UCLA wants me to have a bowel movement everyday before each of the 20 tx? what is the exact purpose of this? ( does it protect anus,urethra?

[JWS13]

UCLA wants me to have a bowel movement everyday before each of the 20 tx? what is the exact purpose of this?It doesn't appear that it can lift or lower any of the anatomy away from the radiation and their is no ultrasound guidance , so no ultrasound in rectum...therefore, I don't know the exact purpose , (i.e. maybe to prevent gas bubbles and movement)In addition , if I can't have a BM , do I do 20 fleet enemas ,which seems excessive and medically unsafe?

Is the last six inches of the rectum that a fleet enema covers enough to protect the rectum from radiation? or do i actually need a clean out with miralax or another laxative each time?

All responses welcome and appreciated...tx..

Tall Allen...thoughts please???

[Tall_Allen]

Turds in your rectum press it against the prostate and change the shape of the prostate. The radiation is planned to hit your prostate in exactly the same shape it was in during your planning CT/MRI.

It is only necessary that you clear your rectum of turds. The radiation technician will check it before starting each day's treatment, and won't start until it matches the planning CT/MRI.

[JWS13 in reply to Tall_Allen]

can this be accomplished by a fleet enema every day for the 20 days or do I need more of a substantial "clean out" by laxative (miralax, dulcolax, etc.).. am i trying just to clean out the last 6 inches or so of the rectum that the fleet enema covers or a more substantial clean out? thanks TA

[Tall_Allen in reply to JWS13]

Do NOT take laxatives - they cause bowel motion. Just the rectum. Follow RO instructions.

[Seasid in reply to Tall_Allen]

Thanks for the information.

[Yearofthecow in reply to JWS13]

when I had SBRT at UCLA they required an enema and a full bladder before each treatment. It was to maintain consistency during treatment due to inconsistent changes that could occur. Though SBRT is not the same radiation therapy you are having, I would address your concerns with the RO, nurse practitioner, including your questions if you can apply an enema etc. Some practices also recommend taking gasx. Didn’t they give you a preparation sheet?

An enema isn’t a laxative, and cleans out the rectum

[dixiedad in reply to Tall_Allen]

The hardest thing about my 45 treatments was to arrive at the facility at 11:00 AM, five days a week, with a full bladder and an empty rectum.

[leach234]

why are you asking us? Ask your radiologist!

[Hidden in reply to leach234]

This is a forum where people exchange experiences and ideas. It is not meant to be medical fact. Give the guy a break.

[JWS13 in reply to leach234]

LL is right... This is the second time you came at me like this and I certainly don't need it...DO YOU THINK I DIDN"T ASK MY RO...HE TAKES THREE DAYS TO RESPOND AND I AM GETTING TREATMENT IN TWO DAYS..I definitely am not asking you for medical advice just what you EXPERIENCED...If you see my questions again , do not respond!

[Jpl506 in reply to JWS13]

If you’re contacting your RO through the Epic MyChart app those messages go to a nurse so there is a lengthy delay. You should ask your RO for a direct contact method while you are receiving treatment. I find these messages are answered very quickly.

[JWS13 in reply to Jpl506]

good idea jpl...i always get the pa when i go through the my chart and get "abbreviated" PA answers rather than straight medical advice...I doubt he'll give a direct number or email as it's a state organization and they have their protocol but i will try next tim i talk to him...ty

[leach234 in reply to Jpl506]

Exactly. The nurse associated with the RO always responds immediately. That’s their job.

[Baldylocks in reply to leach234]

I would remind you that like you others are here at different stages and at different levels to confront in their respective crisis. Myself as an example will admit to being the least savvy guy to understand medical science. I came here seeking those so much “smarter” like yourself to share your experience out of the kindness of your heart.

[dadzone43]

Your bladder and rectum are very close to your prostate, so they can change the position of your prostate. By keeping these organs the same size for your simulation and daily radiation treatments, your radiation therapy will be more accurate. This will also help to reduce some of the side effects from your radiation therapy.

[Hidden]

I had 27 sessions of IMRT. They only required that I have a full bladder which I did very good at. I would start drinking water at home before I left for the center and in the car on the way there. A cup of coffee in the morning usually produced a bowel movement so maybe they looked for it with the pre radiation scan and would have said something if they thought it was an issue. I also had the SpaceOAR done so maybe that exempted me from enemas.

[JWS13 in reply to Hidden]

thank you!

[Mike404]

I only had SBRT, but required both an enema and full bladder. One session they started, but stopped and made me drink water, as my bladder wasn’t full enough. This both insures the prostate is situated similarly each time, and it also protects the other two organs.

A full bladder stretches the wall and moves more bladder tissue away from the prostate. An empty rectum keeps it from pushing against the prostate and getting more radiation. Millimeters count in this situation.

I was requested to do two enemas, but no laxatives. I did get a bit irritated back there and Kishan okayed me doing just one before the final sessions. The machine broke a couple times, so I was doing enemas and getting cancelled last minute, so more enemas than expected. But I also had SpaceOAR, which I’m sure helped.

Good luck! You’re in the best of hands.

[Baldylocks]

this was me exactly but with the stipulation of emptying the bladder one hour prior to treatment then immediately refilling with 16oz. I found 24oz worked best for me but had to rush for relief immediately after treatment. All these steps are to make it easier on you from beginning to end. Let me first caution you “Not” I repeat “Not” to do any fleets especially not daily. I misunderstood instructions and did that for my first week of treatment which caused me to pass out and smack my head against the wall going down.

You are right about gas bubbles being a concern but diet is more the culprit with that. I was told the goal in clearing the rectum was for clarity and allows the full bladder to give more separation for all three areas of concern (Bladder, Anus and Uretha). None of these areas will escape the radiation but this alignment allows less of Bladder and Anus exposure.

Best outcome is the overall endgame. Doing all of the above is meant to help in your healing and recovery.. I hope very much for your best success on this trip.

[JWS13 in reply to Baldylocks]

why did you pass out? were you dehydrated? did you not drink water?

[Baldylocks in reply to JWS13]

I religiously drank 64oz or more everyday but did not realize it was not enough to counter voiding daily by enema. The point is to gain from my mistake.

[Mike404 in reply to Baldylocks]

I also passed out once fully and almost a few times. This was weeks after the radiation and attributed to the Cialis and FlowMax, both of which cause low blood pressure. Dehydration exasperates this immensely, as does alcohol. Orthostatic hypotension, I believe is the word, but it means your bold pressure dips on standing rapidly. I now watch this very carefully.

[Baldylocks in reply to Mike404]

Mike why are you taking Cialis, weren’t you told to give yourself a few months before having any sexual activity? I have been to afraid to attempt any sexual act and won’t likely try anything until my follow-up PSA and a scan to see where my state of healing stands. Having multiple erections was not encouraged at my last consult. I was not aware of fainting being a side effect to Flomax. What dose are you on? As for the enemas I stopped them immediately after my first collapse.

[Mike404 in reply to Baldylocks]

A daily dose of Cialis was prescribed to protect the blood vessels around the prostate. ED develops over time from radiation as the vessels scar and “age” faster than normal. There have been studies showing Cialis and Viagra to have a protective effect, as they dilate the vessels.

I was not told to avoid sexual activity. In fact, it is encouraged to keep the tissues healthy.

[Baldylocks in reply to Mike404]

Blast it! I wish someone had told me. I certainly am not ready to surrender my junk if there are ways to stave off the collapse. I’ll check in with my doctor to see what gives and ask for a prescription right away. Thanks

[Baldylocks in reply to Baldylocks]

There will be no more advice from me here on. Mike I got everything wrong from my last consult but thanks to you I’ve been straightened out. I’ll continue to read and listen and learn. My best hopes to you and all of our comrades in the battle.

[Huzzah1]

I had 44 sessions of IMRT. They suggested a Low fiber diet to help with the stool situation. The day before the first session, they performed a test run, as I am very regular, I decided to just do my normal morning BM and then went to my 11:00 appointment. I asked the techs how everything looked, they said the rectum was fine but to drink a little more water the next day. I never did an enema and was never kicked out of a session.

Every day the beginning of a session, they do an MRI to make sure both issues are fine. I saw a number of guys told to get off the table and go to then waiting room to drink some more water. It generally took them 20 minutes to cycle back into the room.

Have those conversations with the techs, they will guide you.

[MackworthGuy in reply to Huzzah1]

this was my experience too. I was much more concerned about it than they were. They checked every day for BM and urine. Only had to adjust my liquid intake each day to try to reach optimal, but never had to wait or delay a treatment.

[JWS13 in reply to MackworthGuy]

thx...so no worrying..not that big of a deal...how u doing now? IMRT?

[Huzzah1 in reply to JWS13]

I think I'm doing fine! It took a couple months to get my urinary functions normal again. I have my first post IMRT scan in Feb. I'm currently finishing up 3 weeks in Italy to celebrate my wife's 60th and what I've gone through so far.

[MackworthGuy in reply to JWS13]

I had 1 brachytherapy session and 23 IMRT. Doc says I’m doing great. Sexual function seems impaired but I’m single so not that important. Urination has always been good throughout. Bowel function varied afterwards but has settled down some but still not like before. But PSA is lowering and future looks good so what’s to worry. Wish you well on your journey!