by Lauren12 » 11 Dec 2012, 14:09
Wow Steve, I wouldn't refuse all pain relief after the procedure, you might need it!
The general anaesthetic may constipate you slightly. It depends on what they give as part of the general anaesthetic. If they give morphine-like drugs, then coupled with the dehydration that comes from being unable to drink fluids for several hours before the procedure, you may become constipated. There are general anaesthetics without morphine but you might need more local anaesthetic in that case. Talk to both the surgeon and the anaesthetist before the procedure and tell them you want to avoid drugs which have a constipating effect if possible. They should be aware that this is a concern anyway, given the nature of the procedure (botox or LIS).
It's important to drink lots of water after the procedure (when you're allowed to). Also Lactulose to pull fluid into the bowel. I took my own Lactulose into hospital (in fact I took my own lunch!) but I think if I hadn't, the hospital may have given it to me anyway. It's probably not a bad idea to increase your dose of Lactulose, although you then have the trade-off between keeping it soft and having a bulkier stool because of the extra Lactulose, although it should go through without damaging because it's soft. I wouldn't know how much to increase it by - I don't know your current dose and it's a while since I used Lactulose. This is perhaps one thing to ask the doctor, or medical staff.
Regarding pain relief afterwards, if you have the LIS you'll need pain relief. In fact even when I had Botox alone, I found I needed pain relief - I don't know what your experience was when you had your first botox procedure. If you have opiates, which are morphine, codeine, tramadol, you'll tend to get constipated. Opiates decrease gut motility and as a result, as the stool is there for longer, the gut is able to withdraw more water from it.
You could ask for intravenous paracetemol. This may sound like a mild, over the counter drug, but when given intravenously it's apparently as good as morphine. As long as your stomach can take it and you're not asthmatic, you could also ask for the NSAID's - Diclofenac, Ibuprofen or Ketorolac. Speak to the anaesthetist beforehand and discuss it with him/her. Both the surgeon and anaesthetist should recognise that you don't want to become constipated.
Regarding diet, you've no doubt developed a diet that works for you to produce regular soft stools and you should stick to that after the procedure. My procedures were all done in the morning. The hospital need to know that you can eat before they'll discharge you, so come round with dreadful hospital sandwiches. Rather than putting a hospital sandwich through my digestive system, I took in my usual lunchtime sandwich (good quality wholemeal bread, good quality ingredients, etc.) and the fruit salad and probiotic yoghurt I'd usually eat at lunch time (plus Lactulose!). You'll have skipped breakfast (so won't have eaten for twelve hours or more) and won't have drunk anything for hours prior to the procedure, so your dietary routine will be somewhat disrupted anyway, so I try to get it back on course by eating my usual lunch rather than hospital food. I took it all in in a cold bag with ice packs. Even so, I think this only keeps it at the proper temperature for about four hours, so you may want to consider what foods you include. Smoothies might be an idea, if you like them - although that didn't occur to me at the time I had my procedures - whatever foods include the necessary level of fibre but also keep you regular and stools soft. You could try asking if they'll put your lunch in a fridge in the hospital. This didn't occur to me until my last procedure, when a nurse asked, pre-procedure, if she should put my cold bag in the fridge! I should have said yes! Having said that, it may be they don't have a food fridge available. Depends on the hospital and ward perhaps.
Regarding your possibly having re-damaged, having previously done well after botox, I wonder if it's because the botox wore off? The question seems to be, whether with Botox, it'll happen again. If botox has worked for you, the choice may be whether to have botox repeatedly, or to opt for the LIS, bearing in mind the pros and cons of each. Obviously this decision can only be taken in conjunction with your surgeon, who knows your particular case.
All the best, and let us know how you get on. ((((hugs))))