1st Disimpaction, is this normal?

[Teddy500]

Hi, my son is 9 years old and has day and night wetting and what appears to be a small overactive bladder. A disimpaction was recommended and we're on day 10 today with 12 sachets of Movicol (this is the 6th day on 12 sachets). This morning we had 'soup' then 'chicken nuggets' and he's just been to the toilet again and it was 'corn on the cob' - dry, sausage shaped and cracked on the surface (as per Bristol Stool Chart). I just wondered if having a wide range of different poo types is normal and to go from very loose 'soup' to formed/dry cracked poo's? Does this sound okay? I'm amazed that on 12 sachets of movicol that there is anything dry ish coming out? Many thanks for any replies 🙂

[Yaleamanda]

How much water are you mixing the sachets with? Is he drinking enough on top of the movicol as this does not count towards the daily allowance. It does sound like you need to keep going with the maximum dose. Stay there until you reach rusty water looking poo, then remain there for 3 consecutive days before you start reducing the doses very very slowly, 1 sachet every three days.

[Teddy500 in reply to Yaleamanda]

Thanks, he's drinking about 1400ml of extra water each day, we'll keep going with it 🙂

[StellaA in reply to Teddy500]

HI Teddy, Have you made any progress with getting your sons bowels cleared out?

Have you noticed any improvement in his ability to stay dry during the day?

[Teddy500 in reply to StellaA]

Hi, we're still on disimpaction, day 20 and on 12 sachets a day, waiting for 3 watery days which hasn't happened yet. Our nurse advised to give him Senna on a night to try to speed things up which we started last night and today he's had 3 bowel movements, 2 watery but 1 mushy soup which suggests he's not cleared out yet. He's 9 now and daytime wetting started suddenly when he was 6 so there could be really old stuff in there, which may explain why it's taking so long to get to watery?? It's a lot of guess work. So far I have seen some improvement with bladder capacity, able to do 150ml as a regular wee (used to generally do 100ml / 125ml) and slightly less leaking. We're still hopefull that he can improve some more as disimpaction isn't over yet and if the bladder has been squashed and squeezed by the bowel for so long that it may take time to recover and improve. I'd really like a scan to see what they look like but it's not on offer at the moment. We're doing this with the help of York Bowel and Bladder clinic, they're really supportive. Waiting on an appointment with Paediatric Urology too as nothing we do ever seems to help or improve the wetting. It's a nice change to see things possibly going in the right direction with the disimpaction for the first time in a long time but I'm not sure if it'll be the cure we're looking for??

[StellaA in reply to Teddy500]

Poor boy, 12 sachets is quite a lot and if his bladder is small he must be running to the loo all day.

He must be really motivated

[Teddy500 in reply to StellaA]

He's so good, doesn't ever complain, it does get him down at times. He doesn't like school so is very happy being at home as school is closed and giving us chance to thoroughly do this disimpaction, fingers crossed!

[StellaA in reply to Teddy500]

My granddaughter is the opposite, she loves being at school and really misses being with her friends, she got really upset about it at the start of the lockdown being stuck in the house with her boring old granny.

She lost all motivation to stay dry during the day and was tricking me into letting her wear her night nappies all the time by saying she had a sore tummy, now she has gotten used to the new normal she is back in pullups and actually managing to stay dry during the day while I can keep a close eye on everything she's eating and drinking.

She might even be in knickers for school starting back in September!

How does your sons school cope with his accidents, do they make him feel bad about it or is it the other kids who are the problem?

[Teddy500 in reply to StellaA]

Hi, we've managed to keep it mostly secret from the other kids in school as he wears 'Tena for Men' in his boxers and he uses the staff toilet next to his classroom. He leaks rather than having full accidents so they last while he's at school. I can imagine it's really hard having a child who misses school and friends, but lucky to have a granny to care for her. He hasn't ever really bonded with the kids in his class and is quite independent and enjoys playing in his imagination so he doesn't really miss them. Fingers crossed for September for you 🦋

[StellaA in reply to Teddy500]

That's good that they are accommodating of him, when Sophie started at her current school she was still using huggies drynites for most of her continence needs, the school where less than happy about it and made a big deal about changing her.

There policy was either to change a nappy X times a day, but only if they are supplied by the continence service or to supervise toileting, they refused to do both, ie change pullups and make sure she was using the loo, citing a lack of staff time, until I started threatening legal action.

It didn't take other kids long to notice she was different, it's hard to hide that she was having a few dirty pullups each school day, thankfully it all worked out after the first term was over.