Looking for suggestions

On June 15th, I started EBRT. The first two sessions, which were held around 2:45 PM, did not go well because of, either, the rectum wasn't completely empty or the bladder wasn't full enough. I explained to my nurse that my wife and I are plant based eaters. As a result, I wake up about 6 AM each morning and after about an hour of moving about and having my morning coffee, I'm off to the toilet. So, a test run of having me receive my treatment at 7:45 on Friday morning was a complete success. I was in and out in about 15 minutes. The radiation team is now looking at switching my treatment time to 8:45 AM on July 6th, when they'll have a daily opening. Until then, they are going to slip me into any morning opening.
I'm approaching you guys for suggestions on how to make sure the rectum is empty in the afternoon and my bladder is full if I have to go for an afternoon treatment session. My body just has a hard time emptying my bowels in the afternoon. My bladder issue is balancing filling my bladder and not over filling.
Hope you guys can come up with some recommendations. Thank you

Hey Boomer,

How many treatments do you have ahead of you? The plant eater part is not important as prunes, beans and fiber can do more for you than all the meat in the world but I digress.

I had radiation 5 months after surgery so my comments will be based on this and the fact that some constipation has been a problem in recent years. I also had the issues of variable appointment times at first as well as an equipment issue that had me come back the same day at 6pm.

The bladder was the easiest part when I was on a daily 9am schedule. I emptied my bladder again at 7:30am then drank my first 16 oz bottle of water. about a half hour later, I started drinking the second bottle and took it with me on the short drive to the center. After a while, I was doing a little less than 2 bottles and was playing it by ear. Some get by on less water so practice helps. Hard to imagine a surgery patient holding 32 oz of water for a delayed treatment but you do what you have to. Sometimes I was ready to explode if they did not call me back at 9am and running late. The techs were pretty militant at first to set the tone but they let me know after each treatment how I looked. After the first two weeks of variable times and getting used to the routine, I was set for the rest of the treatments. However, the day my appointment was delayed to the end of the day, I followed the same routine and techs sent me back to drink more water and wait for about 20 minutes. I am convinced that different states of hydration exist during the day and what works when you get up does not work the same later in the day.

The empty rectum was a more complicated issue. After surgery, I was not able to poop without peeing (medical terms used for convenience and never tried to poop without peeing before) so the concept of just emptying the colon again would cause a full bladder problem thus I was introduced the “clamp” by the techs. I will spare the details but it solved the problem. Techs know all so just ask.

I am also a big fan of Miralax. I took it 7 days per week to keep my bowel movements soft and easy to pass. It is gentle and really has no side effects and so much better than other products. It also takes a while to work so you should start as soon as possible. I blended a scoop in with some juice daily (or twice a day) which one can adjust based on response. I tended to take more smaller bowel movements and adjust to fit around variable treatment times.

Similar to Terry’s Cellar only I maintained this program for two months, 7 day a week. No crazy drinking beer and eating pizza on a weekend. I ate a high fiber breakfast (Fiber One and fruit) in mornings, smoothie and apple at lunch, and dinner with vegetables. Almonds were my snack food. I think I only drank a small amount of red wine or one beer per day during this period. Consistency was a key item for me.

As a side observation, I traveled a lot during my working years and did lots of presentations. I got pretty good at going to the bathroom when time permitted, not when I felt like it. I had no problem pushing my morning routine back a few hours regardless of coffee or breakfast timing. My wife is the opposite so each person will have a different problem to deal with. Hope this helps a bit but everyone gets through it, some have to drink more water occasionally or get sent to the bathroom to try again.

It gets easier after the first two weeks when your schedule stabilizes and you get used to the routine. The GI tract does not always behave so there will be some variation no matter what you do. I had my coffee and breakfast before I went every morning so it really was not much of a hardship and could run errands afterwards.

I will share that one day my session was running a little late and I really had to go after I left the room. However, the two nearby little bathrooms were occupied. I started to panic and quickly walked down the hall looking for another bathroom. Before I could say anything, staff people would just point down the hall until I found the other bathroom. Must happen everyday when the panicked man appears and everyone knows what the deal is. No words necessary.

Hi Mumbo and Jim,
Thanks for the help. Mumbo, I chuckled with you full bathroom predicament. I had the exact situation happen to me today. Luckly, one of the receptionist recognized my predicament and let me back into the "back area" where the treatments are administered. The bathroom back there was open. Got there just in time.
Jim, The nurse and technicians tell me the same thing that I will develop a routine that will allow me to have empty rectum and full bladder. They keep reminding me that I'm just 5 sessions into this treatment and to be patient.
Thank you again guys.

Thank you Glen. Since I've switched to morning sessions and my wife having me eat more foods that soften stools, I've done much better at emptying my bowels before I leave the house. Now, I'm working on filling the bladder to a point that it's full when I arrive at the clinic at not ready to explode.
Thanks to all of you and really appreciate the support.
Oh yeah, I've also been working on my Kegal exercises.

I had sessions in the early afternoon. The bladder regimen that finally worked for me (figured it out around the last week of RT) was as follows. When I first got up, drink about 32 oz of water to make sure my tissues are fully hydrated. Continue to drink about 8 oz every hour until 2 hours before radiation. This would give enough time for the excess water to work out of my system, but leave me fully hydrated. At 45 minutes before radiation I would drink exactly 13 ounces of water. I found it took me 45 minutes to process the water, and 13 oz left my bladder full, but not overfull.
In previous failed iterations I found that if I did not do the early in the day drinking I would be dehydrated and some of the water would go into my tissues, not fill my bladder. And if I drank more than 13 oz, then my bladder would continue to fill and I would not be able to hold it through treatment.

Some accidental leaks are just part of the process. Maybe we should consider them an indicator that the bladder is sufficiently full. I had two leaks on the table. The staff were extremely professional about it.

Post Edited (fiddlecanoe) : 6/27/2022 12:17:49 AM (GMT-6)