I'mm home now from a rather difficult heart operation that went longer than expected due to some unusual heart anatomy. Six hours under general anesthesia! I got invalided home unable to do much: difficult even to stand upright or walk unaided. That's a good thing because if I had needed to use the bathroom it would have been impossible to get there fast! The general anesthesia left me constipated and after two days I was beginning to get worried. I was even tempted to take dulcolax or some such but held back for fear it might have some dangerous interaction with any of the numerous other medications I was taking. Finally on day three the dam broke and I was back to normal. To conclude: for those who are going to have general anesthesia in their future, anticipate you might have similar problems but don't stress out, just drink plenty of water and be patient- things will come out all right in the end.
Hi Michael, and congratulations on making it home and through what sounds like a grueling ordeal. You bring up a very important point, which is to anticipate constipation and be proactive about it, especially when taking meds (like for pain) that are expected to make things worse. Anaesthesia and immobilization in the hospital, plus the stress on your body, etc. What a relief to be home in many ways, hang in there and wishing you a steady recovery :)
Thank you! It was more grueling for the OR team than me I imagine- I slept through all the excitement! There was one moment I was awake for. As you know, they wheel you from the prep/recovery room through endless hallways with twists and turns, a maze really. All you can see is the ceiling since you're flat on your back. Not my first rodeo so it was all old hat. What was new was there is a point when they get you to the OR where they lift you off the gurney by using some kind of tarp and with a 1,2,3. they transfer you to the operating table; new this time was some kind of air pillow inflated underneath me making the transfer easier. Then the anesthesiologist came over and it was lights out!
You survive! That what my Acupuncture physician (yes, he is board certified internal med) like to needle me (pun and true). He has an interesting sense of humor. Hoping you could use a bit of humor, bad as it is.
I found that general anesthesia, along with oxygen, leaves my mouth feeling like I spent a month in Death Valley without water.
Don't you love it when they tell you about an unusual part of your anatomy?
Dry mouth too here. And yes, the heart was anteriorly rotated due to kyphosis and a previous procedure. The doctor said it was a "challenging' operation. And when one of the most skilled surgeons in the region with 25 years of experience uses that word- watch out! The team in the OR had to put in a long day and I really should drive out there with a stack of boxes of Krispy Kremes for them. But that will have to wait, I'm homebound for now, can't go down the steps, can't drive and it will be two weeks before I can even lift the donut boxes!!
Definitely feeling like the world is going down the toilet, so a timely post here! I wonder if your patients are complaining more this week from the stress? Great post on the election last week. I forwarded it to many people. And one other idea about constipation - a study last year showed eating kiwi works well, about the same as a fiber supplement in a trial I recall (sponsored by the "kiwi industry of course)! And then there's always "the apple a day," the most sage and durable advice physicians have given over decades/centuries!
Thanks for a good review post. A gross topic many shy away from except in exam room conversations, although among my older friends it enters casual conversation these days.
Great comment Grant especially the start! Yes it seems all us elderly folks talk about is our GI problems!! Young folks, watch out, this is in your future!
Hi Grant, and I subscribe to the apple a day philosophy too. There really is something to it - soluble, insoluble fiber, calories, nutrients, and so tasty. I save one for the commute home most days. And yes, bowels and minds are inextricably linked for better and worse. Thanks for spreading the word here :)
Clearlax (Polyethylene Glycol 3350) is about half the price of Miralax (a bit spendy imo)
An rather old school remedy, prune juice.
Liquid could be in many form like soup or juices. Drinking plain water can be boring, add some flavoring. Love your urine DIY advice on hydration. I remember this from a short course I took.
Pre/Probiotics? my usual caveat:
"Government regulation of probiotics in the United States is complex. Depending on a probiotic product’s intended use, the FDA might regulate it as a dietary supplement, a food ingredient, or a drug.
Many probiotics are sold as dietary supplements, which don’t require FDA approval before they are marketed. Dietary supplement labels may make claims about how the product affects the structure or function of the body without FDA approval, but they aren’t allowed to make health claims, such as saying the supplement lowers your risk of getting a disease, without the FDA’s consent."
Great ideas and additions here, thanks KB! I agree that the 6-8 glasses of water, irrespective of total fluid intake, is pretty boring and tough for compliance. Will follow this link later too 👌
Surprisingly relevant! With the drought we've been having in NJ, the low humidity is a likely culprit for having had this issue recently in our household.
Also appreciate the reminder to practice gratitude for life's natural processes like recycling (food 🥦--> waste 💩 --> new growth 🌳 ♻️).
Hi Lisa - no doubt the drought and low humidity are creating subtle health issues here. My skin is dry and itchy and I’ve been dealing with some other minor issues too! Ah, the circle of life, in this respect a little gross but certainly universal!
I stumbled upon this prayer thing too, not being Jewish, but makes total sense to me. for anyone who has suffered from constipation and then been delivered can tell us, it’s quite a humbling experience.
Got a decent amount of UV this summer, trade offs with skin cancer aside. Magnesium often upsets my stomach, but I know the American diet is often deficient. Vitamin D for the winter ready!
The only thing that's managed to solve this problem for me, a problem I never had until I was put on antihistamines for MCAS, is magnesium oxide. I read you saying it hurt your stomach, and I take it with a meal as a result of that too. Psyllium just made the issue worse for me. I do find probiotics help, if I take histamine-neutral strains. But not enough to fix it without the mag as well.
Good points! Most meds/supplements better tolerated with food, appreciate that. Antihistamines are very commonly overlooked as a contributing factor, and are casually taken OTC. I’ll try the magnesium suggestion. I have a MCAS post in the queue, though I know it’s kind of niche. But seeing a lot more syndromes that overlap or could be MCAS after Covid. I find that people who have this condition have also done lots of research and know more about it than I do (such as which probiotics are histamine-neutral). Love when “patients” collaborate as we can’t know everything in such granular detail. Thanks for stopping by :)
Hey doc, I believe it’s Jodi who has a pretty incredible website chock full of MCAS info. Jodi, do I have that right?
I’ve got my own constipation woes since I’ve had long COVID for over 4.5 years. Never much had the problem before as a vegetarian and exerciser. My GI doc believes I have IMO - intestinal methanogen overgrowth - and I’m currently on xifaxan, though it’s not doing anything this time around (a few summers ago, it helped me get back to normal 💩, but it didn’t last). The issue is that although I actually go regularly, it comes out as rabbit poop (sorry for the TMI). And none of the usual tips for improving constipation have done anything for it - even taking magnesium oxide. I’m down to using senna every couple of days or so. Not a great solution, but it’s something.
On a somewhat related note, have you noticed that iPhone predictive text just WILL NOT acknowledge the word constipation until you get to the last ‘o’? I think there’s an ironic Freudian problem here (holding onto poop, holding onto words, etc.), but I can’t be totally sure 🧐😂
I'mm home now from a rather difficult heart operation that went longer than expected due to some unusual heart anatomy. Six hours under general anesthesia! I got invalided home unable to do much: difficult even to stand upright or walk unaided. That's a good thing because if I had needed to use the bathroom it would have been impossible to get there fast! The general anesthesia left me constipated and after two days I was beginning to get worried. I was even tempted to take dulcolax or some such but held back for fear it might have some dangerous interaction with any of the numerous other medications I was taking. Finally on day three the dam broke and I was back to normal. To conclude: for those who are going to have general anesthesia in their future, anticipate you might have similar problems but don't stress out, just drink plenty of water and be patient- things will come out all right in the end.
Hi Michael, and congratulations on making it home and through what sounds like a grueling ordeal. You bring up a very important point, which is to anticipate constipation and be proactive about it, especially when taking meds (like for pain) that are expected to make things worse. Anaesthesia and immobilization in the hospital, plus the stress on your body, etc. What a relief to be home in many ways, hang in there and wishing you a steady recovery :)
Thank you! It was more grueling for the OR team than me I imagine- I slept through all the excitement! There was one moment I was awake for. As you know, they wheel you from the prep/recovery room through endless hallways with twists and turns, a maze really. All you can see is the ceiling since you're flat on your back. Not my first rodeo so it was all old hat. What was new was there is a point when they get you to the OR where they lift you off the gurney by using some kind of tarp and with a 1,2,3. they transfer you to the operating table; new this time was some kind of air pillow inflated underneath me making the transfer easier. Then the anesthesiologist came over and it was lights out!
You survive! That what my Acupuncture physician (yes, he is board certified internal med) like to needle me (pun and true). He has an interesting sense of humor. Hoping you could use a bit of humor, bad as it is.
I found that general anesthesia, along with oxygen, leaves my mouth feeling like I spent a month in Death Valley without water.
Don't you love it when they tell you about an unusual part of your anatomy?
Dry mouth too here. And yes, the heart was anteriorly rotated due to kyphosis and a previous procedure. The doctor said it was a "challenging' operation. And when one of the most skilled surgeons in the region with 25 years of experience uses that word- watch out! The team in the OR had to put in a long day and I really should drive out there with a stack of boxes of Krispy Kremes for them. But that will have to wait, I'm homebound for now, can't go down the steps, can't drive and it will be two weeks before I can even lift the donut boxes!!
Definitely feeling like the world is going down the toilet, so a timely post here! I wonder if your patients are complaining more this week from the stress? Great post on the election last week. I forwarded it to many people. And one other idea about constipation - a study last year showed eating kiwi works well, about the same as a fiber supplement in a trial I recall (sponsored by the "kiwi industry of course)! And then there's always "the apple a day," the most sage and durable advice physicians have given over decades/centuries!
Thanks for a good review post. A gross topic many shy away from except in exam room conversations, although among my older friends it enters casual conversation these days.
Great comment Grant especially the start! Yes it seems all us elderly folks talk about is our GI problems!! Young folks, watch out, this is in your future!
Hi Grant, and I subscribe to the apple a day philosophy too. There really is something to it - soluble, insoluble fiber, calories, nutrients, and so tasty. I save one for the commute home most days. And yes, bowels and minds are inextricably linked for better and worse. Thanks for spreading the word here :)
Good look at a crappy subject :)
Great advice! just adding a couple of notes:
Clearlax (Polyethylene Glycol 3350) is about half the price of Miralax (a bit spendy imo)
An rather old school remedy, prune juice.
Liquid could be in many form like soup or juices. Drinking plain water can be boring, add some flavoring. Love your urine DIY advice on hydration. I remember this from a short course I took.
Pre/Probiotics? my usual caveat:
"Government regulation of probiotics in the United States is complex. Depending on a probiotic product’s intended use, the FDA might regulate it as a dietary supplement, a food ingredient, or a drug.
Many probiotics are sold as dietary supplements, which don’t require FDA approval before they are marketed. Dietary supplement labels may make claims about how the product affects the structure or function of the body without FDA approval, but they aren’t allowed to make health claims, such as saying the supplement lowers your risk of getting a disease, without the FDA’s consent."
https://www.nccih.nih.gov/health/probiotics-usefulness-and-safety
Let' talk about gut microbiomes next time. ;~)
It must have taken guts posting your remarks KB!
Great ideas and additions here, thanks KB! I agree that the 6-8 glasses of water, irrespective of total fluid intake, is pretty boring and tough for compliance. Will follow this link later too 👌
Doctor Ryan! Your serious and very helpful essay has been hijacked by a rampaging mob of punsters! Well, laughter is good medicine so they say...
😁
Surprisingly relevant! With the drought we've been having in NJ, the low humidity is a likely culprit for having had this issue recently in our household.
Also appreciate the reminder to practice gratitude for life's natural processes like recycling (food 🥦--> waste 💩 --> new growth 🌳 ♻️).
Hi Lisa - no doubt the drought and low humidity are creating subtle health issues here. My skin is dry and itchy and I’ve been dealing with some other minor issues too! Ah, the circle of life, in this respect a little gross but certainly universal!
Thank you Ryan, great information. Surprising - reading not good. Good to know about an evacuation massage and a prayer. Always be learning.
I stumbled upon this prayer thing too, not being Jewish, but makes total sense to me. for anyone who has suffered from constipation and then been delivered can tell us, it’s quite a humbling experience.
Chronic functional constipation is associated with low vitamin D - several studies
https://vitamindwiki.com/tiki-index.php?page_id=15663
Functional = no medical reason for the constipation
(but one study has an excellent chart showing the association of constipation to low vitamin D)
Personally, the worst constipation in my life was the result of having too little Magnesium for my high-dose vitamin D
Thanks Henry :)
Got a decent amount of UV this summer, trade offs with skin cancer aside. Magnesium often upsets my stomach, but I know the American diet is often deficient. Vitamin D for the winter ready!
The only thing that's managed to solve this problem for me, a problem I never had until I was put on antihistamines for MCAS, is magnesium oxide. I read you saying it hurt your stomach, and I take it with a meal as a result of that too. Psyllium just made the issue worse for me. I do find probiotics help, if I take histamine-neutral strains. But not enough to fix it without the mag as well.
Good points! Most meds/supplements better tolerated with food, appreciate that. Antihistamines are very commonly overlooked as a contributing factor, and are casually taken OTC. I’ll try the magnesium suggestion. I have a MCAS post in the queue, though I know it’s kind of niche. But seeing a lot more syndromes that overlap or could be MCAS after Covid. I find that people who have this condition have also done lots of research and know more about it than I do (such as which probiotics are histamine-neutral). Love when “patients” collaborate as we can’t know everything in such granular detail. Thanks for stopping by :)
Hey doc, I believe it’s Jodi who has a pretty incredible website chock full of MCAS info. Jodi, do I have that right?
I’ve got my own constipation woes since I’ve had long COVID for over 4.5 years. Never much had the problem before as a vegetarian and exerciser. My GI doc believes I have IMO - intestinal methanogen overgrowth - and I’m currently on xifaxan, though it’s not doing anything this time around (a few summers ago, it helped me get back to normal 💩, but it didn’t last). The issue is that although I actually go regularly, it comes out as rabbit poop (sorry for the TMI). And none of the usual tips for improving constipation have done anything for it - even taking magnesium oxide. I’m down to using senna every couple of days or so. Not a great solution, but it’s something.
On a somewhat related note, have you noticed that iPhone predictive text just WILL NOT acknowledge the word constipation until you get to the last ‘o’? I think there’s an ironic Freudian problem here (holding onto poop, holding onto words, etc.), but I can’t be totally sure 🧐😂