Contrary to the title this isn’t a post about the hardship of having twins. Oh no, for that is a blessing. This post is the one I’ve been thinking about writing for a little while, but ridiculously I felt a bit embarrassed about.
I’m afraid, dear readers, that it’s going to be about bottoms, again. And it’s a long one. But I promise this should be the last toileting one for a while (given that our potty-training is going so well now, but more on that later).
Witholding. This is apparently the accepted term for not letting out your poo when you need to. I didn’t know about this term for quite a long time, so in the early days of my research I found it quite hard to find information. That’s the reason for this post really. I just wanted to cover a subject that is still a bit taboo (involves TMI), is hard to find information on but affects a LOT of people with young children.
A bit of background…
When we holidayed in August 2010 Dolly Daydream was approaching her first birthday. We’d had no issues (that I was aware of) before this. However, on this holiday she must have got a bit dehydrated and subsequently became constipated. This went on for a week or so on holiday but I didn’t think much of it. When we returned to the UK I began to notice that she would go a number of days between dirty nappies. I still didn’t think much of it, I upped her fluids, made sure she had lots of orange juice and thought things would pick up. They didn’t. She would only poo every 5 days or so and in the interim was becoming increasingly distressed. Bloated tummy, crying in the night. Uncomfortable. When the poo finally came it was enormous and hard. Passing it was a traumatic experience. The less frequently she went the worse it got. In the end I’d have to intervene with suppositories, something we both disliked.
6 months later…
I finally took Dolly to the Doctors and described the infrequency and her behaviour when she was trying to go – agitated, leaning back, straight legs. It turns out that instead of trying to push out the poos, as I’d naively thought, Dolly had spent the last 6 months witholding her poo. She was caught in a vicious cycle. She knew doing a poo hurt, so she didn’t want to do it. The more she held it in, the more water is absorbed by the body and the harder the poo becomes. The longer it’s there the worse it is to get out, which just reinforces all the negativity she feels towards her bowel movements. It’s a really easy and dangerous cycle to get into and a REALLY hard one to get out of. And so began our treatment, a long list of medication which increases in strength:
- Lactulose, awful stuff. Gave Dolly tummy ache and nothing more.
- Movicol Pediatric. A stool softener. No effect at all. At this point we were referred to our local hospital as an outpatient.
- Senna. Worked quite well for a while. We were told to give it every other day in the evening. It involved a lot of wakeful nights with Dolly’s upset, grumbling tummy but it did mean she did go… for a bit, until she learnt to fight it.
- And so we were prescribed the Daddy of all toddler laxatives, Dulcolax, or Sodium Picosulphate as it’s officially know. We were instructed to use this in the same way as the senna, every other evening.
If you’re not familiar with witholding it’s hard to explain how it can take over your life.
You become fixated on it. You talk about it endlessly with family members and close friends – ‘has she been?’, ‘when did she last go?’, ‘has she drunk enough?’, ‘has she eaten anything?’ Your beautiful, lively little person is either listless and poorly-looking or agitated and in pain. At her worst Dolly has managed to hold on to her poos for up to 8 days. She couldn’t eat, she was full up to the ginnels with poo. Next time you need a poo, just try not going. It’s so bloody hard. And she felt she had to hold on to them like that for days on end. *another sadface*
OMG. This was hardcore. At first we just dosed Dolly as directed with her evening meal but it took me a few weeks to realise that if Dolly had it as a ‘starter’ to her meal the poo would come first thing in the morning. If she had it during or after her dinner the trauma of her witholding would continue for all the rest of the following day with the poo only escaping in the afternoon! And when it came, Holy Shit. What a mess. Dulcolax stops Dolly having any control over her bowel. We could be anywhere. It makes the poo smell absolutely foul, like disgusting rotten eggs and it’s so loose it plasters everywhere, down to her ankles and up to her neck. It embarrasses Dolly, me and everyone around us. I raised this with our paediatrician but apparently psychologically it’s better for her to go, than not. Dolly would scream hysterically until I managed to clean her up and would lie with her hands over her eyes whilst I did so. I was sure that this wasn’t the thing that would miraculously change the way her subconscious works about her bowel. She found it too traumatic. But still we continued.
When I started potty-training the twins I hadn’t really thought through how it would work with Dolly’s medication. The paediatrician had advised me against potty-training until we’d resolved the issue but it seemed ridiculous not to train them both at once so I thought I’d ignore his advice. It soon became apparent that Dulcolax and potty-training do not mix. So instead of stopping the potty-training, I stopped the Dulcolax. It felt so good. I’d known all along it wasn’t right for her but didn’t feel able to go against medical advice. I put her back on the old Movicol softener once a day and thought I’d see what happened.
And here we are…
3 weeks later and Dolly has pooed on her potty for the last 3 days in a row. They’ve been nice and easy to pass because of the softener and she doesn’t have the mess of it in her nappy to make her feel phobic. I’ve had to use suppositories a couple of times in the last few weeks but the softener has stopped it being painful and upsetting and Hallelujah! I think we’re finally getting somewhere. Our next appointment at the hospital is on Valentine’s Day. I really hope we can go in and tell him Dolly’s beaten it. She’s so proud of her poos on the potty and Arthur has bestowed on them his greatest compliment – ‘Cake!’
There’s so much more I could write about this but I think you must be bored senseless and retching into you dinner by now. I’ll see if anyone comments…