No BM since the day before the first chemo, 5 days ago. Taking senna tablets as recommended, started Miralax yesterday, doubling up on both today. Is it time to call the on call doctor (its Saturday today), or wait another day?

I think so. Have you tried a walk around the block? Sometimes that gets things 'moving'...
Hum, just read your blog about the tiredness and pudding cups and meds. No wonder he's backed up. I am still recommeding a walk - maybe a short block, though.
Maria

In addition to Maria's recommendations, drink adequate fluids. Some foods have more water than others also.

Since your husband has a feeding tube, try putting some pineapple juice or prune juice down it and add extra water. Pain meds can cause constipation so its important to push the water to daily take in a minimum of 48-64 oz. Keep giving the meds and you can also try adding fiber (like benefiber in his formula) too. If he still hasnt gone by tomorrow and feels lousy due to constipation, give the doc a call. There is always one on call, 24/7.

I dont know about Miralax. Does it push liquid through without being absorbed? I used Movicol, which does. Movicol was the only thing that worked. Perhaps ask the pharmacy if its a similar thing.

Do NOT add any fibre right now. Fibre is useful for maintaining regularity but right now, no.

Do not muck about with this. Right now everything is compacting up. Soon it will be compacted up to his stomach. He wont be able to medicate or hydrate orally, he will vomit everything that goes down. He'll be at the ER getting an xray to confirm that its all impacted, and need to be hydrated through a drip. The bowel will distend and be very distressing and uncomfortable for days.

They will stick him full of bowel prep to flush it out, which is basically the same as Movicol. Its a liquid that stays liquid from top to bottom, flushing everything in between.

It was 7 days before I went to the ER, followed by the worst 5 days of my life. Please don't let it get that bad. Talk to the pharmacist about whether Miralax will do the job. Senna certainly won't. All it does is soften the stool, it wont move it. You can talk to the doctors and nurses, but I doubt they will tell you much different. There is no magic pill once you get to hospital, it just needs to be flushed out. And it takes days to do that, very uncomfortable days.

Whew, finally had success after a dose of magnesium citrate followed 6 hours later by fleets enema. Drastic measures, and effective. I was worried after hearing about OzMojo's ER experience! He sees the medical oncologist in the morning and will talk about what to do going forward. Thanks to all for your thoughtful suggestions.

P.s. Movicol and miralax are both polyethylene glycol based laxatives.

Oh thank goodness I've been regularly checking for your response. So glad to hear about your success. Great job!

Yeah I figured they'd be similar. I didn't understand how it worked and hated the taste of Movicol. I thought I could get away with upping the dose of Coloxyl and Senna. Big mistake.

Fleet enemas! Oh what a joyful memory that was. I'm wearing an adult nappy (diaper)and waddling down to the ER toilet after the fleet enema and I just know I'm not going to make it. At least there was no spillage!

The problem with enemas is they only work on the lower part of the bowel. If the blockage is further up, all an enema does is cause cramping and grief down the bottom.

The oncology nurses told me they use my story as a case study for new patients when explaining about constipation. No matter how bad the Movicol tastes, the alternative is much worse.

Painkillers tend to make the bowel go to sleep, and you'll need to keep that Miralax going for a while to keep things moving. Now that you're on top of it you can also look at prune juice or Benefiber, but go easy. A change at the top can take a while to get to the bottom so make those changes very gradual. Don't forget to keep the fluids up.

Further update: his tummy is feeling much better as the laxatives continued to work today. Thankfully, no ER visit needed. MO was firm but kind about not letting it go so long again. Prescribed lactulose for future use. That would be in addition to the stool softener, senna tablets, benefiber and miralax!

Although he is feeling better now, he lost some ground when he went 24 hours with no nutrition because his digestive system was so backed up. I hope future first timers will heed the warning, not be so stubborn, and call the doctor early.

I bet most, if not all, of us have been down that road! I'm glad to hear the problem is under control again.

Indeed so, Uptown. Eventually I found that the only thing that worked was, yes, rubber gloves. Crude but effective.