Can't Poop Due to Anticancer Drugs [Cancer Treatment Diary]

※Since this is a story about poop,
please, please
be careful when reading.

It started from the second cycle after I began anticancer drugs.

I let out a deep sigh in the restroom and hung my head.

It's amazing!

It's shockingly

not coming out.

There was a cancer patient in the restroom,
hanging their head
in a pose like Rodin's sculpture.

It was me.

Cancer chemotherapy and constipation

When you use anticancer drugs, intestinal peristalsis is often suppressed, leading to constipation. In addition, factors such as reduced water intake due to nausea and decreased physical activity also contribute to constipation. In other words, fighting cancer means fighting constipation as well.

I used to be a nurse at a digestive disease center. So, I am more sensitive than most people when it comes to poop.

There are many medical professionals like doctors, pharmacists, and rehabilitation staff, but
among them, nurses see other people's poop the most.

Normal poop
Loose poop
Bloody poop
Black poop
Green poop
Clostridioides difficile poop
Poop with parasites
Baby poop
Elderly poop

I have seen a lot of poop until now.
It is the nurse's role to find abnormal poop among the many and report it to the doctor. So, the poop the doctor sees is the cream of the crop of abnormal poop. Surprisingly, people who aren't feeling that sick

don't look at their poop.

Poop shows important signs of the body.
I hope that those who read this diary
will take a good look at their poop
before flushing it.

Early detection of abnormalities is very important in providing medical care.

So,
as a nurse who is particularly sensitive about poop,
of course, I was well aware of constipation caused by anticancer drugs and had taken measures against it.

Measures against constipation from anticancer drugs

There are mainly two types of treatment.
The first is causal therapy (radical treatment), which involves anticancer drugs or surgery to crush the cancer itself. It starts by exploring why the current symptoms are occurring. The second is symptomatic therapy, such as using painkillers to eliminate pain caused by cancer, or using laxatives for constipation... It is treatment performed according to the symptoms.

These must be combined effectively.

If you only perform causal therapy, you will suffer from the side effects of the anticancer drugs, and if you only perform symptomatic therapy, you cannot crush the cancer. Cancer treatment is about combining treatments in a balanced way. It is very profound.

My body has become complicated because of cancer.
I must strive not to be defeated by the treatment while defeating the cancer.

And since this time it is a battle against the symptom of constipation, it is symptomatic therapy.

Constipation is one of the most common side effects of chemotherapy.
Therefore, I made the following preparations to prevent it.

・Preparation of laxatives
I make sure I can start taking 1-3 tablets of magnesium oxide, a saline laxative, at any time if things start to feel even slightly hard. It increases osmotic pressure in the intestines to draw in water, so I take it along with water intake.
If that still doesn't work, I take sodium picosulfate, a diphenylmethane compound, before bed. This suppresses water absorption and increases peristalsis in the large intestine. It's quite potent and loses its effectiveness with regular use, so I use it only when absolutely necessary.

・Water intake
During chemotherapy, the burden on the kidneys is immeasurable, so regardless of constipation, I drink water to promote the excretion of the drugs. If I feel nauseous, I take anti-nausea medication.
I keep my favorite drinks on hand. Sugar is already prone to being high due to the steroids, so juice is a bad idea—don't do it.
I love black tea, and I've been receiving it from many people and drinking it. It's the best.

・Exercise
Patients who need to get their bowels moving (such as after digestive surgery) walk an incredible amount. They can't lie in bed until they meet their quota, so sometimes they wander the ward in the middle of the night. That's how important walking is for bowel movement.
I walk nearly 20,000 steps in my job as a nurse, but conversely, I don't exercise on days I'm not working.
On top of that, the side effects of chemotherapy make my body feel so sluggish that I don't want to move.
But since I am a nurse, I know the impact of not walking on bowel movements, so I walked as much as I could with a sour look on my face.

・Diet
People often talk about eating dietary fiber or dairy products, but with nausea and taste disorders, I wish I didn't have to eat anything at all.
And thinking about when I might vomit, I don't want to consume dairy products. I don't want to vomit in the first place.
But if I don't eat, I'll lose not just to the chemotherapy, but to the cancer itself. Also, if I don't eat, my bowels won't move and I won't have a bowel movement.
I have to eat in order to have a bowel movement. Damn it...
This involves taking anti-nausea medication (domperidone) before meals and eating in small portions. Anyway, I eat when I can.

・Stress
Stress leads to constipation.
I often explain to hospitalized patients, 'During hospitalization, you are prone to constipation due to changes in environment and treatment, so please let me know about your bowel situation.'
So I tell them to sleep well or try not to hold onto stress, but seriously, how can a cancer patient not hold onto stress?! Grrr!
Just by having cancer, you hold onto stress, your bowel movements slow down, and you can't have a bowel movement. It's the worst. Don't forgive cancer.

Manual disimpaction, the ultimate nursing skill

With all that said, one day,
my anus stopped making a sound or a movement (← sounds like a fart).
But the poop was definitely inside my body.
But it wouldn't come out.

The magnesium oxide didn't make it in time.
Instead of suddenly getting hard, it just stopped coming out.
I'm going to take sodium picosulfate before bed tonight, but

I, I feel like if I try hard, it might come out.

So I put some effort into it,
and it subtly started to say hello.

Yes, yes!

I thought, 'At this rate,'
but just as it went from saying hello to saying good afternoon,
it stopped right there.

W-what should I do...?

I haven't been constipated that much,

so I don't know what to do!!

I'd like to say that, but
I am a nurse.

It's halfway out.
I hold the card for the ultimate nursing skill against poop: 'manual disimpaction'.
Manual disimpaction is a nursing technique where you insert a finger into the anus

to scrape out the stool.
It's not just about taking it out; it's about how to do it safely and quickly without causing distress.
It's a highly advanced skill.
If the patient in front of me were in this state,

it would be an option.

T h e r e i s n o w a y I c a n d o t h a t

I'm a constipation novice, so there's no way I can perform self-manual disimpaction.
This finger, which has performed manual disimpaction on many patients, might be able to break through this pain of my own. But while I can do it to others, I absolutely cannot do it to myself; it's impossible. I can touch a patient's poop, but I can't touch my own—no way! I am fully aware that I'm saying something that makes no sense, but while putting strength into my lower abdomen, I desperately think of means other than manual disimpaction.
I want you to tell me,


how to deal with this guy who is halfway saying good afternoon.

It came out.

I won't say what it is. It came out.

My feelings are like this.
I finally understand the feeling of this song.
It's this one

My butt... it hurts so much.

Also, is there a lot of blood...?

[To be continued]

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Bonus

Sorry to interrupt the poop talk, but I'm holding a talk show. A spirited nurse who is also a cancer patient will have the honor of talking about nursing with the renowned Dr. Tanaka!!!!

Hikaru Tanaka x Kage the Nurse "Morning Drama Motif! Meiji Nightingale: Nagu Ozeki and Masa Suzuki" Talk Show

https://bb260724a.peatix.com/%0A

A medical book that is reputed to have high energy only when talking about poop. I wrote a lot about poop.