My Defecogram Experience - edited with results
I have had some seriously crippling constipation over the past 2-2.5 years. The first year of my DS and prior to my DS -- I pretty much didn't even think about poop. Normal things caused me issues - white flour, etc. I didn't even really think about bowel movements. Now, I pretty much have become hyperfocused on it. Before I eat, I have a secret fear that this food will not make it's way out and is going to get stuck inside of me.
I can't even poop liquid. It gets stuck in me someway, somehow. Because of this, I get stool backing up in my colon that causes extreme pain, weight gain, and a ****ton of anxiety.
Prior to this exam, I have had 2 CT scans with contrast, a gastrograffin enema (pumping a barium enema up my bum while they visualize my colon), a colonoscopy, and a sitzmarker test (swallowing radio-opaque markers, going off laxatives, and watching the markers as they move through my body for a week). My sitzmarker test came back with normal transit time in my colon.
Anyways, on to the Defecogram.
I arrived at the radiology place around 6:40 to fill out the typical paperwork. I was nearly in tears in the waiting room from anxiety. A suuuper nice tech called me back right on time - 7am. Seriously, this woman was wonderful. I am definitely considering dropping off a thank you card to her. I told her I was nervous and she assured me she'd walk me through the whole thing.
I got all undressed, and they gave me 2 robes to make me feel completely comfortable. They set me up with an IV for glucagon -- which supposedly really slows down intestinal transit for just long enough to get the MRI done. I made her promise it wouldn't make me constipated for weeks.
She walked me to the MRI room, and showed me the whole set up. There were 2 tubes of KY jelly prepared (this is different than any other experience I'd read about--most people say they inject a barium paste). Anyhow, one tube was for my rectum and the other was for my vagina so they can differentiate all the organs on the MRI. I've also read that in some placed they inject a barium into the urethra to visualize the bladder. The tech laid down 2 hospital pads on the MRI (for me to poop on--yaaay). I laid down, she got me a warm blanket, and she placed the tube to inject jelly into my rectum for me, I placed the tube for the vaginal jelly myself while she injected it. It did not hurt.
The first ten minutes where just regular MRI stuff. Lay still for 10 minutes while a bunch of banging and clicking goes on. After that, the tech comes back in, and instructs me to do a series of holding my rectum and clenching. I did that about 3 times. She comes back in, tells me to bare down without emptying a series of 3 times. Then--the fun part, the tells me they are going to start trying to visualize the emptying of my rectum (the jelly) on to the pad. I am to relax for about 3 seconds while the MRI is on and then she comes on the speaker to tell you to defecate without straining. I couldn't do it. We had to try 5 times, each time she comes on to check on me, telling me to try again and increase the straining pressure each time.
Let me tell you, it's REALLY uncomfortable to do this...not physically uncomfortable really, but I dunno...socially maybe? Whatever. I was afraid to unleash DS poop, I was afraid to make a mess despite the pads being laid down. I was just scared! Plus, I honestly really just didn't feel much of an urge to go. Plus, trying to poo while laying down is difficult in it's own right, especially in an MRI machine.
This part of the exam was also COMPLETELY different than any story I'd read about. I'd read stories of people sitting on a special commode, people being raised above the ground, barriers being put up. My GI said that this was a new improved thing for the radiology place, so *****ally knows which way is better. Maybe I have the new way, maybe I have some crappy way without the special commode...I just know I had lots of differences so I felt it was important to write about to give a different perspective.
Anyways, I was done, and the nice tech lady came back, and said most women like picking up the pads and holding them themselves on the way to the bathroom and she shielded me with a blanket then let me get all cleaned up. There was a teeeensy bit of tan on the pad, but I was honestly terrified that this thing was going to stimulate a huge DS BM--it didn't. So, I just cleaned gobs and gobs of KY jelly off of me, got dressed, thanked the nice people profusely, and left.
So, I guess I can tell from the test that something is wrong with my rectum emptying processes. Technically you're supposed to easily empty it in a matter of seconds. Whether that got confounded by me laying down, being nervous, etc...I don't know. I guess that's for the radiologist to determine. I do know that I have problems eliminating. I can't even pass gas without contorting my body into all sorts of fun positions (leaning over loosens my gas and sometimes I can't pass gas unless I bend over to touch my toes).
As for whether this is the magic key to my constipation problems, I have my doubts because I also have tons of gas and indigestion. Just seems so crazy that ALL this pain could be related to something so low down in my GI tract.
Oh, and now I'm in a cafe eating a delicious omelet with mushrooms, peppers, feta cheese, topped with a really tummy pecan and basil pesto with a double side of black beans. Oh yum. How's that for ending this tale on a good note? :)
As always, I'm an open book if anyone has any questions, suggestions, personal tales. Whatever. PM me if needed, or ask here.
Thanks for reading if you got this far! LOL
Look down a couple posts for my update/results. I have a weakened pelvic floor.
21 months out and down 160 lbs! 27 lbs to go.
5'2.5" HW: 350? SW: 337 CW: 177 GW: 150
Started at size 34? pants, now at size 12.
BMI: 62+ to 31
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
Weak pelvic floor.
Buuuut, my liver enzymes and lipase are both also elevated so they are going to have me do an MRCP (MRI of pancreas/bile ducts) as well.
I just need to get my next MRI scheduled and I've got an appointment with my GI next Monday so hopefully we'll have a game plan by then.
I'm sorry you had to do this - but appreciate your posting your experience for those who - um - come behind. I'm sure if someone else ever happens to need this unusual procedure, nobody *****ad this post will forget who to send them to for advice and support!
~ Sarah P.
Ask me about pregnancy after the Duodenal Switch!
They're here! My surro-sons were born July 21, 2009. Welcome to the world, Benjamin and Daniel. We love you very much!
Sorry you had to go through this but hopefully you'll have an answer soon. Have they proposed any treatments?
-Band to DS revision on 06/21/2011!
Highest known Wt/ Lowest Wt (Banded)/ Regain-Starting Wt/ Current Wt/ Goal Wt
379.6/ 272/ 342/ 169/ South of 200