An Unplanned Case Study of 1 (Me!)
David M. Brady, ND, DC, CCN, DACBN
I have decided to share a story with you, my colleagues. In the process, I will disclose some medical information about myself that some may find potentially embarrassing. I know it is also a bit gross, but hey, you are all physicians and we all have the same anatomy, more or less, and just remember that it could have been you!
So, I have a chronic, intermittent low back condition. Anyone who has the same condition knows what it can be like, whereas those who don’t will never know how incapacitating it can be when it flairs. Recently, my low back completely went out and I was in severe, acute pain. After trying to get up from a chair in my office at the University of Bridgeport, I went right down to the floor and couldn’t get up from it for a good 30 minutes. When I did, I could not stand, sit, lie or walk without terrible pain. Somehow I walked across campus, looking like Frankenstein’s monster, in the process, and received emergency treatment at the University clinic that afternoon from one of our best staff chiropractic doctors and one of his senior interns. From there, my wife picked me up and drove me, not home, unfortunately, but straight to the airport so that I could speak at a conference in Ft. Lauderdale, Florida, the very next day. I was in no shape to travel but there would be hundreds of doctors there to hear me speak. What was I to do but go? The prospect of standing all of the next day while speaking was very frightening, indeed. The reality of having to travel and deliver a lecture with this severe pain simply necessitated that I take medication, just to get by. I ended up taking prescription pain relievers, muscle relaxers and antiinflammatories, along with a plethora of natural agents. I know that strong pain killers generally cause me to experience bad headaches and severe constipation, so I rarely ever take them. Well, despite taking magnesium citrate preventively, by the end of my trip and returning home to my extremely busy life, I suddenly realized that I hadn’t had a bowel movement in more than 5 days.
Long story short, after many attempts, it became quite clear that I was completely impacted. The bowel obstruction caused abdominal pain and distension, which was quickly worsening. After using multiple enemas, magnesium citrate, polyethylene glycol 3350, and many glycerine suppositories at home without success, I set out at 1:00 am for the emergency department of one of my local hospitals. I knew everybody there, which is a good and yet also somehow very bad thing in this scenario! After a very long night filled with waiting, 4 attempts were made to digitally remove the impaction (which, I might add, was like having multiple prostate exams on steroids from an angry large-handed prison guard, even though the doctor was actually a rather small-framed female, which made it that much more embarrassing). They also tried multiple medical soapsuds enemas, a couple more standard enemas, and then finally injected some sort of magic lubricant into my rectum, using a taped-together, rigged-up NG tube. Nice! Of course, I then had to try to move things along, almost blowing a gasket in the process and producing very limited, to negligible, results. All I managed to get out was the mess that they had introduced up there. If this thing I was trying to pass had been a baby, I would surely have consented to a C-section immediately! Still, the obstruction remained and I just got fed up, realizing they didn’t know what to do next with me, and so I just left, wearing the disposable scrubs they had given me to replace my soiled clothes. I arrived home at 8 am that morning in the same condition, though with significantly more pain and anxiety.
What to do now? I left a message for and eventually talked to my gastroenterologist on the phone as soon as his office opened for the day. I regularly refer patients to him and we know each other professionally. I was hoping he would be my savior by telling me to come right down and then doing whatever it took to free me of my burden. Instead, he suggested that I do a full colonoscopy prep all that day and night, and into the next morning, and to have a colonoscopy the next afternoon since I was “due anyway.” Oh, boy. I was more than a little worried about doing a colonoscopy prep with this distal impaction but what do I know, right? I also wouldn’t be able to eat anything but broth for another 24 hours and I was already starving, having not eaten within the past 24 hours already. However, I know that a bowel obstruction is a serious matter and that I, therefore, needed to get this thing addressed immediately.
So I am left sitting there, and the thought of doing a full colonoscopy prep, given the state of my bottom and the sheer number of times I would have to clean up that area of already-very-tender anatomy in the process, not to mention the total “bowl-time” with legs already fatigued and asleep from my ordeal, was just too much to contemplate. I also know how extreme these colonoscopy preps are and how much fluid they produce. If my distal impaction did not clear, I would be in intense pain, I could possibly end up back in the emergency room with that pain, and might even risk perforation. So, in desperation, and with a plastic bag on the seat of my car, I wound up going back to my own group practice, Whole Body Medicine in Trumbull, CT. I had our colon hydrotherapist, Rose, give me about an hour-long colonic with multiple irrigations and releases, abdominal massage, and deep breathing relaxation exercises, which were followed by some serious “Zen-like” bowl-time and, finally, finally…success! I will spare you the gory details of the final moments, but those interested in the amazing specifics can just ask me about it sometime over drinks.
To summarize, after 8 hours in a major regional teaching hospital emergency department, with the care of a highly trained emergency room physician and a team of nurses, my results are essentially, well, bubkus…bubkus plus pain and loss of dignity, that is. I then contact an even more highly-trained gastroenterology specialist I know, and he suggests a solution that does not help me until the next day, at best, which puts me through more hell, but which conveniently results in a nice, billable, high-dollar procedure for his practice. Once again, bubkus. I then go back to my own practice, and our colon therapist, using a standard colon irrigation machine, fixes it, and in an extremely caring and dignified way, I might add. There you have it! So much for high-tech expensive medicine, and I don’t even want to know what my insurance was billed for zero results.
I am left thinking to myself, “Why don’t they have colonic machines in every emergency department?” I know with all the pain meds given out all the time, this has to be a relatively common occurrence. Even if they understood how effective it can be, it would probably not be profitable enough for them. I also immediately think that this is a story I need to share freely with my ND students, interns, and colleagues, despite any personal embarrassment it may cause, since I know that these days we are often preoccupied with the latest high-tech gadget, the most recent evidence-based this or that, and even the newest prescription agent. Maybe that old colonic machine, and other foundational elements of Nature Cure are more powerful than we now seem to remember and appreciate. I am also aware of how we sometimes think we are so smart and gravitate to a high-tech, latest-technology solution, when sometimes the answer is easy, low-tech, and nothing new. That was the case here.
So in the end, thank you Rose, my angel! I should have come to you first, and had it not been 1:00 in the morning when I experienced rapidly developing abdominal pain and distension, I would like to think that I would have…I really would.
I did take the next day off, though I did manage to check and respond to e-mails and participate in two teleconferences….Wait, maybe that’s the real reason I ended up in this mess in the first place!
David M. Brady, ND, DC, CCN, DACBN is a licensed Naturopathic Physician and Clinical Nutritionist, He is the vice provost of the Division of Health Sciences, director of the Human Nutrition Institute, and associate professor of clinical sciences at the University of Bridgeport in Connecticut. He is also chief medical officer for Designs for Health, Inc., and maintains a private practice, Whole Body Medicine, in Trumbull, CT. Dr. Brady has been a featured presenter at many of the most prestigious conferences in integrative medicine, including IFM, ACAM, A4M, IHS, IAACN, AANP, and many more. He is a contributing author for Integrative Gastroenterology, the first integrative medical textbook on gastroenterology by Johns Hopkins physician Gerard Mullin, MD, and is also a contributing author for Laboratory Evaluations for Integrative and Functional Medicine, by Lord and Bralley, and Advancing Medicine with Food and Nutrients, Second Edition, by Ingrid Kohlstadt, MD.