Bladder and Bowel Preparation for prostate radiation

So yesterday was my third PBT session. My gut was not happy. I got on the table, in position, etc. First X-ray from side and they said my rectum needed to be emptied. Off the table, off to the restroom, diarrhea (but kept from losing urine - a lot easier with diarrhea than constipation). Back on the table, all ok.

I've taken Bentyl to calm the gut. Nope.

But given my gut issues (and history of them), my oncologist suggested an appointment with my PCP, which I was fortunate to get for early Monday.

I just want to find a way where I never fail to be treated, due to this. Yesterday came close. Today (Saturday), my gut is still unhappy.

I'm down to a low volume diet that is Gluten Free (always need that - sadly), low FODMAPs, low residue, low anti-oxidants, no caffeine, and still messed up (I have been on that diet 3 days now).

It’s hard enough without underlying IBS…much harder for you.
Are you still on Miralax?

No, I D/C'ed Miralax several days ago. I'm down to hardly eating, no meds but Beano yesterday. I see my PCP tomorrow for IBS issues (and want blood work to see if I'm malnourished). I lucked into that appointment, after calling Mayo primary care nurse triage late Friday. They wanted for me to be seen in 24hr, but that would have meant either a non-Mayo urgent care, or the ED. I told them I thought I could survive the weekend 🙂

Tomorrow, I have a lunch with old college friends at 1100, Treatment at 1515. I plan to eat nothing at all until dinner that day, unless feeling weak, in which case I'll have a banana early AM.

This morning, woke up due to bowel rumblings at 0530, got up an hour later. Still diarrhea. PulseOx after shower was 144/95, a very slight bit of faint headedness. Not good (hence, the banana and H2O). Oddly, my exercise watch was reading far lower than actual pulse. Normally it's right on. It's spO2 reading was ok, though. I just took pulse manually for 5 sec, the multiply by 12. I'm one of those people who can feel every heartbeat, and that prompted me to measure my pulse.

It is not unusual for me to skip all food until dinner - my lunch is very light and sometimes I just don't bother. But it is not usual to have two weeks of diarrhea, and to feel weak.

And yet, yesterday morning, I walked 1.25 miles with no problem - pulse mostly below 120. I'd do it this morning now that my pulse is down to 95, but I need to head off to the parish to sing in the Easter mass (I sing bass in the choir - which I greatly enjoy).

BTW, I have a number of friends dealing with PC, and of the rest, all that are over 75 have at least one significant disease. One of my PC friends started PT 2 days before me, has the same doc, and was aircrew in the same kind of aircraft I did (Navy P-3 Orion), and went to same place in Vietnam!

Good thinking with ditching the Miralax. Bananas are great for potassium and for diarrhea but you must eat them more on the UN-ripe side or else they have too much sugar and cause cramps. I know green bananas don’t taste as good but that’s the way it is.
Cooked rice and strong tea(tannins) can also help.
Believe me, I know how very hard this juggling act is for you! Hopefully your upcoming consult can shed some light on how to manage this difficult situation. Best,
Phil

My gut problem is getting more complicated. I found out yesterday I have C. difficans. So now I'm on a very strong antibiotic (Vancomycin) and the radiation therapists are wearing personal protective equipment - gloves and waterproof gowns over their clothes.

C diff is common bug that can get pretty serious if not treated. But my concern now is being able to prep right for radiation, as things change from diarrhea (2 wks) back towards normal (IBS).

Every treatment day is a challenge: how do I prepare so that I won't get kicked out of the session.

Whoa!! You only get that when you’ve been on a regimen of strong antibiotics (Biaxin esp). Were you given any prior to treatment or did you take any leftover from some previous illness?
You might have to postpone your treatment if the Vancomycin doesn’t clear it up. C. Diff is some serious sh** - no pun intended! People are now getting fecal transplants for persistent cases.
I strongly suggest you talk to your RO about this before continuing your treatment!!
Phil

Hi... I might have had one pill of antibiotics prescribed pre-biopsy, not sure. But that was 2 months before the symptoms started. But, I had C Diff once before, decades ago, and my gut never recovered. It went untreated for 8 months of disabling sickness (I was working full time but had to half time or more from home due to it). Finally, they gave me two courses of Flagyl and it went away. The gut damage never did get better.

So yeah, Bad sh*t indeed (pun intended)!

I notified my oncology team as soon as I got the test results. It just means the radiation therapists wear PPE (waterproof gown, gloves) when I come in. I have 3 treatments that way already. I'm also practicing good hand hygiene - you have to wash well with real soap.

I think Mayo was one of the pioneers in fecal transplants. I hope we don't get that far.

For what its worth, I am taking 28 radiation sessions as well. I never take enemas, and I drink around 20 oz of water on my way into the center. I did not have the spaceOAR. I will be starting my last week Monday. What worked or me was to schedule radiation in the morning, have some coffee to keep things moving, empty your bowels and bladder, and then refill your bladder with water on the way to the session. It's worked for me, I have never had a session delayed. Good luck!