Sunday coming off the pump I had my first bowel movement. Normally I'm constipated right through Tuesday or Wednesday, which is its own special kind of difficulty, along with a fairly violent lactose intolerance that lasts through Wednesday or Thursday. So that was a surprise, but one I thought worthwhile. After all, this meant my GI recovery would happen a couple of days earlier, sparing me some discomfort and pain. Until now, I had not realized that the constipation was a form of rest for me.
Except Sunday overnight, the diarrhea started. I was on the toilet for an hour at 2 am. By Monday morning it was running free. Not painful, but frequent bouts of high velocity liquid. This at the time in the chemo cycle when my mouth tolerance for just about anything, including the taste of plain water, is poor. Lisa Costello began switching me between multiple liquids — Gatorade, dilute tea, blood orange soda, San Pellegrino limonata, water, Ensure — to try to get me to hydrate.
I'm very stubborn about diarrhea. Generally when I have it post-chemo, whatever's coming out is coming out. All that happens when I take an anti-diarrheal is that everything inside comes out a day later, with additional unpleasantness along the way. I don't gain much, and I pay a lot. However, I was exhausted Monday already. The diarrhea drained me, physically and mentally. Then I couldn't sleep Monday night worth a damn due to the pressure in my gut. Again, up in the middle of the night on the toilet for an extended period. And even when I didn't have to go urgently, that sensation of gut pressure will overcome even a Lorazepam dosage to keep you awake in fear of a blow out.
Yesterday I was even more exhausted. And the diarrhea was non-stop, hitting me every hour or two. Though I could hold it in — I've had catastrophic bouts, which this was thankfully not one of. In my chemo phases, I don't have the physical reserves to power through a state of exhaustion. It's literally debilitating.
By mid-morning yesterday, when it had been over twenty-four hours, I gave up and took Lomotil. I almost never do this, as both Imodium and Lomotil are generally like concrete enemas for me. The unpleasantness of the constipation is if anything worse than the unpleasantness of the diarrhea. But I needed to be able to rest, and focus (on among other things, the Day Jobbe). The diarrhea came back a few hours later, so I took another Lomotil. The diarrhea came back again yesterday evening, so desperate for a good night's sleep to overcome the exhaustion I took two more Lomotil.
So far this morning, I am rumbly but nothing's happened. I'm actually fairly certain I'm about to see another round of diarrhea, which means another round of Lomotil. Somewhere in here, the pendulum will swing the other way, I'll stop up for a day or two, and be that kind of miserable. At least I can sleep constipated.
In effect, I've been trying to find a balance between sleep, diarrhea and constipation. Sleep is the most critical, but the price I pay for managing the other two is high. Plus a sharp drop off in calorie intake because I just can't stand to eat when I feel this way. We think we got about 1,000 calories into me yesterday, half of it as Ensure or Boost, and I went to bed with a hard lump in my upper GI which tells me I'm really, really not eating enough.
As I've said before, dealing with this stuff is like driving a car on ice. Once it starts slipping, you go light on the wheel, lighter on the brakes, and pray you don't wind up in the ditch. It's a freaking nightmare.
At least I got a decent night's sleep last night. Today's lower GI follies will probably be rough.