[healthwork] grumble grumble grumble

[kaberett]

[Discusses gut problems in some detail, nausea, food issues.]

I found, yesterday, the magic words to make a doctor take me slightly more seriously that something is wrong even though my thyroid numbers are ~fine~, and it consisted of going into Rather More Detail about what I meant by "constipation" than I had previously. It turns out that "Bristol stool scale 1, manual release, for actual months" makes medical professionals a lot more concerned than I'd expected it to, given that it's just Been Like This For Months, I have been consistently complaining of gut symptoms that resolve on higher levothyroxine doses, and it's not like it hurts.

But! Now endocrinologist #1 (who is responsible for my testosterone scrip and offered to look at my thyroid numbers, but just... looked at the numbers... without taking a functional history... and declared me fine...) is being sent an update with my latest numbers and symptoms AND endocrinologist #2 (WHO IS IT?? A M YSTERY) is getting me referred to them, and in the meantime I am to drink two sachets of Laxido a day.

It is mildly orange-flavoured.

Nausea is a common side effect.

Neither of these is a Good Thing, from my perspective. I'm not especially bothered by vomiting but I am deeply averse to conditioning myself into Food Is Bad, e.g., via constant nausea or eating consistently causing me pain, because I've done that and it was Not Fun. Mild orange flavours (and ginger tea, and peppermint, and and and) tend to make me more nauseous, not less, which is deeply awkward given Culturally Accepted Nausea Remedies, and is especially deeply awkward in this case, and I have been given sixty sodding sachets of the stuff.

So.

Thus far I have discovered that it is less terrible if (1) I chill it, and (2) I mix in a cordial I don't actually hate the taste of. (I'm currently rotating them in the desperate hopes that I won't put myself off all of them, and should probably be adding in "drinking more cordial in between times" to further avoid that conditioning, I don't know, the intermittent punishment might be worse.)

This leaves, unfortunately, the problem of needing to take this (1) twice a day, (2) at least an hour after and an hour before any other oral medication, and (3) immediately before some food (because it helps with the nausea).

There is no particular reason any of you should remember this, but my current meds regime goes:

• at least half an hour before breakfast: levothyroxine, omeprazole, paracetamol
  
• at some point over the course of the morning, usually while brushing my teeth: mometasone nasal spray
  
• with breakfast (which ideally shouldn't contain significant calcium but I'm pretty much at "fuck that" at this point): fluoxetine, vitD, fexofenadine
  
• with lunch, at least four hours after breakfast: paracetamol, mefenamic acid, vitamin B
  
• with dinner, at least four hours after lunch: paracetamol, mefenamic acid, vitamin C
  
• at bedtime, ideally four hours after dinner and about 45 minutes before bed: paracetamol, amitriptyline

... where the mefenamic acid needs taking with food because it's an NSAID and stomach linings are big and clever, and paracetamol doses need taking at least four hours apart, and if I don't have food both immediately before and immediately after fluoxetine Everything Goes A Bit Wrong, and omeprazole and levothyroxine work best if taken on an empty stomach, and now TO THIS I need to add - preferably relatively evenly spaced throughout the day - two rounds of "mix up sachet of Laxido, stick it in the fridge to cool down, chug it, eat something" with... sufficient... separation... from all my other oral medication...

Thank The Gods I am not currently on oral antibiotics with additional food requirements, is all I have to say, and long may this continue.

Comments

[ewt]

Oof. Good luck.

[karen2205]

There are lots of osmotic laxatives and your GP probably doesn't know many of them (but will have a pet couple they normally prescribe). It's worth going back (if spoons allow) and/or to the continence service directly to ask to try some of the others. I think most will need making up with water and may need chilling to improve the taste, but there are unflavoured ones (eg. movicol) which might work better at not putting you off nice drinks.

[kaberett]

Thank you - I assumed unflavoured was an option but apparently I got prescribed orange flavour by default. :( I will give it a week and see if my aversion to the taste decreases as I habituate to it (because I know this is a thing that does happen) and then... might see about flavourless after all.

[worlds_of_smoke]

I use generic Miralax, polyethylene glycol 3350, for my chronic opioid-induced constipation, on orders from my urogynecologist. It's completely flavorless, but I mix my daily dose with various flavors of sugar-free Kool-aid substitutes. Right now, I'm rotating between blackberry lemonade, pink lemonade, and raspberry ice. Before that, I was getting 4-flavor packs of various fruit punches and rotating through those.

And, even better, I can tweak my dose if needed. I usually drink ridiculous amounts of iced tea and, if I'm having to visit the bathroom too often, I can drop my dose down a tidge to compensate for the fact that I'm drinking a metric ton of tea.

I'm actually in PT for chronic constipation (which IDK if I've mentioned or not). My physical therapist said that getting a toddler's stool (the type you'd put in front of a sink so a toddler could wash their hands) to rest your feet on while trying to have a BM will help. Apparently, the makers of the Squatty Potty were right in saying it's anatomically healthier to have your feet propped up. We're also working on pelvic floor muscles and some core strength to get everything working in sync better, since having everything working together obviously will help things move easier.

(My big problem is that my pelvic muscles are overactive, but I have no endurance. Worse, last session I noticed that trying to hold my pelvic floor tight for more than a couple seconds causes my back to spasm. -facepalms- So we're going to be working with some biofeedback to, hopefully, work on unlinking those two.)

[rmc28]

A vote here for squatty potty type stools (heh) making bowel movements easier. We got one for each bathroom a few years ago when I had a six-month course of meds that affected digestion. They were a big help at the time and they make "normal" (i.e. not messed up by meds) toileting easier enough that we've kept them in use ever since.

[kaberett]

Yes, I am aware of the principle! I've been jury-rigging it but perhaps this is now a Sufficiently Ongoing Problem for me to actually get a slightly more permanent fixture.

[booksarelife]

Oof, that sounds rough!! I hope you can either switch to a different one or the taste gets better! I know my parents have a jug of flavorless Miralax at home that, the few times I took it, made water taste slightly weird but milk was ok (this was also at least a decade ago)

[archangelbeth]

You need a scheduling app for all this, clearly. O_O

(Sympathies! I hope that the stuff works for what it needs to do, without too much nausea.)

[rugessnome]

ooh, you have my sympathies--I think we tried to use orange drink mix to make an antibiotic taste better (it was not amoxicillin, which tasted kind of nice, but I think another penicillin class) before I could take pills, when I was VERY (eventually hospitalized briefly) sick long ago and ever since then I have very low tolerance for orange flavoring myself. (oranges and orange juice themselves are great and I can do Italian orange sodas but drink mix is still Bad)

[hydrangea]

Do see if you can get your hands on the unflavoured version. In my experiene with this kind of meds, they all taste horrible, but the orange flavour kicks up the nausea a lot. I had a much better time with chugging something icky with no particular flavour and then having something nice after than with combatting the intense nausea from the "orange flavour".

[shanaqui]

I know you know all the other tricks for constipation so am sitting on the infodumpy part of my brain for that, but this is a practical offer: I had something that was not flavoured at all and was kind of like drinking really bland water, and was equally as good as Laxido for the purpose. If this would be an improvement for you and something you wish to pursue, I can find out what it was. I may even have a great deal of it left (it's either I have a great deal of it or none, depending on what we did with it while moving) and would be willing to mail you some so you can try it and know if it is worse or better as an experience, if you want. Let me know at any time if you would like me to do this!

(I had no side effects from it beyond "a fervent desire to chug it, because making water taste bland is an Achievement I don't wish to admire any longer".)

[kaberett]

Oooh, if it does show up and you'd Just Like Rid then yes please! And YES, it is REALLY BLAND SLIGHTLY SLIMY WATER with this astonishingly hideously unpleasant overlay of oRaNgE!

[shanaqui]

Found it! ...However, it is older than I thought and is past expiry date?! I don't know how critical the expiry date is on this stuff, but if you wanted to chance it or you want to just get one sachet to see if you can stomach it, I can still put some or all in the mail if you just give me your address. Let me know! PM or thebrightspark[at]gmail works.

[kaberett]

I am entirely unfussed about expiry dates and happy to take the lot off you! PM with address to follow.

[vass]

*looks in direction of your endo*
*sighs heavily*

makes medical professionals a lot more concerned than I'd expected it to, given that it's just Been Like This For Months

And of course it's not like one wants to go into detail with each medical professional.

Many sympathies.

[killing_rose]

...Thank you. I now have a way to point out to my doctor that, no, this isn't normal even on the meds I am on.

[kaberett]

... <3 glad to have helped!

[cesy]

I had not come across the Bristol stool scale before, that is quite useful.

[azurelunatic]

Logistical question, is it Necessary to mix it up semi-immediately before consuming or can a good brain time be picked for a task of "mix up tomorrow's two servings and chill"?

[kaberett]

Oughtn't to be kept chilled for more than six hours, alas, so what I am currently doing (though I need to work out how to wrangle this for tomorrow, when I will be In Lab) is making it up when I'm having a meal, sticking it in the fridge, and then drinking it an hour after said meal, which does at least cut down the executive function some while also meaning the stuff is good and cold.

(Milestone: managed to drink it without cordial today, chilled, without gagging.)