Cluster Movement

Recently I received another email from a reader of my ABC's of Home Recovery. She is less than two weeks out of surgery and was having a bad weekend so I was emailing her back and forth trying to ease her anxiety. During out emails she mentioned one of her Dr.s used the term "Cluster Movements." I Googled it and sure enough the description was almost exactly what I have been experiencing for some time. Because my colon is now so short and the rectum virtually gone stools don't have as much time to have the water removed by the colon. The result is a thick, viscous stool that can be formed but difficult to clean. In addition because the accumulation chamber of the rectum is much smaller stool want to pass right through so you have a frequency problem.

The cure, well there is none. However, you can retrain your system to a more normal regularity. It takes a combination of deciding what meal you wish to have a BM after then setting the meal up to stimulate the peristaltic and hopefully have a BM soon after eating. By repeating the routine you should eventually retrain your system.

I have been doing some of that but now have embarked on an actual program. I am taking two anti-diarrheals  before going to bed. This slows the system down and while I may have two or three BM's before going to sleep seem to be sleeping more soundly and not waking up as often.

I take one anti-diarrheal with breakfast to slow down the morning, however I have been having several BM's before noon. In the afternoon nothing and I eat dinner and take nothing to slow the action. I am now going to the bathroom several times during the evening, but I consider that the best time of day for me as I am most often home and can handle the situation with comfort.

What I have noticed is the consistency of the stool is getting firmer and less messy. In addition I have not had an episode in a week or two. However, I am also cutting down on snacks and large meals. My weight has dropped about three pounds and seems to be staying there. I am hoping for more weight loss.

I have also upped my fiber supplements to five a day, two in the morning and three at night. However I try not to drink too much liquid with the fiber because the idea is to slow the movement of the material through my system, not speed it up. The other thing I have done is begun to take a probiotic daily to improve the bacterial action in my gut. That also seems to be making a difference.

I am going quite slowly because there are so many variables that one can't point to anyone thing and say that's the fix. However I have shown good improvement in control and consistency in the past few weeks and hope to improve even more over time.

A Life on the Toilet: Ill Health and Bowel Cancer by Kat Ward

I recently finished a short book by Kat Ward chronicling her bout with bowel cancer. It sounds like the same type of cancer I had only the tumor had gotten way bigger than mine. This lady had a lot of problems that compounded the cancer or in someways disguised it. She suffers from panic attacks and has a phobia about vomiting that forces her to make a decision to discontinue chemo treatment that I did not encounter. Kat has a long history of bowel troubles including chronic diarrhea and bleeding, turned out they also diagnosed Diverticulitis which masked the cancer.

At first the book is an ongoing litany of trouble with her bowels and after a while you start to dislike this lady instead of commiserating with her. Her panic attacks and bowel issues tend to rule her decisions when logic suggests you take a different course of action. Kat antagonizes doctors, nurses and  other health care people. She refuses treatments, she disdains appointments, she is rude and selfish. I have a hard time with that behavior because it is so far removed from mine. She seems ruled by emotional outbursts and unable to think through what is being suggested to her because her panic or phobia so rule her decision making.

As the book goes on she finds that some of the procedure and treatment she receives are not nearly as bad as her mind conjures. This realization only seems to temporarily improve her confidence which can be dashed by her own imaginings. Nonetheless Kat gets through the treatment and surgery. She only takes one week of chemo, but does have a full month of radiation. She only has one week of chemo because of nausea and her fear of vomiting. Frankly, it was the radiation that caused me severe side effects that she seems to avoid. However, her chronic diarrhea may mask the side effects.

In the end she has a good prognosis although she seems to have some misgivings. She does make amends with many of the people she was rude to and seems to come away with a greater realization of friends and what they mean to her. I will say, she has an amazing number of friends who seem to put up with a lot of abuse and demands that I'm not sure I could tolerate. I trust she has attributes that outweigh the emotional outbursts.

At different times she becomes suicidal and I think if it had not been for her sons and friends she may have carried it out. Kat does realize what a selfish act that would be and what pain she would cause, particularly her sons and obviously does not commit that act.

What did I learn? Well I learned that people with different types of behavior patterns can have a very hard time. I also learned about the health care system in Great Britain and it appears to be nowhere as cumbersome and bureaucratic as critics of one payer systems in the U.S. make it out to be. She gets into doctors and clinics very readily, and has home health care beyond what I ever had, and for longer periods. However, the missed diagnosis of diverticulitis is bad, it caused her long periods of suffering that may not have been necessary. Misdiagnosis however can happen regardless of the health care system.

This story is not particularly inspiring, but it is educational and for that reason I must say I liked it. I don't like Kat very much, but it is a remarkable journey and I hope her outcome is positive.