

Ok.....so here's my question....As the 2-level fusion surgery (and recovery) is much bigger than a microdiscectomy/laminotomy, I am worried that I will be on painkillers for a MUCH longer period of time (not to mention a longer time on the table which I think can also sloooooww things down a bit.) Since I never had to deal with this problem for a very long period of time, I am now starting to panic (a little) about what to do.

What sort of PRACTICAL advice can you all offer? I know the drill on paper ("eats lots of fiber, drink lots of water, get exercise, take a stool softener, take a laxative") but some of those things are hard to do when you're really hurting and really nauseous. (when I'm feeling really awful, I don't want a bowl of carrots.) What sort of program did you follow for the long-term to help keep things regular?

Sorry if that's too "delicate" a question (but if I can't ask it here, don't know where I CAN.)

Kimberly

**Justin** · 06-09-2011, 11:29 AM

Hi Kimberly,

ALL patients that have spine surgery and that will be on narcotics for an extended period of time, should be on a good bowel regimen. This usually means a stool softener (Colace) and a stimulant laxative (senna). Of course, speak with your surgeon before any medication changes. As you mentioned, stay well hydrated (8+ glasses of water a day is very helpful). The above bowel regimen is used "long-term."

The Colace and senna is usually an "easy" couple of pills that patients take either in the morning or at bedtime. There's no need to eat large quantities of figs, prunes, etc.

**ajj1001** · 06-09-2011, 11:46 AM

Originally Posted by Kimberly

What sort of PRACTICAL advice can you all offer? I know the drill on paper ("eats lots of fiber, drink lots of water, get exercise, take a stool softener, take a laxative") but some of those things are hard to do when you're really hurting and really nauseous. (when I'm feeling really awful, I don't want a bowl of carrots.) What sort of program did you follow for the long-term to help keep things regular?

Sorry if that's too "delicate" a question (but if I can't ask it here, don't know where I CAN.)

Kimberly

its completely the right place to ask such questions. i have just done the "bowel" talk with one of my friends who is going in for abdominal surgery next week. i wish someone had told me about how much more comfortable i would be if i had done things properly when i had my first op.

you have to work out what works for you but my regime is to try to keep meals pretty light and easily digestible for the previous 48 hours, no huge steak for my "last meal". i routinely take laxatives with my painkillers but that does mean that i haven't got many stronger options after surgery. My magic bullet is dried prunes. They taste like sweeties to me so I can eat them as soon as i am able to eat something. I have a couple every hour or so and these start to give me an amount of jet propulsion alongside big quantities of stool softener and laxatives (i must admit to keeping a small stash when I hand over my meds on admission, so there is no waiting for a nurse to dispense them, you sometimes get missed out for oral tablets when you are on IV pain medication on a busy ward). This usually result in things getting moving again 3 or 4 days after surgery. I also like ripe bananas alot as well as other dried fruit & licorice, anything that you will be able to nibble on when feeling a bit yucky that has fibre in is good.

If you are having an anterior or lateral approach holding a pad over the dressing helps things feel much secure and comfortable when "going".