get it out before she pops 2

[littlemaemae]

Following on from aibu to take dd3 to a&e

Ps. Cats starting a trend

LittleMae might not be feeling terribly lucky right now poor little sausage, but she is lucky. Lucky to have such a brave and amazing mummy

Seriously, well done. X

My gm used to give us liquid paraffin if we got a bit egg-bound. That was 50 odd years ago. You could probably get it on the internet, if you really, really wanted to. It is true that sometimes the old ways are the most effective. Sometimes.....

Littlemae Hoping with all my heart things take a dramatic turn for the better. Your poor DD. And you should take stock of how you have massively stepped up and dealt brilliantly with all this, all the more impressive given how anxious you were at the outset. Well done!

I have done fire-breathing with liquid paraffin. I can confirm it has an impressive effect on the bowels if you swallow it.

Well done OP, you are fab and your DDs sound like bright and brilliant characters :) Wishing little DD a speedy deliverance from her unwelcome lodger, and some long overdue answers for you all.

Regarding how long it will take to shift, she will not be able to pass it in one go. They have to rehydrate it and soften it from the outside in. Will take some time. That is why the enormous enema - get the fluid in, soften it up, pass bits of it, repeat until it is small enough to come out.

Oh op, your poor little girl! I am really hoping this is resolved soon, at least now you are getting decent care and attention.

My heart goes out to littlemae and you, OP . I've had Picosulphate (as Picolax) before a colonoscopy, I didn't think there was anything that it couldn't shift.

Ditto with the Pico (for a colonoscopy) - its hardcore stuff. Still following your story, am really happy she's where she needs to be and that the ball is well and truly rolling. You must be exhausted, but take strength in the fact that you are doing such a bloody great job at caring and advocating for your DD.

I hope you both managed to get some sleep

We are having another enema then being sent home tonight as its not budging and we could be in here for a lot longer.
She's going to be on klean prep when we get home.
Does anybody have any experience with that med?
We were alone in our bay and DD has 12 hours sleep. Was bliss

Didn't think they would keep you in.

Before you leave get written instructions as to what is the course of treatment and time scales accosiated with it.

DT2 had Klean Prep last year. It is awful stuff to drink and they have to drink a hell of a lot of it. It's what they use to clear people out before a colonoscopy. DT2 stayed in hospital for 3 nights to have it (as well as Picolax) as she had to take 2 litres of it over the course of 24 hours and there was no way she'd be able to actually drink it all (partly because it's disgusting apparently, and partly because it's a huge volume of liquid to ingest). She had a nasal gastric tube, so it went straight into her - not pleasant to have the tube inserted, but the easiest way to administer the medicine.

I can't believe they want to send you home to get her to drink this stuff. Particularly if the ward is quiet at the moment. We had to wait for a bed to come up, just as the ward was getting really busy because of winter illnesses, but the doctor said there was no way she'd be able to take it all at home. We had to wait a bit longer so that we had a side-room with just one other patient and a bathroom shared between us. DT2 needed access to the bathroom frequently and urgently once the stuff started working! By the way, DT2 was 10 at the time, so a bit older than your DD, but they still considered it too difficult for her to take the Klean Prep at home.

If I can be of any more help to do with this treatment (or testing for coeliac disease), please let me know. It's all quite fresh in my mind still!

If you're not able to get oral meds down her then how will you be able to get her to drink large volumes of something horrible? (I have a medicine refuser so I know how hard that is).

I'd insist on trying some in hospital so you can see if getting her to take it at home is viable.

Can she have an NG tube at home?

Yes I have had klean prep several times for colonoscopies (I have crohns), from my experience it's very strong and within a couple of hours everything is liquid, but this maybe different for someone severely impacted.
It basically tastes like burning lemons, you can disguise the taste with lime cordial though. I have to drink 4 litres over 24 hours, which is a huge volumes of liquid to get down. Good luck & fingers crossed for you.

P57
www.ncbi.nlm.nih.gov/pubmedhealth/PMH0033414/#!po=0.0694444

The GDG discussed the use of Klean-Prep® (Norgine) bowel washout for disimpaction as GDG members were aware that some clinicians use it in children who fail to tolerate or to respond to oral disimpaction. The GDG noted that Klean-Prep should only be used within specialist centres and it may require inpatient admission and insertion of a nasogastric tube. The GDG also noted that the BNFC says that bowel cleansing solutions (including Klean-Prep) are used before colonic surgery, colonoscopy or radiological examination to ensure the bowel is free of solid contents, but they are not treatments for constipation. For these reasons, they agreed that they should not recommend its use.

Been lurking on this thread since the beginning but I have to say I would insist on staying in to take the kleen prep , I know it's very inconvenient being in hospital but it probably is the best place for your daughter at present - however long it takes .

Thank you son very much for these replies. Really detailed information. I would have just taken it home with high hopes otherwise.
I have a terrible feeling about going home and trying. Feels like a recipe for disaster.
She's hardly drinking or eating now as it is. She's about to have another enema. I can't see her drinking huge volumes of burnt lemon!
I will ask about it being tube fed to her. I'm also concerned about the pain when she eventually passes it and she is refusing oral paracetamol.
It might be a bit ott but if her pain gets bad she may need IV pain relief. I don't want her to suffer with no relief, an adult wouldn't have to.
The hospital is very quiet and lots of spare beds. I would hate for it to fail, then come Monday there are no beds for her.

I don't understand why they're sending he home after saying she was in until it was passed??

I am so sorry to read this is still ongoing but released to see you are finally accessing medical help. If I were you I would refuse to budge from hospital, DH has had to take Klean-Prep for colonoscopies and he struggled with it as an adult, I can't imagine how you'd cope with a little girl who's already been through so much.

What is her weight in kg? That would give you an idea of the volumes shed need to drink. If it makes adults vomit I can't imagine getting it down a child.

Could she have PR pain relief? Not sure if it's appropriate with bowel problems.

www.evidence.nhs.uk/formulary/bnfc/current/1-gastro-intestinal-system/16-laxatives/165-bowel-cleansing-preparations/macrogols/klean-prep

By mouth, nasogastric or gastrostomy tube

Child 1–18 years
10 mL/kg/hour for 30 minutes, then 20 mL/kg/hour for 30 minutes, then increase to 25 mL/kg/hour if tolerated; max. 100 mL/kg (or 4 litres) over 4 hours; repeat 4-hour treatment if necessary

Relieved not released, sorry.

Sigh.
It's the weekend again, isn't it?
I'm afraid if I were you op I wouldn't be going anywhere!
Kleen prep is disgusting and some can't tolerate it and just vomit it back up :(
I can't believe they keep sending you home.
What's the point?
You will be worried, you won't have medical back up if things done t go to plan, and she needs pain relief!

I would strongly advise you not to try Keen Prep at home given your circumstances. In hospital using a ng tube if they must but I must admit I have never heard of it being used to clear a blockage.

Klean Prep is really awful. As a grown women I wept at having to finish litres of the stuff. The only think that kept me going was the knowledge that if my bowels weren't clean I would likely have to do the same all over again and I really COULD NOT have done it. It is really not cool to make a child go through this at home. I'm not particularly a woose when it comes to medical stuff, but this was horrible.

If they do make her do it - I can only advise to flavour it with lime cordial. The one I had was "vanilla" flavoured and didn't taste like burnt lemons (which sounds far more pleasant than it actually tasted).

Good luck Mae, be thinking of you all.