Constipation 12 Days - Due to Morphine / Opiates

[Guest guest]

Hello all & Happy Holidays !

 

A dear friend has a brain tumor, and just underwent removal of 1 of

the 3 brain tumors. She also has a shunt in her brain to drain excess

edema.

 

After 12 days in the hospital, she was released, but with profound

constipation.

 

She is Qi Xu, having lost a tremendous amount of weight.

 

She is currently trying Da Huang Pie, however, it is clear that

Rhubarb Pie is not the root, that is used in TCM.

 

Also Da Huang is prescribed raw for constipation, and Da Huang Pie, is

cooked Rhubarb, thus lessening the purging effect.

 

The formula I am considering for her is:

Ma Zi Ren Wan

 

The danger her is that nothing can be prescribed that would increase

cranial pressure in her brain, or strain her.

 

He has very little Qi to push down the stool out of her body. And it

is now 13 days since a true bowel movement.

 

Any suggestions in addition to the above-mentioned ?

[Guest guest]

Are you going to write a formula or give patents? Is there a build up

of heat right now?

Doug

 

 

 

 

, " d.siena " <sienasmiles

wrote:

>

> Hello all & Happy Holidays !

>

> A dear friend has a brain tumor, and just underwent removal of 1 of

> the 3 brain tumors. She also has a shunt in her brain to drain excess

> edema.

>

> After 12 days in the hospital, she was released, but with profound

> constipation.

>

> She is Qi Xu, having lost a tremendous amount of weight.

>

> She is currently trying Da Huang Pie, however, it is clear that

> Rhubarb Pie is not the root, that is used in TCM.

>

> Also Da Huang is prescribed raw for constipation, and Da Huang Pie, is

> cooked Rhubarb, thus lessening the purging effect.

>

> The formula I am considering for her is:

> Ma Zi Ren Wan

>

> The danger her is that nothing can be prescribed that would increase

> cranial pressure in her brain, or strain her.

>

> He has very little Qi to push down the stool out of her body. And it

> is now 13 days since a true bowel movement.

>

> Any suggestions in addition to the above-mentioned ?

>

[Guest guest]

Hi Doug,

 

She has undergone an 12 hour brain surgery just 10 days ago, and is

due for another surgery shortly. There are a total of 3 brain tumours,

which are affecting her speech, swallowing, equilibium.

 

Since she has a shunt in her brain, one has to be mindful of depleting

too much fluid thru a purging treatment.

 

Found an interesting explanation of the side effects of formulas such

as Ma Zi Ren Wan, and the possible side effects:

 

http://www.acupuncture.com/herbs/dahuang1.htm

 

Here is the concern of using a purging formula:

1) Possible Hemostatic Effect, which could cause a blood clot in her

brain.

2) Draining an excess amount of fluid out of her body, when she is

already fluid deficient, and has a shunt in her brain.

 

She is also still taking an opiate daily, which is further cuasing the

side effect of constipation.

 

She is truly in a fragile & weak state, with Qi Xu and Jin-Ye Xu.

 

She is actually not my patient but a dear friend. We have been trying

to do everything thru food not herbs thus far.

 

I most likely will not be giving her any type of herb formula, due to

the possible side effects, pharmacological interactions with her meds,

and her circumstance.

 

Promoting a bowel movement thru food is of the highest priority....

 

The Rhubarb Pie did not promote a bowel movement unfortunately. Again,

it is not the root as in Da Huang, and not raw as in Da Haung.

 

 

 

, " "

wrote:

>

> Are you going to write a formula or give patents? Is there a build up

> of heat right now?

> Doug

>

>

>

>

> , " d.siena " <sienasmiles@>

> wrote:

> >

> > Hello all & Happy Holidays !

> >

> > A dear friend has a brain tumor, and just underwent removal of 1 of

> > the 3 brain tumors. She also has a shunt in her brain to drain excess

> > edema.

> >

> > After 12 days in the hospital, she was released, but with profound

> > constipation.

> >

> > She is Qi Xu, having lost a tremendous amount of weight.

> >

> > She is currently trying Da Huang Pie, however, it is clear that

> > Rhubarb Pie is not the root, that is used in TCM.

> >

> > Also Da Huang is prescribed raw for constipation, and Da Huang Pie, is

> > cooked Rhubarb, thus lessening the purging effect.

> >

> > The formula I am considering for her is:

> > Ma Zi Ren Wan

> >

> > The danger her is that nothing can be prescribed that would increase

> > cranial pressure in her brain, or strain her.

> >

> > He has very little Qi to push down the stool out of her body. And it

> > is now 13 days since a true bowel movement.

> >

> > Any suggestions in addition to the above-mentioned ?

> >

>

[Guest guest]

An herb often used for qi xu constipation is bai zhu atractylodes. You might

consder that herb alone in moderate quantities. Pretty benign stuff which

can give her a little more oomph for pushing out poop.

 

On Tue, Dec 30, 2008 at 8:08 AM, d.siena <sienasmiles wrote:

 

> Hello all & Happy Holidays !

>

> A dear friend has a brain tumor, and just underwent removal of 1 of

> the 3 brain tumors. She also has a shunt in her brain to drain excess

> edema.

>

> After 12 days in the hospital, she was released, but with profound

> constipation.

>

> She is Qi Xu, having lost a tremendous amount of weight.

>

> She is currently trying Da Huang Pie, however, it is clear that

> Rhubarb Pie is not the root, that is used in TCM.

>

> Also Da Huang is prescribed raw for constipation, and Da Huang Pie, is

> cooked Rhubarb, thus lessening the purging effect.

>

> The formula I am considering for her is:

> Ma Zi Ren Wan

>

> The danger her is that nothing can be prescribed that would increase

> cranial pressure in her brain, or strain her.

>

> He has very little Qi to push down the stool out of her body. And it

> is now 13 days since a true bowel movement.

>

> Any suggestions in addition to the above-mentioned ?

>

>

>

 

 

 

--

, DAOM

Pain is inevitable, suffering is optional.

 

 

 

[Guest guest]

Arnaud Versluys said in his Shang han lun course that his teacher

uses Bai shao in high dosages (over 30-60 gms) as a laxative.

You can contact him for more details. info

 

I'm sure they've given her every kind of stool softener and enemas.

Probably did the apple sauce and prune juice too.

 

Maybe Bai shao with Bai zhu?

Looks like Tong xie yao fang...

 

K.

 

 

 

On Tue, Dec 30, 2008 at 6:39 PM, Al Stone <al wrote:

 

> An herb often used for qi xu constipation is bai zhu atractylodes. You

> might

> consder that herb alone in moderate quantities. Pretty benign stuff which

> can give her a little more oomph for pushing out poop.

>

>

> On Tue, Dec 30, 2008 at 8:08 AM, d.siena

<sienasmiles<sienasmiles%40sbcglobal.net>>

> wrote:

>

> > Hello all & Happy Holidays !

> >

> > A dear friend has a brain tumor, and just underwent removal of 1 of

> > the 3 brain tumors. She also has a shunt in her brain to drain excess

> > edema.

> >

> > After 12 days in the hospital, she was released, but with profound

> > constipation.

> >

> > She is Qi Xu, having lost a tremendous amount of weight.

> >

> > She is currently trying Da Huang Pie, however, it is clear that

> > Rhubarb Pie is not the root, that is used in TCM.

> >

> > Also Da Huang is prescribed raw for constipation, and Da Huang Pie, is

> > cooked Rhubarb, thus lessening the purging effect.

> >

> > The formula I am considering for her is:

> > Ma Zi Ren Wan

> >

> > The danger her is that nothing can be prescribed that would increase

> > cranial pressure in her brain, or strain her.

> >

> > He has very little Qi to push down the stool out of her body. And it

> > is now 13 days since a true bowel movement.

> >

> > Any suggestions in addition to the above-mentioned ?

> >

> >

> >

>

> --

> , DAOM

> Pain is inevitable, suffering is optional.

>

>

[Guest guest]

When I did my internship at San Diego Hospice, we treated many end-of-life

patients for constipation, using needles only.  Sometimes we would place 3

needles in the constipation area on the ear, and leave seeds in place after we

left.  Patients reported significant relief.

 

Andrea Beth

 

 

Traditional Oriental Medicine

Happy Hours in the CALM Center

1770 E. Villa Drive, Suite 5

Cottonwood, AZ  86326

(928) 274-1373

 

 

--- On Tue, 12/30/08, d.siena <sienasmiles wrote:

d.siena <sienasmiles

Re: Constipation 12 Days - Due to Morphine / Opiates

 

Tuesday, December 30, 2008, 5:44 PM

 

Hi Doug,

 

She has undergone an 12 hour brain surgery just 10 days ago, and is

due for another surgery shortly. There are a total of 3 brain tumours,

which are affecting her speech, swallowing, equilibium.

 

Since she has a shunt in her brain, one has to be mindful of depleting

too much fluid thru a purging treatment.

 

Found an interesting explanation of the side effects of formulas such

as Ma Zi Ren Wan, and the possible side effects:

 

http://www.acupuncture.com/herbs/dahuang1.htm

 

Here is the concern of using a purging formula:

1) Possible Hemostatic Effect, which could cause a blood clot in her

brain.

2) Draining an excess amount of fluid out of her body, when she is

already fluid deficient, and has a shunt in her brain.

 

She is also still taking an opiate daily, which is further cuasing the

side effect of constipation.

 

She is truly in a fragile & weak state, with Qi Xu and Jin-Ye Xu.

 

She is actually not my patient but a dear friend. We have been trying

to do everything thru food not herbs thus far.

 

I most likely will not be giving her any type of herb formula, due to

the possible side effects, pharmacological interactions with her meds,

and her circumstance.

 

Promoting a bowel movement thru food is of the highest priority....

 

The Rhubarb Pie did not promote a bowel movement unfortunately. Again,

it is not the root as in Da Huang, and not raw as in Da Haung.

 

 

 

, " "

wrote:

>

> Are you going to write a formula or give patents? Is there a build up

> of heat right now?

> Doug

>

>

>

>

> , " d.siena "

<sienasmiles@>

> wrote:

> >

> > Hello all & Happy Holidays !

> >

> > A dear friend has a brain tumor, and just underwent removal of 1 of

> > the 3 brain tumors. She also has a shunt in her brain to drain excess

> > edema.

> >

> > After 12 days in the hospital, she was released, but with profound

> > constipation.

> >

> > She is Qi Xu, having lost a tremendous amount of weight.

> >

> > She is currently trying Da Huang Pie, however, it is clear that

> > Rhubarb Pie is not the root, that is used in TCM.

> >

> > Also Da Huang is prescribed raw for constipation, and Da Huang Pie,

is

> > cooked Rhubarb, thus lessening the purging effect.

> >

> > The formula I am considering for her is:

> > Ma Zi Ren Wan

> >

> > The danger her is that nothing can be prescribed that would increase

> > cranial pressure in her brain, or strain her.

> >

> > He has very little Qi to push down the stool out of her body. And it

> > is now 13 days since a true bowel movement.

> >

> > Any suggestions in addition to the above-mentioned ?

> >

>

 

 

 

---

 

Chinese Herbal Medicine offers various professional services, including a

practitioner's directory and a moderated discussion forum.

 

 

 

[Guest guest]

Dustin, this is very difficult to treat a life threatened case and

especially with a good friend. You and all of us don't want to do

anything that could harm her in such a state. However since we know of

each other I'll offer a few comments. Take them as you will.

 

(I've added a little to a post I just put up (and then deleted) after

talking to colleague with significant hospital experience in China.

His comments briefly are that the first task is to remove the

stagnation/excess. Once the bowels are moved the hydration should come

back to the rest of the body. (He suggests Tao He Cheng Qi Tang

because there is elements of blood stagnation as a result of the

surgery.) After the purging then you can do the tonification. Standard

TCM stuff we all know but is the standard for good reasons)

 

 

I would say that the Ma Zi Ren would be a good choice. I wouldn't

worry about any hemostatic effects of the Da Huang. Just about every

formula you could choose (the Cheng Qi's etc...) are going to be very

downward in their orientation and shouldn't affect brain areas.

Our formulas are going or should have some qi moving in them which is

going to make them significantly better for your friend than the

cathartics that she probably will get from her MD's if this continues.

They most likely will just be water exchange in the bowels leaving her

less hydrated.

 

Some combination of purging and tonifying is obviously needed but you

can try one of the Cheng Qi Tangs along lots of liquids and tonics.

Acupuncture is a good idea and moxa would be great if you have the

chance. Moxa really seems to help after surgery to counteract the

coldness of the anesthesia. I've personally been taking Ginseng

Sublime from Dragon Herbs and find it really good and gentle even on

my damp heat body. You can talk to the good folk at Dragon about it.

 

Is she receiving or going to receive radiation or chemotherapy?

 

You can give me a call later in the day if you'd like to talk it over.

Take care, best of thoughts for your patient and yourself.

 

Doug

 

PS:

 

based on what you've said and suggestions from the others...

consider this after the first purge:

Zeng Ye Cheng Qi Tang

Xuan Shen

Sheng Di Huang

(Mai Men Dong )

Da Huang

Mang Xiao

with

Tai Zi Shen

Zhi Shi

Hou Po

Bai Zhu

Bai Shao

[Guest guest]

Doug,

 

Thank you for your thoughts & prayers.

 

Some great reccomendations you have mentioned.

 

Since I am her friend, as I mentioned, I am not treating her with

herbs. She is fortunate enough to have an Eastern Dept. in the

hospital, which may offer her Acupuncture & Herbal Medicine.

 

She has been at home, under the loving & wonderful care of her mum.

 

And the good news is that she finally had a BM, with the help of a

saline enema.

 

I am not her Doctor, and just a good friend. No herbs have been used,

and we have been using food as her medicine.

 

Again, I am not her doctor, just her good friend.

 

We will have to find ways to regulate her bowels with food.

 

But perhaps the Eastern Doctor at the hospital will be apt to utilize

herbal medicine.

 

However, one must truly understand the phamacodynamics and

pharmacokinetics of the medication-herbal combinations.

 

This is something that is an ongoing learning journey for us all, as

new drugs are released all the time, and more and more patients are on

medication cocktails that we treat.

 

Since she is extremely fragile, we have to proceed with caution, and

food is the safest for her at this point.

 

Her cranial nerves have been compromised effecting her in other ways,

in terms of swallowing, eating, talking, etc.

 

Love, support, correct food combinations, and rest are great assets to

her right now.

 

 

, " "

wrote:

>

>

>

> Dustin, this is very difficult to treat a life threatened case and

> especially with a good friend. You and all of us don't want to do

> anything that could harm her in such a state. However since we know of

> each other I'll offer a few comments. Take them as you will.

>

> (I've added a little to a post I just put up (and then deleted) after

> talking to colleague with significant hospital experience in China.

> His comments briefly are that the first task is to remove the

> stagnation/excess. Once the bowels are moved the hydration should come

> back to the rest of the body. (He suggests Tao He Cheng Qi Tang

> because there is elements of blood stagnation as a result of the

> surgery.) After the purging then you can do the tonification. Standard

> TCM stuff we all know but is the standard for good reasons)

>

>

> I would say that the Ma Zi Ren would be a good choice. I wouldn't

> worry about any hemostatic effects of the Da Huang. Just about every

> formula you could choose (the Cheng Qi's etc...) are going to be very

> downward in their orientation and shouldn't affect brain areas.

> Our formulas are going or should have some qi moving in them which is

> going to make them significantly better for your friend than the

> cathartics that she probably will get from her MD's if this continues.

> They most likely will just be water exchange in the bowels leaving her

> less hydrated.

>

> Some combination of purging and tonifying is obviously needed but you

> can try one of the Cheng Qi Tangs along lots of liquids and tonics.

> Acupuncture is a good idea and moxa would be great if you have the

> chance. Moxa really seems to help after surgery to counteract the

> coldness of the anesthesia. I've personally been taking Ginseng

> Sublime from Dragon Herbs and find it really good and gentle even on

> my damp heat body. You can talk to the good folk at Dragon about it.

>

> Is she receiving or going to receive radiation or chemotherapy?

>

> You can give me a call later in the day if you'd like to talk it over.

> Take care, best of thoughts for your patient and yourself.

>

> Doug

>

> PS:

>

> based on what you've said and suggestions from the others...

> consider this after the first purge:

> Zeng Ye Cheng Qi Tang

> Xuan Shen

> Sheng Di Huang

> (Mai Men Dong )

> Da Huang

> Mang Xiao

> with

> Tai Zi Shen

> Zhi Shi

> Hou Po

> Bai Zhu

> Bai Shao

>

[Guest guest]

I know this is not Chinese herbs, but the drug methylnaltrexone is made

specifically for constipated cancer pts who are on long term opiates to

control pain. It is newly approved by the FDA in the US, has been used in

Canada and Europe for a number of years.

 

Chronic constipation in oncology pts can be deadly - I just saw one who

perf'd her bowel due to it. The trick is to stay on top of it and never go

over a day without a bowel movement or get aggressive - da huang, senna,

bulk agents and stool softeners. Enemas if needed.

 

Methynaltrexone can be Rx'd by the ONC MD.

 

Janet Yelowchan, ND, LAc, LPC, LAC

Medicine Buddha Clinic

1623 Mathews St

Fort Collins, CO 80525

970.494.1120

www.bluebuddha.net

 

 

 

 

 

[Guest guest]

Happy New Year!

 

Is she even eating? Abdomen hard/soft? Abdominal tuina if no herbs.

Suppositories didn't work?

 

Geoff

 

, " d.siena " <sienasmiles

wrote:

>

>

> Hi Doug,

>

> She has undergone an 12 hour brain surgery just 10 days ago, and is

> due for another surgery shortly. There are a total of 3 brain tumours,

> which are affecting her speech, swallowing, equilibium.

>

> Since she has a shunt in her brain, one has to be mindful of depleting

> too much fluid thru a purging treatment.

>

> Found an interesting explanation of the side effects of formulas such

> as Ma Zi Ren Wan, and the possible side effects:

>

> http://www.acupuncture.com/herbs/dahuang1.htm

>

> Here is the concern of using a purging formula:

> 1) Possible Hemostatic Effect, which could cause a blood clot in her

> brain.

> 2) Draining an excess amount of fluid out of her body, when she is

> already fluid deficient, and has a shunt in her brain.

>

> She is also still taking an opiate daily, which is further cuasing the

> side effect of constipation.

>

> She is truly in a fragile & weak state, with Qi Xu and Jin-Ye Xu.

>

> She is actually not my patient but a dear friend. We have been trying

> to do everything thru food not herbs thus far.

>

> I most likely will not be giving her any type of herb formula, due to

> the possible side effects, pharmacological interactions with her meds,

> and her circumstance.

>

> Promoting a bowel movement thru food is of the highest priority....

>

> The Rhubarb Pie did not promote a bowel movement unfortunately. Again,

> it is not the root as in Da Huang, and not raw as in Da Haung.

>

>

>

> , " "

> <taiqi@> wrote:

> >

> > Are you going to write a formula or give patents? Is there a build up

> > of heat right now?

> > Doug

> >

> >

> >

> >

> > , " d.siena " <sienasmiles@>

> > wrote:

> > >

> > > Hello all & Happy Holidays !

> > >

> > > A dear friend has a brain tumor, and just underwent removal of 1 of

> > > the 3 brain tumors. She also has a shunt in her brain to drain

excess

> > > edema.

> > >

> > > After 12 days in the hospital, she was released, but with profound

> > > constipation.

> > >

> > > She is Qi Xu, having lost a tremendous amount of weight.

> > >

> > > She is currently trying Da Huang Pie, however, it is clear that

> > > Rhubarb Pie is not the root, that is used in TCM.

> > >

> > > Also Da Huang is prescribed raw for constipation, and Da Huang

Pie, is

> > > cooked Rhubarb, thus lessening the purging effect.

> > >

> > > The formula I am considering for her is:

> > > Ma Zi Ren Wan

> > >

> > > The danger her is that nothing can be prescribed that would increase

> > > cranial pressure in her brain, or strain her.

> > >

> > > He has very little Qi to push down the stool out of her body. And it

> > > is now 13 days since a true bowel movement.

> > >

> > > Any suggestions in addition to the above-mentioned ?

> > >

> >

>

[Guest guest]

HAPPY NEW YEAR 2009!!

 

Ayurveda formula for constipation

Terminalia chebula (part use-fruit) crude powder = 6g

Terminalia belerica(part use-fruit) crude powder= 6g

Using above ingredients make the decoction (add 1920ml water and get the

extraction around 240ml), give this decoction 120ml two times per day when sever

constipation ouucrs for three days, if its is moderate use 120ml once a day

therapy for three days.

 This decoction is good for severe constipation.

 

 

 

________________________________

G Hudson <ozark.canuck

 

Friday, January 2, 2009 2:39:14 AM

Re: Constipation 12 Days - Due to Morphine / Opiates

 

 

Happy New Year!

 

Is she even eating? Abdomen hard/soft? Abdominal tuina if no herbs.

Suppositories didn't work?

 

Geoff

 

, " d.siena " <sienasmiles@ ...>

wrote:

>

>

> Hi Doug,

>

> She has undergone an 12 hour brain surgery just 10 days ago, and is

> due for another surgery shortly. There are a total of 3 brain tumours,

> which are affecting her speech, swallowing, equilibium.

>

> Since she has a shunt in her brain, one has to be mindful of depleting

> too much fluid thru a purging treatment.

>

> Found an interesting explanation of the side effects of formulas such

> as Ma Zi Ren Wan, and the possible side effects:

>

> http://www.acupunct ure.com/herbs/ dahuang1. htm

>

> Here is the concern of using a purging formula:

> 1) Possible Hemostatic Effect, which could cause a blood clot in her

> brain.

> 2) Draining an excess amount of fluid out of her body, when she is

> already fluid deficient, and has a shunt in her brain.

>

> She is also still taking an opiate daily, which is further cuasing the

> side effect of constipation.

>

> She is truly in a fragile & weak state, with Qi Xu and Jin-Ye Xu.

>

> She is actually not my patient but a dear friend. We have been trying

> to do everything thru food not herbs thus far.

>

> I most likely will not be giving her any type of herb formula, due to

> the possible side effects, pharmacological interactions with her meds,

> and her circumstance.

>

> Promoting a bowel movement thru food is of the highest priority....

>

> The Rhubarb Pie did not promote a bowel movement unfortunately. Again,

> it is not the root as in Da Huang, and not raw as in Da Haung.

>

>

>

> , " "

> <taiqi@> wrote:

> >

> > Are you going to write a formula or give patents? Is there a build up

> > of heat right now?

> > Doug

> >

> >

> >

> >

> > , " d.siena " <sienasmiles@ >

> > wrote:

> > >

> > > Hello all & Happy Holidays !

> > >

> > > A dear friend has a brain tumor, and just underwent removal of 1 of

> > > the 3 brain tumors. She also has a shunt in her brain to drain

excess

> > > edema.

> > >

> > > After 12 days in the hospital, she was released, but with profound

> > > constipation.

> > >

> > > She is Qi Xu, having lost a tremendous amount of weight.

> > >

> > > She is currently trying Da Huang Pie, however, it is clear that

> > > Rhubarb Pie is not the root, that is used in TCM.

> > >

> > > Also Da Huang is prescribed raw for constipation, and Da Huang

Pie, is

> > > cooked Rhubarb, thus lessening the purging effect.

> > >

> > > The formula I am considering for her is:

> > > Ma Zi Ren Wan

> > >

> > > The danger her is that nothing can be prescribed that would increase

> > > cranial pressure in her brain, or strain her.

> > >

> > > He has very little Qi to push down the stool out of her body. And it

> > > is now 13 days since a true bowel movement.

> > >

> > > Any suggestions in addition to the above-mentioned ?

> > >

> >

>

 

 

 

 

 

 

 

[Guest guest]

Have you considered stewed prunes or stewed figs in addition to

acupuncture points for constipation?

 

When she had her stool did it have any bulk (fiber) to it?

 

If not, then perhaps some psyllium would help. Standard Process has a

product called Gastro-Fiber in capsules which an easy way to include

fiber.

 

--

Duncan E

 

 

" We are here to help each other get though this thing, whatever it is. "

-Mark Vonnegut