Well - the Calm helped because it's basically magnesium. I took 4 gummies at night (for sleep & the constipation). Metamucil - I found some chocolate cookies that I could stand to eat, I'd eat 4 cookies a day. I didn't care for the powder in water. And Finally it got so bad I used Colace (2 to 4 tablets a day - the generic form). That really helped when the other 2 things were not moving things along. It didn't seem to matter how much water I drank or how much fiber I ate - it was never enough on it's own. The other thing that ticked me off - both my regular doctor & the oncologist acted like this was something trivial & waved me off. Same thing with the insomnia. I mean I got tired but Never sleepy. I'd lie in bed for hours awake. Sometimes I still do. The doctors do not realize these items really affect the quality of life. I meant to add - it took about 3 or 4 months on exemestane for my hand pain to go away, but it did. Went from a 7 to a 0 or 1.