Our Current Enema Routine

Life is always busy at our house so I’ve been a bit lax in posting about things.  I think it has something to do with having my eighth baby last month…LOL.  I wanted to do a post sharing more about Mason’s enema routine because it’s something I was curious about before we were doing it. 

Let me start by explaining why we are doing enemas.  Mason has what is called a neurogenic bowel.  The nerves to his bowels are damaged (part of his Spina bifida).  This means different things for each person.  For Mason it means that his bowels do not eliminate poop on their own because his colon doesn’t have the rhythmic muscle movement needed to push things down and out.  We are not sure yet if his colon has ANY muscle movement.  If we keep his stool very soft he will poop some when crying or crawling around because he’s using his abdominal muscles and that naturally pushes somewhat on the colon/pelvic area.  He has spent more time constipated than not.  We use Miralax to try to keep poop soft but often we swing from constipation to diarrhea, not a good cycle. 

Mason has an open wound we’re trying to get healed on his backside (skin tore when he was scooting and it is really hard to heal).  In an effort to keep poop out of that open wound and avoid infection we started daily enemas.  It was something we were needing to begin soon anyway, this just moved the timetable up a bit. 

We went with a cone enema because Mason’s anus is really weak and doesn’t hold fluid in well.  So what you’re looking at is a bag to hold fluid, a tube, and a white cone on the end of the tube.  We use water and mineral oil currently for the fluid.

There is a lock that slides open and shut to control the flow of the solution.  The cone keeps things from coming out.  Why is that important?  Well, we want the fluid to have time to go up through the whole colon.  The cone mostly keeps Mason’s bottom from leaking.    

The process takes time and will take longer the older he gets.  Right now we lay Mason on his side on a towel right outside our tiny bathroom.  We hang the bag inside the bathroom on a hook.  Then we put just part of the cone tip into his bottom and hold it there.  Open the lock and let the fluid in, then close the lock and wait.  Our current wait time is 5 minutes.  During this time we need to keep Mason happy laying on his side, and we have to keep holding the cone in place.  It’s a good thing he’s so easygoing!

When our timer beeps we remove the cone and move quickly to the toilet.  I usually have a diaper on him for this transfer to save my floors from the fluid rush.  Remove the diaper and entertaining part two commences.  We need to keep Mason on the toilet until he poops. 

Right now that is still being tweaked.  It takes 5-10 minutes at least.  What we are still tweaking is the amount of fluid to use.  We need enough that it brings the poop out with it.  Mason’s body isn’t helping at all.  He simply doesn’t seem to have any muscle reflexes working for us.  When he is older he will learn to use his abdominal muscles to try to bear down.  But how do you get a 1 year old to do that?  For now the most effective ways to get him to engage that abdomen are:

• Laughing like crazy.
• Coughing
• Crying

We try to get Mason laughing but it doesn’t always work. 

The biggest adjustment to this has simply been making a consistent time each day to do the enema that works with everything else going on.  It’s one more thing that *needs* done.  I think some days our life is run by when things need to be done for Mason.  We already have the every four hours cathing schedule (8am, 12 noon, 4pm, 8pm, 12 midnight).  Then we have physical therapy and stretches to do several times a day.  Now we have enemas.  Oh, and his medication needs done twice a day (8am and 8pm). And bandage changes at every diaper change.  Add in cooking and mealtimes, playing, homeschooling siblings, cleaning the house, feeding/diapering/seeing to the needs of baby Samuel, and life in general and you can see why we live by a routine.  We have to!!!  <smile> 

 

What is something you’ve had to adjust in your family’s routine?  Was it easy to make time for something new or did you struggle with it?