There’s nothing like being in hospital to bring home to you just how much you are an organic being. Hospitals and all the professionals in them are extremely interested in any secretions you have but most of all they appear obsessed by poop. Every day a record was taken in the unit of not only whether we had pooped but of what size, colour, consistency and volume said poop was. Sizeable deposits were greeted by murmurs of approval, sometimes even of congratulation, whilst, in contrast, pitiful attempts were accompanied by the shaking of heads and sorrowful looks. To be fair, it IS pretty important, as it was explained to me, that spinal patients are not allowed to back up, as it were, since being full of waste can, eventually, cause a toxic reaction, a poisoning from the inside out.
So imagine the disappointment when one day I failed to produce anything. The nurses on duty noted this failure on their chart, shook their heads sadly at me and let me know, by voice and deed, that they felt let down by my performance.
The next day came. I failed to produce anything again. They tsked at me. “Are you eating properly?” I was asked. “Er, yes” I replied, if by ‘properly’ you mean with one spacca hand and hospital food”
There was muttering as they consulted. “We’ll give you another day” I was warned “But if you don’t do anything tomorrow you’ll have to take a laxative. Make sure you eat.”
I duly consumed another three meals. The next day rolled around. Nothing. More shaking of heads and noting on the chart followed by the production of my first ever sachet of laxative – some orange flavoured powder entitled ‘Movacol”. This was mixed with water and down it went to do battle with my recalcitrant colon.
“How many of these am I going to have to take?” I enquired, not being a fan of half pints of artificially orange flavoured liquid at the best of times. “Another one tonight should sort you out nicely by the morning” I was promised.
The next morning rolled around. Nada. I was now on my fourth non productive day and twelve disappeared meals. Reinforcements, in the form of the doctor on duty, were called in. “Up the Movacol to two sachets this morning and again tonight” he said. “What happens” I asked “If that doesn’t work?”. “Oh it’ll work” he informed me “and in the unlikely event it doesn’t we have a nuclear option available to us that never fails.” Everyone laughed knowingly at this except me. I eyed them all darkly whilst I imbibed a whole pint of fizzy, orange liquid. I ate three more meals. I drank another pint of FOL.
Day five in the house. Nothing. The disappointment had now morphed into genuine concern tinged with puzzlement. My Movacol tally was at six sachets (from memory the blurb on the back promised surefire results after two), I was now fifteen meals down without result and people were starting to ask me questions about how I was feeling (fine, thanks), did I have tummy ache (nope), was I experiencing any signs of autonomic dysreflexia (luckily, no).
(Here comes another science bit – autonomic dysreflexia is a potentially life threatening condition common to those with SCIs. Devoid of proper sensation to identify problems – such as being chock full of poop – the body can react by blood pressure rising. Symptoms usually include a crushing headache and can involve shivers, chills and nausea. If the offending issue, which can be as simple as too tight clothing, is not dealt with then the blood pressure just keeps on rising and you are then into a medical emergency with strokes and and death being potential outcomes.)
My temperature was taken, my eyes were peered into, my FOL serving went up to three pints (six sachets) that day and my card was marked as an oddity.
Day six. Nothing. Three more meals, six more sachets of Movacol, administered now with an air of desperation.
Day seven. Everything was fine. Just kidding. Once again, nothing. The doctor was called once more and my eighteen vanished meals along with my matching eighteen sachets of the now ironically named Movacol recounted. The doctor looked at my chart, then he looked at me, then at he looked at my chart. “Well” he said, with the air of one taking a hard but necessary decision “I guess we are going to have to Picolax her.”
There was an audible gasp from everyone in the room except me. I understood from the reaction that this must be the nuclear option referred as almost never resorted to earlier. The Cold War with my colon was over and the gloves were coming off. (Metaphorically, obviously. The LAST thing you’d want to do as a medical professional in this situation is take your gloves off.) A nurse was dispatched to the pharmacy, presumably with a locked suitcase chained to her wrist, to acquire some Picolax. She returned, bearing the box gingerly, as well she might. Picolax is the stuff they give you to ‘empty the bowel’ before something like a colonoscopy. Given we have multiple metres of bowel inside us, this is already quite an impressive production of poop – one that would score a full 10 out of 10 on the poop chart and a standing ovation from the nursing staff. If, however, like me, you are currently storing six days of poop in your bowel, well, you could probably decorate the room. I read the instructions on the back. “Add this sachet to 150mls of water and dissolve.” so far, so normal. “The water may become warm” WHAT??!! Holy cow, what the hell is in this stuff that its chemical reaction with good, old H2O is enough to produce heat? “I’m not sure…” I started. A nurse held out the, presumably warm, glass “Drink” she instructed. I drank and my status changed. Pre-Picolax I was a constipated patient. Post-Picolax I am now an unexploded bomb. The nurses edge nervously towards the door. “How long will this take to work?” I asked, worriedly. “We don’t know” they replied, equally worriedly “But we would advise staying in your room”.
I sat in my room. The hours ticked past. The whole morning went past. Occasionally someone would poke just their head round the door, making sure to keep the rest of their body behind the protective barrier. My stomach didn’t even gurgle. At lunchtime, bored and hungry, I wheeled myself down to the cafeteria. Word had spread and I was given a whole table to myself. I ingested my 20th meal without result and trundled back to my room. The afternoon ticked past and it got to 3pm, my physio appointment time. Since I attended my physio sessions religiously as they were one of the few things that were keeping me sane, I waited until the coast was clear and shoved myself as rapidly as I could to the gym. I was just about to clamber out my chair onto a plinth for my session when my pursuers caught up with me, bursting in with the information “She’s been Picolaxed!” The reaction was instantaneous. Physios threw themselves protectively across their patients or behind the nearest piece of equipment and finally I understood the etymology of the word arsenal. “Get her out of here!!” bellowed the Head Physio, presumably with horrific visions of exactly how many nooks and crannies there are on a leg press to have to clear the effects of Picolax out of. My wheelchair was firmly manhandled at speed back to my room and deposited there with firm instructions NOT to leave it again.
Evening came. Nothing. By now I was a cause celebre of the whole unit. Fellow patients pointed at me through the glass wall of my room, laughing; visiting small children, held firmly by the hand, were brought to see the Picolax Lady and last but not least, a stream of medical professionals dropped by to see with their own eyes the patient that refused to poop even after Picolax. Morosely, I ate my 21st meal and then had to work very hard to persuade some staff to help me get ready for bed.
Day eight. Morning. FINALLY, to everyone’s immense relief, not least of which was mine, I pooped. Unexcitingly, normally and as if the last seven days, eighteen sachets of Movacol and one of Picolax had never happened. Colon 1, Picolax 0.