A Journey with Love and Laughter

Read about our family as we journey through life as a family, with siblings, school and spina bifida, and lots of fun and laughter along the way!

Monday, August 4, 2014

Recovery - flushing

Once we got home, it was time to actually get started to get everything to work! The whole reason we did this MACE to begin with. Constipation, independence.

I was worried about constipation. Nick didn't poop after his operation, and not before he left the hospital. 24 hours after we had been discharged and still nothing. That was 4 days.
I had flushed it twice, little 20mL flushes and nothing.
So I was messaging back and forth with his Nurse Practitioner. She said just give it some time, 20 mL is nothing, but we could start to increase it and add glycerin (an irritant to get the bowel moving).
So I stopped worrying and kept working on our daily flushes.

I had been told to go slow. So it was 20 mL for the first 2 days, then 40 mL for the next 2. They said to mix the glycerin (10mL) with 10 mL of normal saline and put that through first, and then the rest of the mix.The goal is to be at our optimum fluid volume (360 mL) by 2 weeks. Putting in the glycerin first means that the bowel is irritated and working before the rest of the fluid is put in.

I have also been going slow with pushing the fluid as well. I've been doing it all by hand through a large syringe, and just pushing slooooow. I did 60 mL yesterday, and it took about 10 minutes. With larger volumes we have a bag and tubing to hang as well.

They sent us home with supplies. A 60mL syringe with a catheter tip (which means it has a pointy plastic tip to fit into the catheter end). Normal saline to use for flush-fluid. Alcohol wipes, extra foley catheter and the bag and connector for larger flushes, also a small syringe (6mL) for removing the air from the foley ball.

Nick has been having some cramping with the flushes. Not so much when we are doing the flushing, but afterwards when it starts to work. I'm not sure what to do about that. I've tried slowing the flushing and warming it up to decrease the cramping. But it also means that it is working. So we've been breathing and distracting.
When we first started Nick also got nausea at the same time, but I think that is passing. We have a bucket by the toilet just in case.

Right now the foley is staying in, so all we are doing is flushing it. After clinic next week they will take out the foley, so that when we do the flushes we will put the catheter in and flush. We also have a fluid bag to fill for the larger volume (probably I'll use the bag after tonight).

Nick hasn't minded the foley hanging from his belly. It remains capped and hangs with some tape.

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