In the river guiding world, there are numerous references to the port-a-potty or the act of evacuating one's bowels. When you host 26 people on a river trip and fill them full of good healthy food (also called a "float and bloat" trip), all that good food gets processed into the inevitable. To reduce the potentially nasty impact on river canyons and wild places, ALL waste must be packed out and disposed of properly. Nowadays there are fancy systems and products that do this with little "yuck" factor. However, the old days were not so efficient. Therefore reference to all things involved with the port-a-potty deteriorated aggressively over the course of a few days on the river, especially for the rookie who got saddled with rowing that particular containment apparatus on his or her boat. Names for this apparatus were varied and comical. They included, but were not limited to, the "Porta," the "Honey Pot," "Big Windy," "The Pooper," "The Shitter,"and finally, "The Groover". The rest of the names are self-explanatory but the "Groover" was an anomaly. It originated from a c.1970's practice of using military ammunition containers to carry gear down the river. They were watertight and fit nicely into the metal frames of a raft side by side. One of these cans was designated specifically for the removal of human waste. Multiple plastic bags were placed in the can and the can was taken down wind of camp and placed in a location with a view. Patrons would then either "squat" over the can or simply sat on the can and enjoyed a picturesque backdrop of the river, the area surroundings, and even some wildlife. Afterwards, the can would be filled with lye, the bags closed and a strong, watertight lid would be placed over the top. It was then tied into a raft with great care. In fact, it was often the only thing that was never lost in the event of a flip because no one ever wanted the liability of swimming in the river with an open honey pot. However I digress.....the reason the Groover is called the Groover is that depending on one's length of stay while visiting the portable human waste receptable, it was altogether possible to have the marking of a perfect rectangle or a "groove" on one's backside upon standing. Thus, the term "Groover" was coined along with it's associating components in the English language. The verb "to Groove" was the action of having a bowel movement and feeling "groovy" indicated that a movement was imminent. Of course, there are degenerations that developed over time such as groove-a-licious, groove-a-matic, groove-worthy, groovinski, groovanator, etc. Ironically, it is one term that is specific to the river industry that most river people understand and share with a reflective grin.
Not my favorite libation, prune juice tastes like liquefied raisins to me. This is odd because a prune is not a dried grape, it is a dried plum. However, the taste of prune juice makes me think of someone putting a bunch of raisins into a Vita-Mix blender and liquefying them until they resemble a dark black liquid which is ugly enough to scare the crap out of you let alone inspire peristalsis. I drank it twice daily. My daughters made all kinds of faces as they watched me drink it. None of their faces matched mine. Picture a blend of grimace, wince and disgust all rolled up into one contorted face. The girls felt hopelessly sorry for me. I tried to take the high road without success.
By this time, my stomach felt "full". My nurse voice started to take over. Ileus? Bowel Obstruction? Soap Suds enema? Fecal disimpaction? My nurse voice could scare the daylights out of the most stalwart of our tribe. I contemplated the worst case scenario and what I was going to do if the Mcmuffin principle held out to be true. I envisioned presenting to our local ER, which is also my place of employment, with the chief complaint of "can't poop." My colleagues would massacre me. Not because of my actual malady but because it meant that potentially, one of them was going to have to glove and gown and manually eliminate the contents of my rectum. This was not a pleasant thought for either of us, having been on the gowning and gloving end of the poop removal process. This would be a huge favor to ask of anyone, let alone a person I had to work with. I decided to go to guns.
Laxatives are tricky. If you are already backed up, the last thing you want to do is send a whole lot of liquid contents to the the site of the blockage because it will only increase that "fullness" and discomfort. It is hopeful that this liquid will soften the offending blockage and break the dam thus releasing the pressure and relieving the discomfort.
Whenever I am faced with complexities of the human body, I try to put things into simple, analagous terms that are helpful. For example, when I worked in the cardiac catheterization lab, I had to learn, very quickly, the anatomical and physiological workings of the human cardiovascular system. If you consider everything that goes into the functioning of the human heart and the network of arteries and veins that compose it, you will be lost in electrical, mechanical and biochemical oblivion. The intricacies of this system are infinite and therefore completely overwhelming. However, it you break it down into the most simplest form, it's really just pumps and pipes. I learned about the mechanical aspects first. How does a pump work? It has to fill and then subsequently eject its contents. How do pipes work? These are simple basics of volume and pressure that you can get in a quick study of fluid dynamics on the internet. Now let's consider the human gastrointestinal system. It's basically a gravity-fed, septic system with a pipe that squeezes to assist gravity's job of moving things through it. Imagine this pipe getting clogged. How would you unclog a clogged bathtub or septic pipe? You would probably start with a declogging agent such as Drano.
Important disclaimer: DO NOT DRINK DRANO, EVER. Drano is an alkali. The Merck Manual, put out by Merck & Co, one of the largest pharmaceutical companies in the world and makers of most medical reference material for physicians and healthcare personnel, says the following about alkalis:
"Alkalis cause rapid liquefaction necrosis; damage continues until the alkali is neutralized or diluted. Alkalis tend to affect the esophagus more than the stomach, but ingestion of large quantities severely affects both."
Taken from The Merck Manual Website
In other words, ingesting Drano would liquefy your bodily contents, cause gastric perforation and stop your heart. It is a very horrible death and one you should seriously avoid. No playing around.
So what do we use instead? Laxatives. There are many on the market, some gentle, some not so gentle and some downright violent. The general idea is to start gently and move in an aggressive direction. Prune juice is a gentle and an appropriate starting point. Adding fiber to your diet is also a very smart "move."(Pun intended). Remember: all drugs have side effects so natural means should be the preferred starting point. From here, the grocery aisle of digestive products gets large and variable. There are groups such as lubricants (i.e. mineral oil & glycerin) that coat the inner lining of the gut to prevent water absorption out of the intestines, leaving stool more opportunity to be loose.
Next are the softeners composed of Docusate Sodium, a.k.a "Colace" or "Phillips Liquigels." They bring water into the stool directly. Some may argue their effectiveness. Smart Money says start these early because by the time you are blocked, they don't do much. They are more of an insurance policy than a declogger. Take them for good karma.
Up next we have the Saline or Osmotic Laxatives which attract fluid into the bowel to soften contents. These are also known as Mira-lax, Milk of Magnesia, and my personal favorite, Magnesium Citrate (Boom!). I have rarely seen Mag Citrate not get the job done. Things get pretty exciting with this one. I consider it "going to guns" in the war on poop.
Finally, we have the stimulants. These are the least comfortable as they stimulate the muscles of the gut to move things through, often given the term "cramping." Stimulants include anything with bisacodyl or castor oil. You may recognize products called Dulco-Lax , Ex-Lax or Senokot. If Osmotics are "going to guns", then Stimulants are "going nuclear." Important safety tip: Do not plan any activities that take you far from a restroom when you take this stuff. You will have little or no warning when it breaks the clog free and you cannot even fathom how much the human gastrointestinal system can actually hold.
Speaking of which, it begs the question. How much can the human intestine hold? The volume of a tube is V=∏r2h.In the interest of time, I took the liberty of doing the calculations on my own and came up with a max volume of 9 liters. 9 liters! That's 2.38 gallons of maximum capacity. Thankfully, we are never at full capacity, although I know plenty of people who are totally full of crap. However, in the interest of making a point, let's say half of your gut is full of poop and you just drank the pharmaceutical equivalent of Drano. You soon will be evacuating a gallon (or more) of a foul, highly odiferous, substance that will not wait unless you have Herculean sphincter strength and a rectum of expansive proportions. Keep the porcelain near.
My particular defecation pickle found me backed up for four days with no success from the prune juice nor the mountain of steamed vegetables, raw spinach salads, bran flakes, or roasted corn that I was eating. It was time to go to guns. I introduced the Mira-lax and mixed it with my prune juice. This worried me because I was not a fast walker with crutches and if things started happening, I was going to need rollerskates to get me to the throne. When minutes turned into hours and hours led to night, I started to panic. I kept wondering who was going to be working triage and the look on their face when I presented my chief complaint. In anticipation of this, I threw out an email to my tribe of nursing buddies to smooth the path and put everyone on alert.
Dear Nursing Posse: No BM X 4 days. Prune juice not working. Pain meds and surgery suspected culprits. Stool softener and Mira-lax on board. Thoughts?
The general consensus was of course, go nuclear. However, a couple of my friends pointed out that 4 days wasn't really that long and perhaps, my morning coffee might be just enough to tip the scales. I had been avoiding coffee, which explained the headache. Coffee was part of my regular routine prior to surgery. Perhaps my body was just waiting for that particular communication that all systems were go. Just to be safe, I cautiously administered half a bottle of mag citrate in my evening spinach smoothie as a precursor for success.
That night, my husband prepared a yummy stir-fry selection of all his favorite gut-movers, carrots, onions, chicken and corn among them. I passed on the rice since this is generally a "binder" and potentially a step in the opposite direction. I was soon full after very little and slightly fearful that each bite was just adding to the blockage notwithstanding the foreboding rumbling sounds now coming from my abdomen, blatantly audible as if an event were looming. Still, there was no result before bedtime and the sounds of liquid rushing through my gut were now beginning to sound ominous. I anticipated a cataclysmic outcome and feared that it would occur sometime during the middle of the night.
Yet, morning came with the rising of the sun and I remained perturbed and poopless. Day 5 was now underway and my optimism was waning. My splitting headache reminded me of the coffee idea. In light of my present irritable mood and my head feeling like it would soon explode, coffee was probably a good idea on many levels. I made my way to the kitchen. Upon walking into the kitchen, I smelled coffee already made by my doting husband (bless him!). The waft of roasted Arabica Beans present in the air was another reminder that we were in fact home. I was heartened by the sight of my girls drinking Saturday morning smoothies and the fact that mine was sitting there waiting for me. And in this magical moment of being with my family, in our peaceful home, on a sunny, beautiful mid-winter's day, I was truly "feeling groovy," groovy enough to send me scrambling for the Honey pot whereupon I finally grooved............And grooved.............and grooved.
3 magazines later, mission accomplished. Now, I had a new problem.......making it stop. Looks like sushi and pizza were back on the menu!
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