Saturday 29 September 2012

Constipation Blues

"Push a Poo, push a poo, push a poo poo poo!"  That's what I used to sing to Nick when he was little.  Recently, I sang the little ditty again into Nick's ear and we both had a good belly laugh.  But the laugh wasn't enough to elicit any action 'down there' and neither were buckets of medication or even a one litre soap suds enema (we'd given a fleet the day before).  This state of affairs is naturally causing him to feel nauseated and exhausted.

Nicholas has always suffered from severe constipation.  When he was small, we received a diagnosis of gastro-intestinal pseudo obstruction.  Here is a simple description from the New York Times Health Guide:

In primary intestinal pseudo-obstruction, the small or large intestines lose their ability to contract and push food, stool, and air through the gastrointestinal tract.
The condition can occur suddenly (acute) or over time (chronic). It may occur at any age, but is most common in children and the elderly. Because the cause is unknown, it is also called idiopathic intestinal pseudo-obstruction (idiopathic means occurring without reason).
Risk factors include:
  • Having cerebral palsy or other nervous system (neurologic) disorders
  • Staying in bed for long periods of time (bedridden)
  • Taking narcotic (pain) medications

Nicholas did recover from his childhood bouts of being unable to eat anything at all due to his miserable gut function (at one point he needed to be fed through his vein, bypassing the stomach altogether).  But recently, this chronic, adult form, or something like it, has reared its ugly head.  It's rather typical of Nicholas and people like him who are the first of their generation of children living with severe disabilities - they are pioneering the territory of aging with severe health challenges.  None of the medical literature can give any hint as to what to expect next from Nicholas - he is one of the first to survive his challenges to adulthood.  Now, Nicholas has all the risk factors for pseudo obstruction in spades.  I guess his intestines are finally fed up with trying to digest his feeds (not to mention the odd bit of fried chicken and french fries), especially when he's lying down most of the time and popping oral morphine.  What does the future hold?  I don't know - only Nick's gut will tell.

Yesterday, I made the short (on Canadian standards) drive to visit my Mum in Montreal.  It was a few months ago, but it seems like yesterday that she got out of hospital after battling two back-to-back cases of that dreaded hospital superbug, C-Difficil.  My Mum's problems are quite the opposite of Nick's.  Perhaps we could put my Mum in the next room to Nicholas and they could kind of create some intestinal karmic meeting in the middle.  Now, wouldn't that be grand?  Then, I could change my song to "Don't Worry, Be Happy!"

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