Pre=hysterectomy Bowel Cleansing Prep Combo

[Sophia3]

I am scheduled for laparascopic hysterectomy surgery for the 10th of November, but had to sign waiver for abdominal surgery if they see a problem...I understand that.

But the cleansing prep has me nervous. I know it is CRITICAL as the uterus is right up against the bowel. He wants me cleaned out as if getting a colonoscopy.

I know the nurse and said if the prep makes me sick or vomit, do I have to take the full doses? She said to use my discretion, she trusts me and I NOW the importance of cleaning out things.

A few hours after surgery, I will have blood work to make sure everything is ok...and I will be in overnight. UNLESS i feel marvelous and go home that night...but he's only had a handful of women do that. He releases pts in the morning. And this hospital only has private rooms. YAY.

Here is the questionable part.

Two days of clear liquid but he said YES to Ensure..(and the nurse told me last week he let's some pts do Ensure) even though it ain't clear? But I will drink it as it is high in sodium and potassium!

I can NOT come across this exact Combo of cleansing agents and it seems like a lot to me with TWO DAYS of liquid diet?

the PREP:

4 Ducolax tablets 10AM day before surgery

10 oz Bottle magnesium Citrate 2pm

Fleet enema that night 8pm

FOLLOWED by another Fleet in the AM

oy vey!?

On my NORMAL days, I have two cups coffee, water and gatorade and NEVER eat solid food before 4-6 pm. Isn't this amount of cleaning over kill?

I have heard horror stories of Golytely and NuLytely. My room mate had some stuff where he put a couple ounces into Sprite and drank it a couple times aday.

SOMEBODY did once post, re: colonoscopy prep that if you do a liquid diet for two days, the laxative clean out is not as harsh.

10 oz of Magnesium Citrate sounds like a lot? Anybody done THIS specific cleansing? ALso not sure about the Dulcolax? I am NEVER constipated.

Any thoughts?

The doctor said to have a good book handy. Oh, and he prefers the lime Citrate that tasted like salty mountain dew.

It's not JUST the affect of PREP on POTS but this COMBINATION I wondered if folks were familiar with?

[Laura]

Hey Sophia,

This is a fairly common bowel prep. As I'm sure you realise, you need to be sure to be completely cleaned out incase something happens that you end up needing abdominal surgery as any stool left would be likely to cause very serious infections. Basically, the dulcolax is a very good thing to do as it will soften everything up and get things started. A kind suggestion by your doctor as it will make things easier for you. 10 oz of citrate is the dose that you'll need in order to ensure that you are fully cleaned out, and the fleet will take care of any residual bits left over.

Try to get as much of the mag citrate in as you can, and it sometimes helps to make sure it is very cold. If you are ok taking gravol, you might consider taking a small dose about an hour or so prior to drinking the prep. It's not pleasant to drink, but very necessary. Basically, it is super important to be sure that you are completely emptied out because any kind of infection risk is very serious stuff!

Hope this helps you a bit! Laura

[Sophia3]

Thanks, Laura. Never heard of Gravol? what is that?

sophia asks, as she goes to search a new word!

Never mind...anti emetic..can't handle those. But thanks for the quick reply.

[DancingLight]

oh sophia,

just READING what you have to do for the prep makes me cringe! (this really helps a lot doesn't it?)

okay, let's try another approach. i should get out my pom poms instead??? what colors do you want?

so, you are going through with the hysterectomy? i think i missed the final decision you came to...sorry! i don't get to read many posts a day.

i know you are struggling a lot and i will be keeping you in my thoughts extra. and ORDERING you to stay overnight no matter what.

i made the dumb decision to BEG my surgeon to send me home after only one day after my GB surgery and well, ended up back by ambulence. not worth the risk until you are sure your bp is stable.

do you have someone who can be with you while you are doing the prep in case you do become weak?

later alligator!

sending good thoughts your way....

emily

[Sophia3]

Thanks, Emily.

I will get thru the prep..I have a room mate but prefer to do such things on my own.... he and I have known each other for years...but he works 3 minutes from here if I feel badly. I have my kitty cats, too.

My older sister is going out of town for THREE weeks , two days before surgery, on business and to see her kids for thanksgiving....but I have to get this surgery done before the end of year and new Medicare deductible starts.

[Shiner Kitty]

Hi, I don't know specifically about the bowel prep you've been prescribed, but I did find information that I thought you should be aware of about people confusing two types of Dulcolax. One is only a stool softener (won't clean you out properly) and one is a laxative. They can both be side-by-side in a pharmacy and both labelled Dulcolax. Here's a link to the warning: Pharmacy Times .

I've never done a bowel prep, so I can't advise you about that. I would be very nervous too, but I'm sending positive thoughts that you'll be fine during and after the prep and the surgery!

[Sophia3]

Thanks Shiner. Dulcolax is supposed to just soften things and the Magnesium Citrate will do the rotor rooter part!

My autonomic doc just emailed me back to say to put in as much fluids as I put out, or more. To use Gatorade or diluted grape juice or apple juice with pinches of salt to break monotony.

He also said I should be ok on the Zofran used to prevent vomiting after surgery...or maybe that is mixed with anesthesia? I forget. I know the surgeon told me they have many "recipes" now for patients compared to 20 years ago.

I am going to keep walking on the treadmill and doing exercises up until surgery time...and hopefully the first day of liquid diet, to make myself stronger.

Should be an experience! I guess like one of my favorite race car drivers says "You may not like some things but sometimes, you just have to put on your big girl panties and deal with it and move on."

[BuddyLeesWife]

Great idea walking on the treadmill and keeping your abs strong prior to surgery - if you can incline it at all that is even better for your abs. Walking was also the best activity for my recovery. I was directed to take a stool softener for several days following surgery as things can really firm up when your system tries to start back up following the anesthesia and pre-surgery prep. Plan on living for about a week in flannel PJ pants or sweats as your abdomen will be swollen - fortunately the PJ bottoms are in style now!

In response to one of your earlier questions on post surgery bleeding - I only had some diluted bleeding for the first week, my system figured out pretty fast that the uterus was gone. Very occasionally, maybe 2-3 times a year, I will have a very slight trace of blood but neither my gyn or pcp are concerned.

I hope you get a great lift in energy soon.

[kmpower]

Hi Sophie,

I waited until today to reply because I was going through a prep yesterday and wanted to report on how it went. Two weeks ago, I had a routine colonoscopy, but the GI person couldn't see it all well. It was my decision to get also a barium enema just to be sure everything is OK.

Both preps were very complete but both were different due to doctor preference. First one was 1/2 day of clear liquid (coffee is clear for us addicts) and the morning of the exam I did two liquid Fleet laxes two hours apart. It was gentle and, ahem, effective.

Yesterday was a different story. It was no food all day, then one liquid Fleet, then 4 Bisacodyl tablets at night, and an enema this morning. It was less gentle and, ahem, less effective.

The liquid part and the sodium part was not an issue. You drink a lot and my body liked that.

The only complicated thing was timing my twice-a-day beta blocker. I get such white coat syndrome that I wanted to be sure to take it so it would be absorbed. With things moving through me so quickly , I worked with the techs to time the rx doses. If you take meds, they need to be at least an hour away from a laxative of any kind, with two hours being even better.

I hope the entire process will give you some long-sought relief.

OLL

[Sophia3]

Thanks OLL

Wow! you been thru this twice!

I have to do liquid diet TWO whole DAYS but ENSURE is allowed, thank GOD. Also they said after Dulcolax softeners and Magnesium Citrate (10oz but I am starting with half) I have to do enema night before AND in the morning of surgery. The AM of surgery has me concerned.

OBVIOUSLY, if I am cleaned out before bed, I am NOT going to put myself thru an enema in the morning unless I "feel" I need it. I have a 20 minute or so ride to the hospital. I may just make that one a warm water one minus the drugs.

My autonomic doc said to dilute apple juice or white grape juice and add 1/8 tsp salt per quart. Same with my Gatorade...and I am making home made chicken soup broth. He said to try and take in at LEAST as much liquid as goes out...or more. He actually GAINED weight as he drank so much chicken soup broth for his colonoscopy, LOL. but he is a heavy set doc.

I am going to put something soft to lie on in the bathroom, candles, anything to calm me down.

[DancingLight]

Sophia,

Perhaps you can make your bathtub your haven? Sorry, but when I saw you were going to set up the bathroom with something to lie on, I recalled my caregiver telling me that her mom often SLEEPS IN THE BATHTUB!!! I am not kidding! It's her favorite place to sleep! Sounds terribly uncomfortable to me.

Better get yourself some good air freshener too!

Sorry, just wanted to let you know that I am thinking about you...

Em