Category — toileting issues
How is that for a catchy blog title… I have meant to post this for weeks, today seems like as good a day as any and it is sort of adoption related…. I know it`s a stretch but work with me
Yes poop, I have brought it up before, I have talked about some of the issues that kids who come from hard places might have and the long-term damage that can cause, if you want to read about it you can go read about here and here. If you struggle with this with your kids you need not go back because you already know way more than you ever thought you would.
That being said we had tried everything we could think of to get things moving and keep them moving, it was all awful for all of us and then by accident a friend of mine stumbled across something that changed our whole world
Cue choirs of angels singing.
Magnesium Citrate Powder, get to the health food store nearest you and find it ( this is what is available locally, there are other brands I am sure). Yes it has to be powder not tablets ( they do not work as well). I gave my boy the adult dose for about a week and then once we were sure things were moving we reduced him down till we found the right amount to keep things moving. He takes a little more than 1 teaspoon a day and it has changed our world.
I will be forever thankful that stumbling across something suggested for helping ADHD has had so many other benefits because there is now no more Miralax/Restorlax in our house
November 2, 2012 No Comments
All is well. They let us come home yesterday morning. Well, all may not be well and only time will tell but, we are home and Calvin is ok and Fudge was thrilled to see us. Calvin and I walked down to meet the bus yesterday and Fudge got off and ran to Calvin like he has not seen him for a month of Sundays. It was sweetest moment I have witnessed between them in a long time, I cried.
Their connection to one another runs so deep that even when they are trying to kill one another they can not stay mad for to long. And to think that system though about splitting them up in an attempt to place them more easily, it would of killed them to not be together. I cannot even imagine the outcome of that and I can’t really dwell on it because it makes me to angry to think that they would of done that to them.
Anyway, we are home and Calvin is all cleaned out so to speak. The medical professionals and I still disagree about the cause of the obstruction and we are clearly not going to agree anytime soon. They are stuck on the behaviour issue ( that is really no longer the case although it was for a long time) and I am stuck on the fact that I think the behaviour was secondary and that there was an underlying problem to begin with. No one can hear that though so we came home with a larger daily dose of PEG and we will see what happens. I have also called the adoption worker that was assigned to us and I am going to ask her to contact birth parents ( since we do communicate with them via letters) so we can get some actual solid history aside from the little bit that we have on paper because going back to having an NG tube when this happens again is not going to be any ones idea of a good time.
That all being said, I must say that Calvins attachment to me is becoming more and more established and this was a great time just to be together. He looked to me for comfort and was appropriate with other adults. He did not push the limits beyond what one would normally expect a kid in his situation to do and he listened to me when he did start to get rude/pushy and was asked to stop.
I am thrilled to be home and near a hot shower and clean clothes. The boys brother and sister are coming for pizza tonight and I have to go make dough and get her a much belated birthday gift. I am looking forward to seeing them and so are the boys. So I must be off, hope all you American had a great thanksgiving and are enjoying your shopping today!.
November 26, 2010 4 Comments
I tweeted yesterday about being at Children’s Hospital with Calvin and waiting for an adult to come into the room and tell me what to do. I continue to be caught off guard by the fact that I am the adult. Me, just me. I have to argue with the residents and the doctors, I have to advocate for my kid and I have to convince the snotty night nurse that indeed he is not withholding poop on purpose.
Calvin and I have had a very long 36 hours. We came to Children’s yesterday knowing that they might admit us and low and behold they did. We did not get a lot of information as we began our afternoon but as time wore on things became a little clearer and to make a long story short we are here to try to deal with some of Calvin’s poop issues as everything tried at home was not getting us anywhere.
My little man has an NG tube and an IV and he is behaving like the bravest little boy I have ever met. We are pumping him full of Miralax and I mean full to actually empty his bowel out once and for all. It is working but it is taking a lot longer than anyone thought and we are here for our second sleepless night. Last night was awful because Calvin’s roommate whined and cried all night long and none of us slept. Then we had a really long day full of poking and prodding and arguing with residents and absent surgeons about plans and options.
Calvin has held it all together and not actually had a meltdown yet. He has had a few rude moments but I can only imagine how crappy he must feel and how hard this all must be him.
Fudge is home with P and N ( our temporary teenager, another story for another day) and he to is handling it all pretty well.
I just spoke to the nurse who is concerned that they are hitting Calvin to hard with the meds and has had them reduced. Which might mean less poop but might not given how much is already in his system. This is going to be a really long night.
That all being said though things are going as well as they could given what is going on and hopefully by the end of all of this we will be able to move one from all the poop issues because that would be so, so nice.
PS excuse the lack of coherence I am exhausted.
PPS the hospital has blogs blocked on the free wifi so I can not comment but I am reading in my reader while I am here .
November 25, 2010 6 Comments
Yes this will be a post where I talk about poop, if you are interested in reading about how trauma can effect the bowel habits of children than I suggest you leave now because that is all I have for you today.
When two social workers sat on our couch and first told about the boys it was mentioned that Calvin had “some soiling issues” and Fudge had accidents. That is code for is unable to a have a normal bowel movement and pees all the time everywhere. Why would two crown wards have these problems? They have them because they have been traumatized and their reaction to that trauma has been to control the only thing in their lives that they had the ability to control .
Since we are talking about poop I am going to leave Fudge and the crazy peeing out of this because that is something we are still battling.
So Calvin stopped pooping. It was not dealt with well, no one took it seriously and he was shamed over and over again as he tried to make the big people know what an unhappy little boy he was. When he was with his foster parents he did ok but then each and every time that there was a visit with Mom he regressed again.
I naively thought that I would be able to fix this problem for both of my sons. Some love, consistency, good toileting routines similar to those that are used with toddlers and we would be on track. Right.
Let me say that again. I was wrong.
I did all those things and you can read about the things that worked in this post. I tried really hard not to shame them about what was going on and I was not always successful. It is really hard not to make shame based comments when you are at someones house and your six year old pees all over their floor. I would get mad and say things I should not of said but hindsight is always 20/20. I regret some of the things that I said and did in those early months of being parent but I can not change the past and I can guarantee that I would not say them again.
That being said Calvin is 10 and still struggling with the aftermath of withholding his poop for well over 2 years of his life. From what we can piece together he has had bowel issues since he was a small child and there is perhaps some genetic components to them but coming into foster care just made everything worse.
As soon as the boys were placed with us I started talking to doctors about what we could do about this and to make a long story short we discovered that the damage that has been done to Calvin’s colon may be permanent. When a child withholds for a long time their colon actually stretches out and little pockets develop where the poop sits and then begins to create a blockage this causes leakage and constipation problems and even though the child is trying to empty their bowels they are unable to do so completely and then there are accidents. It becomes a horrible cycle for the child and the parents.
There was some discussion and testing for about a missed congenital problem but that has been ruled out it and appears that Calvin is just unable to poop when he needs to and to that the damage that has been done may take years to repair if it can be repaired at all. How are we going try to repair it, laxatives, lots and lots of laxatives and then we are going to monitor him with x-rays to make sure that things are continuing to move through his colon. We have already been doing this for well over a year and it appears as though we will be continuing to do it for years to come. Although we have been giving Calvin an adult dose of Miralax ( PEG) on daily basis it is not really working, things are still backing up so to speak. So we are bringing out the big guns and doubling his dose for the next few days.
Calvin and I are looking forward to a fun filled few days that will include lots of liquids, movies and trips to the bathroom in an attempt tp actually empty him out so we can start again and perhaps finally find the right dose of medicine that will keep things moving through him.
I had no idea that talking poop would become such a huge part of my daily conversations when I decided to become a parent.
November 11, 2010 2 Comments
Yes I said an 8 year old.
In the world of older child adoption toileting issues are very common and not something that is talked about very much. It is very real and very challenging for many adoptive families because it is not something that they can really talk about with other parents. We have been through this, we have worked hard, we sought medical interventions and although we are not free of the issue we are well through the worst of it. I thought I would talk about it here because I know that there are a lot of parents who are dealing with the same issues and after a lot of mistakes I have learned a few things.
When we first learned about our boys one of the first things that we heard was that Calvin had “soiling” issues and Fudge rarely made it to the bathroom on time and had a lot of “accidents”, (those were the terms that were used by the social workers who presented the boys file to us). We did not think that it was a significant issue but we would soon discover that we were wrong. Because the boys had very different issues and for very different reasons I will discuss them separately.
Calvin came into care when he was 5. He had been neglected, his biological father had bowel issues (which we only just found out) and he had experienced a lot of trauma. When Calvin was apprehended it was discovered that he was a “poop holder”, meaning he would not got to the toilet when needed, instead he would hold his bowel movements until they began to leak out. This is a common behaviour among traumatized children and one that often leads to more trauma because the issue is not understood or openly discussed.
I was pretty sure that I could handle this, I had toilet trained a lot of little kids and I was sure this was just an issue of time and love – HA, I was so wrong. Calvin wore pull-ups every day in an attempt to control the mess and one of the first things we did was get him out of them. Then we used them as a threat when he did not comply with the toileting routine. That was a mistake. He also had a lovely habit or putting feces on his hands and wiping it on whatever was closest. It was awful. I began to understand that this was not something that was going to go away with a little love and training.
Here is what has worked for us in regards to the challenge of encopresis (poop holding) in older children
1. Buy them a large supply of underwear and keep multiple pairs in the bathroom where they are easily accessed by the child. Do not put your child is diapers or pull ups.
2. Create a schedule for sitting, in the summer it was after each meal and during the school year it was breakfast, after school and dinner. We always had to come straight home from school because Calvin had held it all day and was usually desperate.
3. Talk to your doctor, get your child on a daily stool softener, it may need to be given for as a long as a year. Prolonged stool holding causes damage to the bowel and the nerves of the anus, it is a medical problem and it often gets to the point that the child is unable to maintain any control because they actually do feel the urge to go. Chronic constipation becomes a secondary issue.
4. No Consequences for toilet issues. When your child soils their clothes have them clean up but do not assign any other consequence ( it does not work, trust me). Be vigilant, do not let them sit in soiled clothes because they will happily stay in them thinking that they are going to get some attention, negative attention is attention to a traumatized child. When I even thought that the odor in the room might be from Calvin he was escorted to the bathroom and his underwear were changed. Praising Calvin got us no where, if his underwear were clean I would apologise for making a mistake and move on.
5. Clean up is his responsibility. We used facecloths for clean up, underwear were washed out by Calvin and put into a bucket or washer with the rinsed out face cloths. This was supervised activity as he could not be trusted to be in the bathroom alone but no comments were made ( well not once I learned better), I just stood there. When he was finished I released him to go back to his task.
6. Talk to them about how your body feels when you have relieved yourself and about how that feels. Do not be shy, this is not something they understand and they need to learn it.
7. Teach them how to wipe their bottom. We had a lot of success with flushable wipes, it was easier for him to get himself clean.
8. Diet makes a difference. High fiber, whole grains, little refined sugar and lots of water. If the stool is softer it is easier to keep it moving.
9. Remember that many children who have experienced trauma use this as a coping strategy, do not be surprised when you have a week of good days and then it starts happening again. Sometimes anxiety or anger can cause a child to begin soiling again after a long period of success.
10. Be Patient, let me say that again Be Patient. It took us well over a year to get to a place that we had a lot of success and even then there were still steps backward. We came very close to major surgery in an attempt to correct the issues. It will 2 years this summer and we still use stool softeners everyday and probably will for some time to come.
Fudge was a different story, he held his poop to but not like his brother did and it was easier to deal with because it had not become a medical issue with him. Fudge was mostly just to busy to stop playing and go to the bathroom. Dealing with a boy who won’t stop to go pee is a lot easier. He was having fun and frankly he just did not care if he was wet. Do numbers 1,2 4,6 and 10 from above and then buy a watch with an alarm. Set that watch to ring every hour. Put it on. Each and every time that it beeps you send that child to go to the bathroom. In summer we let him go outside which was a huge incentive for a little boy. Make him go all the time, make him be successful because he has no other choice. Carry lots of extra clothes when you are out of the house and when he says he has to go drop everything at find a toilet.
And here are things that I did that I regret because they did not work and I am sure that I will hear about them later when the boys are telling the world about all the mistakes I made.
1. Do not punish them for accidents/soiling/doing it on purpose. They clean it up, where ever it is and move on. Sometimes things get ruined, throw them away, explain it, talk about, pitch it and move on.
2. Do not shame them by saying that no other kid there age does this. No other kid they know has had the life they have had.
3. Do not lose your temper because they have had an accident at a friends house and you are embarrassed.
4. Do not put them back in diapers or pull ups or threaten to do so.
5. Do not expect that this going to be quick process, it may take years.
6. Do not let siblings shame one another about toileting issues at home or in public. In our house that results in consequence for the child doing the teasing.
7. Do not let your child manipulate you into believing things to distract you from the issue – oh well it happened because so and so was in the bathroom and I could not get it in – this was usually a lie in our house and attempt to distract the adults from the poop on the wall.
8. Do not let your guard down, it is an invitation for them to walk all over it.
9. Do not use a reward system, it is to hard for them to be successful in many cases and they just get discouraged.
10. Well I think I only made 9 mistakes because I can’t think of another one.
Hang in there, be patient and know that you are not alone.
March 30, 2010 7 Comments