One could say the trouble started when Lorena Smedley died, and, since I was just over a week post-op, I wasn’t able to walk down the stairs to give her a proper burial in the backyard.
Lorena was my beautiful white goldfish, half fantail, half comet, bred and born (by accident) five years ago in my own tank (her parents passed on over the last few years). She was living in a tank in my bathroom when I crutched in early one morning, dizzy with pain, and noticed her floating.
She’d been eating with her usual gusto the night before (more than can be said for me these days), and yet there I was, still standing, and she was gone.
In my defense, grief can really compromise your judgement. So can narcotics.
After a week of relying on others for everything down to my socks in the aftermath of hip and pelvic surgeries, something in me rebelled at calling someone in to handle Lorena’s half-pound body. I said a few words and flushed her down the toilet, my tears dotting the bathroom rug.
Everything was fine for two days — as far as the toilet was concerned.
I wasn’t so lucky.
It seems strange to me, in retrospect, that constipation, while a nearly universal experience, is so little discussed. Even my surgeons, in the pre-op appointments, made the merest reference to it as a common side-effect of the narcotic I’d be on, airily recommending the addition of a stool softener to my at-home pharmacy.
Oh, society gives some leeway to the public discussion of poop — pregnant women, for example, seem to get a pass on this in their own circles — but for the most part, large-scale conversations about constipation are limited to ensuring the proper Metamucil dosage for the octogenarians in our care. No, I can tell you how much the sutures hurt or how the anesthesia felt, or how the PT made me cry, but can I discuss the sheer misery of a serious case of constipation? That just ain’t polite.
And yet, get somebody one-on-one, and everyone’s been through it. The war stories range from the wildly colorful to the deadpan. Someone confided to me that he once feared being the world’s first man to need an episiotomy for a “cauliflower”-sized shit; someone else said her sister, suffering from constipation after surgery, came to her in the middle of the night with nine words: “I took a laxative. Can you empty the commode?”
My own surgery, and the painkillers that came with it, wreaked havoc on my body and soul, but for eleven days after the operation, my bowels took a different tack. They apparently ceased to exist at all.
For the first few days, as my caregivers worked round the clock to keep me medicated, clean, fed, properly positioned, and generally alive, nobody gave much thought to my colon.
But my aunt did broach the topic of stool softeners soon after, brashly introducing the dilemma, and indeed the bottle itself, in front of a visitor of the opposite sex who was either truly unembarrassed or a flawless actor.
I insisted on perusing the bottle for myself, only to find that, due to a coincidence of the peel-back label, I could conceivably congratulate myself on at least possessing all the proper anatomy:
(“If you fail to have a bowel…movement in 72 hours.”)
At about eight days out, my aunt began to refer to foods like apples as “roughage.”
All I had to report on the subject was the feeling that the stool softeners gave me heartburn.
Finally, I had to admit to growing abdominal discomfort (no small thing when you have five incisions in the neighborhood), along with a sudden crescendo of nausea. Dark references to a buildup of “toxins” began to dominate the conversations in my bedroom. I’m pretty sure one of my surgeons was phoned.
My only personal experience with a laxative had been about a year ago, when an ill-advised and short-lived prescription for nortriptyline completely halted my bowels for no less than two weeks. Part of me imagines that the pain of my forcibly reactivated colon was comparable that of un-anesthetized 19th-century surgery, and much longer-lasting.
So this time, I was leery.
But when I agreed one morning to go beyond the stool softeners and try the full-power dose of a “gentle” OTC laxative secured from the nearest CVS (with a money-back guarantee), a decidedly festive air crept into the household, as my caregivers seized upon my willingness to swallow the additional pills as if I am a person with fleeting and unpredictable moments of sanity which they must never hesitate to take advantage of for my own good.
Nothing happened for about ten hours, but then I felt quakings akin to those that must have heralded the final days of Pompeii.
In the hour or so that followed, I cursed our lax attitude to the stool softeners in the first days post-op, but this was tempered by undeniable relief and the knowledge that, unlike last time, I had gotten off easy.
There was only one problem.
When I brought the tidings to my caregivers, it was a good news/bad news scenario.
The good news was that nobody needed to go to CVS to get our money back. The bad news was that the toilet in my bathroom was clogged.
The problem persisted over the next two days, despite the purchase of a new plunger, and the household, to my utter embarrassment, began to face the necessity of calling a plumber. But they insisted they were so happy at this sign of my evident road to health that nobody minded.
Unfortunately, none of us knew that this event was the Fort Sumter of laxatives: the opening shot in a conflict of which no-one could have comprehended the scope. By that night, a Sunday, my humiliation over the toilet faded as an internal battle loomed. I made my first (wholly unproductive) trip to the bathroom (down the hall from the site of my first foray back into normal digestion) around 10pm.
I could recount the solitary agonies that transpired over the next twelve hours. The distinct sensation that a tiny, tar-hot steamroller had taken up residence in my guts and was slowly flattening them, from the pyloric sphincter to the colon, over and over again, followed by a helpless gurgle like that of a baby humpback whale caught in a fishing net. The nausea that made me want to lie down on the tiles and die. The violent trembling; the cold sweats that made the crutches slippery in my hands. The hours-long archeological survey of the contents of my large intestine, the geological precision of the strata of our delayed and then slowly increased dose of stool softeners. But I’ll leave it at that.
By 10am, I lay weakly back in bed, a heating pad clutched to my stomach. I felt it was too bad the sound mixer for James Cameron’s Titanic, in the scenes (spoiler alert) where the boat founders and breaks in half and sinks, could not have just held a microphone to my belly. My pain and exhaustion were so acute that I barely noticed the arrival of the plumber and his own battle with an unknown object blocking the bowl.
Ultimately, for the knock-down price of $200, he had to detach and lift the entire toilet to behold Lorena blocking the pipe. He removed the fish and wrapped it in one of my aunt’s cushy, clean, new bathmats.
“You might want to throw that out,” he said.
I caught a whiff of the corpse as it was borne quickly down the hallway, my stomach heaved, and despite the entire episode being my fault, could only croak that they please get that thing out of here now.
After I published the first blog post about my post-op journey, a friend who has survived much more serious surgeries than mine messaged me to say that she related to it all, but could never have told anyone about it. Rather, she kept a rosy veneer to her progress for all her Facebook friends, and downplayed the pain.
In some perverse way, her reticence helped inspire me to break out my whole story. This is recovery from surgery, when your body decides that it may just begin to work again after it’s been sewn back together. It’s not fragrant or polite. But it’s real.
After my night in crisis and the exhumation of the fish, my guts again went dormant for almost a week.
My snacks became bowls of green beans.
No-one dared suggest further doses of the laxative, but my primary care doctor, brought up to speed by phone with all the gravity of an organ donation board, recommended the use of a magnesium supplement known as Cleanse More, sold at Whole Foods.
When a single large, brownish, woodsy-tasting capsule at bedtime for about three days apparently yielded nothing but flatulence of such a sulphurous nature that I wondered if someone had accidentally fed me Yellowstone National Park instead of hearty whole-grain breads, my aunt declared that she was upping the dose from one to two Cleanse Mores.
Her son, a recent college graduate, was on hand for the gala announcement and said he was glad he’d worn his nice shoes.
When the double dose of Cleanse More yielded nothing, I spoke in desperation to my physical therapist, who, I reasoned, must have dealt with many surgical victims in my bind.
She recommended something called Smooth Move tea, and I gulped a small, weak cup of it that afternoon.
The next morning, at about 7:30, I awoke to ghastly yet familiar tectonic shifts beneath my belly button.
All I would really like to say about the following hour is that Smooth Move is, at best, a fifty percent misnomer. It’ll move you, alright. But there’s nothing smooth about it. Goodbye constipation; hello gastrointestinal lava.
The end result was my earnest appeal that we Cleanse no More.
Meanwhile, family members in two states privy to the fish fiasco practically bust a gut over my failed attempt “not to bother anyone” with the demise of Lorena.
Somehow, this lapse in my judgement as to the capabilities of the toilet, at a moment when I should have called for a helping hand, reminded me of the lonely agonies of my laxative journey. Perhaps we dread these workings as much as we do not only because of the violent discomfort, but also the certainty that unlike many other kinds of pain, we’ll suffer it alone. So here’s to sharing the pain. Or at least being honest about it. May you never feel alone as your surgeons sleep tight and you pray for the flush.