CSN Login
Members Online: 5

Bowel Obstruction - please help

me_and_my_mom
Posts: 44
Joined: Dec 2012

Please - any thoughts, suggestions appreaciated. I am quickly losing all hope.
Prior to beginning chemo, my mom was nauseaus - and bloated. She was able to eat and drink small amounts, and was urinating and having small bowel movements.
She had her first chemo on Friday,and it has been a steady decline ever since. First of all, she is a lot more nauseous and vomitting a lot. She had a small bowel movement on first day, and has not had one in 3 days now. They have been taking xrays and have been keeping an eye on a possible obstruction. They have a ns tube in her to suction out secretions. The last xray showed, according the the nurse I talked to, to indicate that things were just moving slowly through her -(and that her intestines are squished), but not a tumor type blockage. Well, tonight, the oncologist tells us that it appears the blockage is the cancer wrapped in and choking the intestines,and that there is not much we can do. He says she is not a surgical candidate, and our only hope is that the chemo she just rec'd will shrink things around her colon. He said the increase in nauseaous and vomitting that we noticed immediately after her first chemo were not related to the chemo at all, but most likely the bowel obstruction. I disagreed, saying that chemo can cause the increase in nausaous - but he said what she is getting (Taxol and carboplatin) do NOT cause nausea and vomitting if taken with zofran. Is this true????? I thought I have read of others having nausea and vomitting from these two drugs.
He basically gave us no hope - putting his hands on my mothers shoulder, looking sad and apologizing. He sais only time will tell if it is a blockage, but he does not expect a good outcome.
I asked about a second opinion, or possible surgery, and he did not think that was necessary - that any doctor would say the same thing.
Has anybody here gone through an obstruction that cleared from the chemo? Doesn't the chemo constipate you, and how would they know it's not just that instead of an obstruction? Again, is it true these chemo;s should not make you vomit? Has anybody ever heard of one doctor saying something is inoperable, and another saying it is?
I want a second opinion - maybe something can be done. My emotions are all over the place. Any thoughts on this greatly appreciated.
Maybe I am being naive, but I feel like the increased in vomitting is the chemo, and that she is just constipated and squished, but does not have a bowel obstruction. he kept saying 'But she hasn't had a bowel movement in 3 days". Is that really unusual given all that is going on?
Please, anybody.

Alexandra's picture
Alexandra
Posts: 1260
Joined: Jul 2012

Dear Carol, I am very sorry about the painful setback you mom is going through.

Sometimes people vomit from chemo and sometimes from bowel obstruction.
Being a medical professional yourself, I am sure you understand that what you read on this board can not be interpreted as solid medical advice.

You have to trust your doctor.
But if you can not accept his passive strategy, you need to get another doctor's opinion. It's not uncommon for doctors to disagree.

Stay strong and positive

MJensen
Posts: 93
Joined: Oct 2012

Hi Carol,
This is true. I was in the hospital for 5 days with a bowel obstruction this past Oct.( 2 months ago). This is when I had the NG tube put in. The DR was worried I had a bowel obstruction that could have been caused by the cancer infiltrating my colon wall. I had X-rays in the hospital all day long (hourly) to see if things were moving. I had 4-6 enemas a day. I had 4 Drs visit me in the hospital and look at the X-rays. GI DR, GYN/ONC surgeon (did my 2 OVC surgeries) , General Surgeon/family friend and my Oncologist. All said a bowel resection was not an option because the cancer was not located in one spot...it has attached to my colon in many areas. What happens is the cancer strangles the colon and stops the natural parastalsis which keeps things moving through your intestines. I was throwing up, as is your mom, because food, drink cant go thru the intestines due to the blockage so the only option is to throw up. If the nurse said things are moving slowly then this is good.
All 4 Drs said we have to count on the chemo to destroy the cancer on my colon....no surgery. On top of that I have to be on a low residue diet and drink Miralax, do shots of Flaxseed oil and take stool softeners and suppositories as needed. I vary my routine. YES chemo can cause constipation as can narcotics. So if your mom is talking vidicon, morphine etc for pain she needs to be on a stool softener as well. Hopefully the nurses and DRs have talked to her about Miralax etc. I know several of us on the board have recommended that she take Miralax before chemo. If I keep getting obstructions then the Dr's next choice is to put a stoma in to collect the waste. I work hard to keep things moving. It sounds like your family and Drs are talking with you about what is going on. This is better than yesterday. BTW. When I was in the hospital I wasn't allowed to eat or drink for 5 days. I was being being hydrated by IV only. Hopefully the chemo is working on your mom. If they check her CA125 this might be a good indication the chemo is working. Please keep us posted. All the best to you and your mom and family!!! It is tough to go thru ....I know it was tough on my family but I made it through it and the chemo did it's job....I just have to hope it keeps on working! Michele

me_and_my_mom
Posts: 44
Joined: Dec 2012

My mother has not even had surgery yet. She was taking miralax daily for over a week prior to starting her chemo. My mother hasn't eaten a thing in 5 days now. They say our only hope is for chemo to do it's job - is that what made your obostruction better Michele? Was it the chemo?

thank u all for your replies.

MJensen
Posts: 93
Joined: Oct 2012

Carol,
When I was diagnosed in Aug 2010 I was nauseous, throwing up, in pain and very very sick.. I was continually told it was IBS. Once they diagnosed OVC the Dr went in and removed my ovary to biopsy it. There was so much cancer everywhere, to include on my colon and I was filled with ascities fluid. The DR stitched me up and came out to tell my husband he couldn't do surgery because there was too much cancer and he would only be able to get 50-70% of the cancer and that wasn't an option. He said we had to wait and see if the chemo would do it's job. It did. When he went back in for the second look and debulking surgery (after 3 rounds of treatment) he told my family it was like night and day. The chemo had worked really well. He did my full hysterectomy and I went right back on chemo. Regarding this last bowel obstruction I was still on chemo but what cleared my obstruction was the enemas, stool softness and the Miralax. I hope the chemo is working on your mom. Please keep us posted!

abrub's picture
abrub
Posts: 1537
Joined: Mar 2010

However, ask if she is getting TPN - IV nutrition. I didn't get that for much of my time on the NG, because my dr felt that "tomorrow" I'd be off of it. He later admitted that was an error on his part. I ended up extremely week from several weeks of no nutrition, just standard fluids (and massive drugs.)

abrub's picture
abrub
Posts: 1537
Joined: Mar 2010

I know of people who have not had good results with Zofran (which also constipates.) Emend didn't seem to help me much. Often, it's a matter of trial and error to find which anti-nauseants work the best:

Zofran
Emend
Aloxi
Atarax
Ativan
Ginger

There are others - it's a matter of finding which combination works. I don't know that Emend helped me; I was violently nauseous by the end of the primary chemo infusion, until they started giving me ativan shortly before I left (I would then have 48 hours of chemo at home on a pump - FolFox is a colorectal regimen.) Zofran did help, as did Atarax. Everyone is different.

wholfmeister's picture
wholfmeister
Posts: 265
Joined: Dec 2012

My chief symptom at diagnosis was INTENSE lower abdominal pain when my bowels moved, or were getting ready to move. After studying the CT scans and MRI, my oncologist said the bowel was being squeezed and contorted due to the tumors. He said there was no way to operate right then unless I wanted to lose my whole colon. I wasn't happy, but all I could do was trust him. (I did have the assurance from two other family-friend physicians who looked at the CT and MRI reports) I started on taxol and cisplatin, and within DAYS of the first round, the pain was so much better! After 3 rounds, I had surgery and there was no problem clearing the cancer from the bowels! So, there is hope! Everything the other women have told you is true regarding Miralax, stool softners, and anti-nausea meds. But don't be surprised if the CA 125 actually goes up with the start of the chemo...mine went up about 10-fold as the chemo attacked and killed millions of cancer cells.

me_and_my_mom
Posts: 44
Joined: Dec 2012

thank u all for your replies. I come from a very dysfunctional family, and things are not going well w/ my sister, father and I. When I visited my mother last night, I went in strong, full of concern yet w/ hope and optimism. She was in a lot of pain, and I tried to be quiet and comforting, leaving the room now and then so she could rest, and stayed a total of an hour and a half. I asked how she was, reassured her she would feel better, and made occasioanl small talk. I asked her if she wanted me to go, and she said no, not yet, and I told her to let me know when she needed the visit to end so she could rest.
During my visit was when the oncologist came to tell my mother that she had an obstruction, and that she may be too sick for further chemo - basically - things do not look good at this point - she has declined significantly. It was the first time I have actually met the medical oncologist, and after he delivered this upsetting news, I asked him questions, such as whether or not the chemo could clear things up, whether my mother might benefit from more pain/nausaes meds, and relaying him info I felt was important, such as that my mothers decline has been dramatic since the chemo and that she was better before it, bascially trying to remain optomistic and look at all our options (looking for any silver linings). When the doctor left the room, I followed him out and asked him, in private, what my mothers prognosis currently is. HE told me her disease is extremely advanced, that he does not think we will be able to clear enough to debulk her, that she is declining quickly, but that they would not give up hope. I left the hospital feeling concern about the blockage and the doctors news, but still trying to be optomistic, and honestly feeling proud of myself for being strong and keeping it together in front of my mother. I am a very emotional person, and it is hard for me to keep my emotions intact - but I have double my dose of anti depressant and took 3 klonopins - and I thought the visit went well on all fronts. My husband was w/ me, and agreed.
I rec'd a call from my father this morning, where he screamed at me for 45 full minutes. Apparantly, my mother did not have a good night after I left, her breathing was erratic, her blood pressure rose, and she 'held his hand tighter than ever before". My father layed the blame squarely on me, for asking the doctor questions in my mothers presence. (the converation was 3 sided - me, my mom and the doctor, and I only brought up optomistic silver lining things in front of mom - it was the doctors words/news that, imo, where extremely upsetting). My father accused me of upseting my mother greatly be talking to her doctor in front of her, and that as a result, she suffered tremondously throughout the night. He said I should not be asking questions, I should not be talking w/ the nurses (I have talke to 2 over this past week, for a total of a whole 5 minutes) - he said I was demanding, that i was telling the doctor what to do, and that we do not need to know everything - the doctors will tell us what we need to know on an as needed basis, that they are doing everyting they can (I disagree, I work in the medical field and feel it is so important to have an advocate, to ask questions, and to talk w/ the doctor to work as a team - and I know the doctor took know offense to my questions, in fact, when he said goodbye to me he took my hand, smiled, and said I reminded him of his wife - I laughed and asked "crazy" and he laughed and said, "no, intuitive"). My father accused me of calling my mothers room incessantly and 'hanging with the nurses" which a complete and total lie.
My father has always scapegoated me like this my whole life, and we are not close. He is a very difficult man to deal with when things are going well. My sister called and basically warned me that my father is threatening to not allow me to visit or call my mother, or get updates from the doctors of hospitals of any kind.
I am full of devastation and anger. I am stepping out of the picture. I called my mom this morning, was cheerful w/ her, told her how happy I was that she had a small bowel movement (Thank you God! This is wonderful news), and that I would be stepping back for a bit to let her rest and relax, and that if she needs me at anytime to call me and i will be there.
that's it. I think I'm done. I cannot handle the fighting, the accusations, and my fathers insanity. I thought of calling the hospital to see if maybe a social worker could help me navigate this better, and make decisions so as to keep my distance, but let my mother know I am here if she needs me.
I am also thinking of just sending my mom some card and letters to let her know I have not abandoned her.
I'm sorry I'm so needy right now. I hate the way I sound.

lulu1010's picture
lulu1010
Posts: 367
Joined: Feb 2011

I am so sorry you have to deal with family issues at the same time as dealing with your mothers illness. I am sure it is hard for the entire family and everyone reacts differently.
That said, let me tell you that I had the same situation in late August. Surgery was not an option. The Dr told me the only thing that would help was the chemo which would probably make me feel worse before it made me better. I was started on Carbo alone and it didnt kick in for about 2 weeks. After the 2 weeks, the pain eased and eventually went away and the bowels started to move. By October, I was on a golf vacation in the south! I have now had 5 treatments and have no problems. Actually I feel very good. And my Ca 125 is 12!
Of course, everyone is different but just give the chemo a little time and keep up with the Miralax and stool softeners and see what happens.

I pray your mom responds as well as I did!

me_and_my_mom
Posts: 44
Joined: Dec 2012

Lulu,
Were you vomitting? Did you have to stay in the hospital on NG Tube until the carbo worked? It has been 5 days since chemo, and no changes. What a wonderful response you had!

abrub's picture
abrub
Posts: 1537
Joined: Mar 2010

Then again, your father might be further infuriated that you are taking "personal family issues" outside of the family. He sounds both unreasonable and old school. My parents were also of the belief that you didn't question drs - you allowed them to tell you what you needed to know.

However, your father's accusations go beyond that - he is looking for a scapegoat, and would probably love to blame your mother's illness on you as well.

It sounds like you are handling things wonderfully. I can't imagine doing anything differently from what you are doing in your specific situation. Try to maintain a background contact with your mother - she needs your sanity.

And yes, perhaps she will respond. Having a bowel movement is huge in her situation. It is a significant step forward (boy, we learn to talk about everything here.)

Sending support and hugs,

Alice

MJensen
Posts: 93
Joined: Oct 2012

Hi Carol,
I am so sorry your dad is in denial and taking this out on you. I don't understand why he doesn't understand you have been thru this yourself and it helps to be informed. With a card or letter I hope you do let your mom know you love her and will do anything she wants to help her through this nightmare. She may be too weak to argue with your dad on your behalf. Your family dynamics is not what I am used to but certainly have seen this in other families. I am sure it is hard to cope with this but I do feel you are doing the right thing by trying to be her advocate, She needs someone to be her advocate and ask the hard questions. Maybe you can call the overseeing DR in Boston and explain the situation to him. Not sure if he/she will be any more helpful. Hippa law may require your mom to give the Boston Dr permission to talk with you which may be overruled by your dad. I know this is frustrating but the fact your mom had even a small bowel movement means the colon isn't fully obstructed which is a good sign. As I said earlier it took me a couple weeks to feel better once I started chemo. Keep the hope and faith! Have they checked her CA125 lately? If that is coming down then it should indicate it is starting to work. Is the NG tube still in and giving her any relief? Hopefully they are checking her blood regularly and giving her potassium, magnesium and any other nutrients she needs thru the IV to keep her strong. Hope you will get some updates and your mom will ask to see you soon! Keep us posted. Stay strong and positive! Love and light.....Michele

me_and_my_mom
Posts: 44
Joined: Dec 2012

My mother has had 3 bowel movements. That sounds to me like she does not have an obstruction, or is she does/did it is better? If so, this is amazing, and maybe the chemo is starting to work? Her NG tube has been turned off, but is still in. She is sipping clear liquids today. She is still in pain - or pressure, in her upper abdomen, but it seems "better". Today is day 6 after first chemo, and they tapped 1.5 liters from her chest today - this has me worried that the chemo is not working because she still has some ascites? She is still nauseous, but she says it is getting a bit better. She is extremely week,is existing only on the IV fluids (not sure if it is TPN or just glucose and water) and been in the hospital since chemo on Friday, and is only getting out of bed to transfer to bedside commode at this point. Talking wears her out, she is not very comfortable, and she does not really want any visitors.
Can anybody relate to this? Does this sound like progress, or like she is declining? Her weakness worries me - her bowel movements are excellant news though.

lulu1010's picture
lulu1010
Posts: 367
Joined: Feb 2011

I had dry heaves but no vomiting. I was in ER 4 times and they kept saying to come back when I vomited or they didnt want to put a tube down unless I was vomiting. My Dr finally got on the case and said to put the tube down. All kinds of yucky stuff came up. When they figured out what was happening they let me go home and get the chemo and I remained sick for 2 weeks.

Subscribe with RSS
About Cancer Society

The content on this site is for informational purposes only. It is not a substitute for professional medical advice. Do not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Use of this online service is subject to the disclaimer and the terms and conditions.

Copyright 2000-2014 © Cancer Survivors Network