What can I do for my father who is either "running" or "stopped up"?
There is no in between. I just started being a caregiver to my 78 year old father. He was just uprooted from Michigan 10 days and brought down to Florida to be closer to his daughters. I had the bigger home and flexible work schedule so he came to my house. He was diagnosed with squamous cell carcinoma of the nasal cavity in March. He had surgery in April. What should have been a week in the hospital ended up being a month followed by a month in rehab. He went home in June to an empty house and no one to really help care for him except rides to appointments and shipping. Long story short, he began six weeks ago on Klonopin for anxiety and Lexapro for depression. I don't know if these drugs are what caused him to simply decline rapidly but he was no longer able to take care of himself and had to move down here. Since I have had him, he either has diarrhea or he's constipated. He has no in between. I can't get him to drink a lot of fluids. I started with Miralax and he was able to go, so I stopped it. Then he goes a few days of not being able to go again, or he has a day of diarrhea. I talked to the doctor and she suggested I don't do the Miralax but do something like Metamucil to help get him regulated. I have been doing this for a couple days, but he's constipated again. My sister had Lactulose that her late husband was given to help him from the opiod constipation. It's only been 2 doses so far, but my father is miserable. I told him he needs to drink his water and has to be patient. We have already done one trip to the ER because he was so bloated and his stomach hurt. I can't run to the ER every time he can't go!! :-) I need suggestions on what we should (I should) do for him. I am trying with the liquids, but I also know his diet is not the best. He only eats oatmeal, soft boiled eggs, Activia, applesauce or chicken broth (he hates the noodles so I just make him broth). I know he's not getting enough fiber and protein (oh yeah, he drinks the carnation instant breakfasts for the protein as Boost is too thick for him). He has just a few teeth so he can't really eat hard food. I have also introduced the V8 Splash juices that have fruits and vegetables as that's the only way I can get that in him. HELP!!!!
Add some seasoning to it (because it's bland as heck) but I'll bet he could get it swallowed.
I would try probiotics to try to normalize the flora in the intestines.
Check the side effects of the meds he takes at Drugs website. Just type in the name of the med and click on side effects. Many drugs bother the intestinal tract.
When you take medicine for diarrhea, it slows down the movement of the stool in the intestines. If you take too much, you can get constipated. Then you're dealing with the opposite,
problem, a revolving door!
Great suggestion to get lactose free dairy. At 47 I couldn't drink the nonfat milk I had drank for 42 years. Why? Who knows. (I blame everything on menopause!) But I still got bloated and "loose" with lactose free products. (Maybe I'm sensitive to a certain milk protein.) I now use almond "milk", great on cereal. There are coconut, soy and rice milks too. Sometimes drinking through a straw can cause gas they (doctors) say. Lack of exercise can definitely cause sluggish intestines (leading to constipation). Walking up and down the block would encourage parastaltic (gut) movement. Increase fluids however he can get it, broths, soups, decaf tea or coffee, lemonade, hot chocolate. Older folks have to be reminded to drink because they loose the "thirst" sensation. Offer fluids frequently. If possible add more veges/fruits to the diet.
Hopefully your dad will settle in and be back to regular soon.
P.S. Any "bulk" product (oatmeal, Metamucil, etc.) has to be taken with a large amount of fluids, as the nature of the food is to absorb water. If not, it just turns into a lump. The job of the large intestine is to suck excess water out of food (so we dont have runny poo all the time). If you haven't had enough fluid with your oatmeal, it will suck out whatever's there and you'll be left with a brick of cement to pass. You can take a very safe stool softener (Docusate sodium) to prevent this process. It's given to pregnant woman so very safe. It just keeps more water in the stool, so you can pass it easier. Sorry for the bluntness. You should have heard the conversations in the nurse's lounge when we were eating lunch! 😝
When my mom was suffering with anxiety and depression, I discovered that diarrhea alternating with constipation can be a symptom of depression. I know he's being treated, but....I'd once again ask his doctor if the meds need adjusting. I know it takes a awhile to see improvement with meds, but,.....you can tell them what you are observing.
Also, I would do trial and error with his diet. Some people's system cannot handle certain foods. Most people go well when they eat oatmeal. I CANNOT GO at all if I eat it. It's weird, but it clogs me up bad. The same goes for greens with me. What works for me to go are fresh fruits like pears, apples, oranges, grapes, and veggies like squash. I'd figure out what works for him, but if it's his meds no diet may keep him regular.
In the meantime, ask his doctor about him taking 2-3 daily stool softners if it's clogged up. I've also heard that pro-biotics are helpful, but, I've never tried them.
Another issue could be a wheat allergy. If Dad eats a lot of cereal, try the "gluten-free" cereals for awhile. There is a blood test to test for gluten issues.
Usually if the situation is diet related, it can take 2 to 3 weeks of trying to keep dairy and wheat out of the diet before you see results.
I would go back to the Miralax if it worked for you, there is no harm in taking it long term and it is much easier on the system than heavy duty laxatives like lactulose. Experiment with the dosage, half the amount every day or the full amount every other day or whatever works. As awful as being too loose can be constipation is 1000X worse. (You might want to keep a Fleet enema on hand, but you don't want to go there lol)
His diet actually sounds pretty good to me, probiotics in the yogurt, fiber in the oatmeal, plenty of protein in the broth and eggs and yogurt. Try adding fruit in his oatmeal and juice for breakfast, whiz soups with veggies in the blender.
Do a search for it to read the reasons it's effective.
You might try Ensure Plus; it's one of the few supplements my father likes. It was used in the SNF he just left as opposed to just plain Ensure, or Boost, or some other supplement.
If he doesn't want to drink water, try to add watery foods, such as soups, or even something like sherbet in summer.
You can also make smoothies of various foods; it's another way to get liquids into the diet. If he likes cider or juices, try those as well.
Could he eat mashed potatoes? Mashed vegetables?