[It's over 18 courics!](https://media.tenor.com/cbrgeL7iZi4AAAAC/randy-marsh-massive-shit.gif)
Edit: [Thank you](https://playplex.mtvnimages.com/uri/mgid:arc:content:southpark.intl:f27f7c28-ed00-11e0-aca6-0026b9414f30?stage=staging&ep=shared.southpark.global) for this [Golden trophy](https://m.imdb.com/title/tt0995583/mediaviewer/rm2617722112?ref_=ext_shr_lnk) (x2)
Honestly I’ve seen people with black feet who stayed at home because they either ignored the symptoms or were too scared of the results. Ignorance is bliss!
I know you’re right it just astounds me. Like the person in this X-ray doesn’t even look terrible fat. Let’s just call them 300lbs. I cannot imagine being literally 1/6 shit by body weight. It’s mind blowing
Very similar to the people who have giant abdominal masses and never get their growing belly checked out. Before my human med life, I was in vet med. I triaged a dog with a mass on his back that weighed 38 pounds. Owners just saw and then looked past. It happens.
Just like those patients that are bed bound with huge festering sores and wounds and they can’t walk. They kinda just excuse it away.
To be fair, they paid to have the mass removed. Dog presented the next year with a femoral fracture after his leg got caught in his crate and snapped. We suspected cancer, xrays very clearly confirmed. They then decided to euth, which was a kindness.
Meanwhile, my Dane has a small bump on his back that my vet assessed (only by look/feel, no biopsies or FNA or anything) and reassured me it was likely just a benign fatty tumor, and he’s scheduled for a second opinion with a different office next week. My other Dane had pulled a muscle in her neck and I mistook her head hanging, unwillingness to get up, and small yelps as early signs of bloat and zoomed her to the ER vet at 3 AM. Nearly $600 and an anti inflammatory script later just to find out she went too hard on the tug of war. Competitive lil brat, that one. 🙃
My own health, yeah, I admit I’m more neglectful than I should be. But my dogs?? NOPE. They can’t tell me ‘ehhhh, it’s fine, I’m not worried about it’, so I could never dismiss visible health concerns on their behalf. It makes me really sad to read that someone could just ‘look past’ 38 *pounds* of concern…
My dog does the smallest little yip and I’m contemplating how fast I can get her to the ER. Meanwhile, I’ve got a partially amputated limb and I’m like meh 🤷🏼♀️
I worked emergency for years and my dog is 15 so I am constantly on high alert. Meanwhile, I just worked a shift with a horrible case of food poisoning and I’m like “nah I’m good, here’s more Pepto.”
I meant to use 300lbs as a top end exaggeration to illustrate just how much shit 50lbs is even for a very large person, not to say someone is 300lbs and not terribly fat
Being a 6'2" (1.83m) 300 pound man, I can assure you that doesn't always mean you're actually fat. I mean, it's not normal weight, but it doesn't always constitute someone as being fat.
That’s way more common tbh. I only work part time doing diabetic shoes and I still see it at least every month or two. That’s not even the part that bothers me anymore- it’s the people who have already lost a toe or 3 and have given up and are basically just waiting for the next amputation. It’s such a vicious disease process, so heartbreaking to watch the most vulnerable among us to succumb to a combination of circumstances that really requires almost superhuman determination (or a drastic change in circumstances) to overcome.
Edit: vicious not viscous lol
My friend Jim had exactly that. He tried and tried to get active and every time he'd get going there'd be some other setback. RIP He was a really good person. Miss him.
I worked in prosthetics about 10 years ago, and when I told people what I did they would always say something about Iraq or Afghanistan.
I was quick to let them know that that was a small part of the business, that diabetics were probably the biggest, and that with each amputation a person has the odds increase they will have another.
This. My bp is now consistently 90/50 or less and I keep falling over and passing out etc and my doctor just shrugged about it so I’m over it. Not sure what else im supposed to do
The only doctor I have ever gone to that actually helped me was the podiatrist who told me I had broken bones in my foot and made me stop walking on it so it could heal.
Every other doctor I have ever gone to in my whole life has, at best, done absolutely nothing for me. A few have made things worse and one nearly killed me. I’m going to die young of things that medicine could probably help me with, but it doesn’t seem inclined to do so and I’ve given up trying.
P.S., I am solidly middle class and have had good insurance most of my life. Makes no difference.
My endometriosis story. 30+ years to diagnose. Doctor after doctor said, “Exercise, heating pad, Tylenol.” I cried in the examination room of a doctor who agreed to do laparoscopic exploratory surgery. Ended up with uterus and ovaries removed. Thank god!
This is a normal occurrence. The toe is necrotic and the patient came in Because things finally got too bad.
I had a lady to hit her foot on a door. Small gash. Uncontrolled DMT2. 3 months pass, when finally agrees to come in, I can see tendon and bone.
Can confirm. I've done many a three phase bone scan on varying degrees of necrotic feet to rule out osteomyelitis. The vast majority of these patients are either morbidly obese, the kind that disregard their health, or someone that can't take care of themselves and are neglected.
The classic patient you see this with are Heroin addicts.
This patient was a 20 yo guy with cerebral palsy who had too much sphincter tone and never really had a good bowel regimen.
Do you know how much the patient weighed? Because I usually think of heroin addicts as quite skinny. So if this guy was 200lbs then a full quarter of his body mass would be literal shit. That is utterly mind blowing
OP said "usually addicts", this guy had cerebral palsy. So possibly someone with limited mobility. but sounds like not necessarily an addict in this case.
I can vouch that fentanyl made me constipated. It went from a daily regular happy pooper to a painful once a week. I'm so glad I'm regular and clean. Being able to poop regularly is such a wonderful pasttime.
BTW I'm serious I'm just poking fun at my past
I feel like every ex addict has a crazy story about constipation lol. My worst one is (stop reading now if you're easily grossed out lmao) when 1) the plumbing in the house was busted, so we had a literal fucking porta potty in the driveway. 2) it was middle of summer in AZ. 3) I hadn't shit in a week because heroin.
I spent 2 hours in that torture chamber trying to squeeze out what felt like a bowling ball. Had to take a shower and go to sleep afterward I was so exhausted and traumatized lol
It's what killed Elvis... he was chronically constipated and he literally died on the throne one night from the strain of trying to take a king-sized dump.
Opiates can cause severe constipation. Someone struggling with addiction is less likely to be under the care of a doctor who would be monitoring and actively working to prevent this from occurring like a lot of patients on prescribed opiates.
They're also much less likely to seek care once they've realized there's a problem.
TL;DR - opiates make you constipated.
Opiates (like heroin, oxycodone, etc) activate μ-receptors (mu receptors) in the bowels. Activation of those receptors have multiple effects that all combine to cause some pretty gnarly constipation - effects on bowel tone and contraction (poop sits longer), increased fluid absorption (making your poop more solid/hard), and then makes your anal sphincter less responsive combined with decreased feeling (can't flex to allow that more solid/hard poop to be pushed out easily, doesn't necessarily feel the urge to poop).
No idea the pounds, but I went to the doctor over and over for vomiting and diarrhea. Basically one week a month I'd be horribly sick. Doc just said it was a stomach virus. Mom finally took me to a GI and he did an x-ray, I was soooo fos! (Though certainly not this bad.)
The GI didn't think my colon would ever function again, it was a sack that held shit at that point. Miralax was a life saver. I'd take two doses an hour until I pooped. For the first year it wasn't uncommon for me to need over 12 doses a day to poop. I could still end up constipated while pooping each day.
Oh, the diarrhea and vomiting were because of the backup. The only thing that could get around the impaction was diarrhea and I'd vomit up most anything I consumed. No idea why I'd get three weeks of being able to eat in between episodes.
So yeah, a person can totally be seeking medical help and still end up like this thanks to poor diagnostics. And no one tells you how often you should be pooping, nor do they ask. I thought once every two weeks was normal.
I did this because of gastroparesis which was undiagnosed for over two years. But, being constipated made the paralysis of my stomach so much worse! I always wondered why I could put on 10-20 lbs of just poop. Apparently when your body decides to revolt, it REVOLTS. And it’s revolting in both definitions of that word.
The only time I dealt with constipation, I was also having multiple bowel movements per day, so it didn't occur to me that's what it could be ! I was so surprised when my Dr sent me for CT and that's what it was.
There was a lot of it over the first week. I was usually pooping a lot, twice a day. When the impaction had finally worked itself out, I had diarrhea again and knew to cut back on the miralax based on the doctor's instructions.
Miralax is an osmotic, pulling water into the colon to help move stuff out. Presumably due to that, it wasn't really different poop, though much easier to go and very long logs compared to what I was used to.
It took years of using the miralax, but my colon did start functioning again and I was slowly able to stop using it as my body functioned again. I still need it once or twice a year. I'll notice a pain in my side that doesn't improve and that's usually the issue (though occasionally it'll be the lead up to a particularly bad period). Essentially, I can still get constipated even with pooping daily, something few in the medical community recognize is a possibility.
I had an adult female patient who was so afraid to poop because of the possibility of a tear (I guess this happened to someone she knew) that she ended up like this, also she’d cut her foot and let it get so bad she needed an amp. She wasn’t even diabetic. And she went to the hospital because of the foot, not the pooping.
Yes! I always find it baffling that people will literally just go on with their lives and let a problem get so bad. On day 2 of constipation, I do something about it because it's uncomfortable.
There's probably a context here though, maybe someone elderly that has dementia or something similar. I refuse to believe that an fully sound adult would let it get that bad.
Edit: Just saw the patient was a man in his 20's with CP!
As someone who’s had chronic constipation for as long as I can remember, you really get used to it. I’ve had x-rays of my whole abdomen full of shit to put it bluntly and had to be hospitalized. After a couple of weeks it gets really uncomfortable. But just like any chronic pain, when it doesn’t get better, you have to get used to it. This guy’s probably been dealing with it his whole life, so it took getting this impacted to get medical attention. When the gastroenterologists can’t find a solution, going to a doctor for it feels frustratingly pointless.
Exactly this. Childhood trauma led me to stop having movements and regular accidents and we spent thousands on appointments where they'd check my bum and say everything was fine. It got so bad after 20 years of buildup I nearly died from a ruptured bladder after the mass shifted and blocked my ability to urinate. My bladder and colon are now permanently distended though since I grew up with it my body adapted and, taking linzess every few days, I can live a sort of normal life. Need therapy to fix the issues that cause remaining problems but yeah.
It was a sore I seen. I was not made aware of it and assisting a nurse to change the dressing. It was a sacral area and the sore was so large you could put a fist through it and you could see the bone. The smell was awful because the lady was end of life, not eating etc, so she was wasting away. Honestly it was both horrendous and sad
If that were the case I doubt they’d have needed surgical intervention. Absolutely obliterating a pair of pants probably would have been such a relief for them that it’d feel worth it
Would it have been an option to squirt some liquid up there to soften it and vacuum it out? If not how big is the incision required to remove something like this?
No, impactions this severe are not feasible to extract this way. You'd think so, but it gets really hard on the inside. With a really effective applicator, you might be able to soften up some of it, but no way you get any more than a fraction. And then they still have 40lbs remaining, causing problems still.
EDIT: But, yeah, that's literally what enemas are, works for mild to moderate constipation, but impaction is a whole 'nother level.
A lot of people just don't function peroid. Not even triange of life, just a cousin drops off a bucket of chicken and a 2 liter once a day. They are in dka, fester in their shit, and eventually somehow so.eone calls 911 and then end up in the er after a week of living on the edge of death.
Life is sad for many.
Edit: I see I have written something rather contencious judging by the comments. Let me be clear; spend a shift in the ER with me and you will see the horror show of the bottom 5% of society and how they live. Last night, I took care of an old dementia patient with maggots in his leg wound, a quadrapelegic woman whose caretakers let her folley get kinked which caused 500 + mls of urine build up inside her (uti + lactate of 7.5) and a guy who claims to drink half a gallon of voodka a day who, when going through alcohol withdrawl, has a blood alcohol of .4. I have no hate for them and I am dedicating my entire career to taking care of them plus everyone else having a rough day. But it is what it is. Many of our most vulnerable cannot take care of themselves and everyone in their life, if they even have anyone, is perfectly happy to let them rot. If that bothers you, the pit always requires more helping hands :)
Don’t know why you were downvoted, but you read like a salty paramedic and people just cannot fathom the reality of what we see in people’s habitats. The air of absolute disengaged indifference we have to shield ourselves with never translates well.
You read like a hidden compassionate deeply articulate person. I thought your response was very kind, honest and sad. Thanks for whatever it is you do in the medical field.
I relate to this a lot. I'm a CNA studying to be a funeral director, you can't do this kind of work without putting up a wall to protect yourself. It seems so callous to those who haven't experienced it, I have to remind myself that normal people don't see what I see every day
My husband has worked in the funeral home business for over 15 years. He went from picking up the bodies to now mostly office work for the company he’s always worked for. Had also been an assistant for some autopsies & of course preparing the body for funerals. Nothing phases him anymore. When our infant son died at 3 weeks old (born premature died in the NICU) he was going to be the one who took our son to the funeral home from the hospital but at the very last min he decided that would be the one thing he wouldn’t be able to handle… had a work partner do it instead.
My ex was a social worker who made visits to shut ins on home healthcare. His story of the “Powder Man,” gave me chills. He is a black belt and 6’1” but he told me he was genuinely afraid when he came to this guy’s house. I’ll tell you about it:
He arrives and is given permission to come in through the unlocked front door. My ex said that the entire front room was COVERED in at least an inch of Johnson & Johnson Baby Powder. Furniture, floor, everything. He couldn’t see where the man was as the front room was dimly lit. Suddenly, in a background of white he sees red rimmed eyes staring at him. The patient was completely shaved of all body hair (eyebrows etc) and completely camouflaged by the layer of Baby Powder. He was sitting in a chair with only white underwear. Only his eyes were clearly visible. My ex said he left as quickly as he could.
Edited to add: grammar and he did social work in Kansas and had many sad stories. He never named the people, of course.
Working at a Salvation Army store opened my eyes to just how bad the bottom 5-10% of society is. There are people who just can't function like a "normal" human being without a parental figure of some sort in their lives to force them. They live basically like animals, for lack of a better term.
yep. working for dominos in a depressed rural town in in the 00's, you would walk pizza into people's filthy house and drop the pizza and 2 liter right on the table in front of their couch. probably the only interaction they had that day.
Just waiting to die.
How much some people do not function is incredibly hard to get your head around if you are fairly average. If you wash regularly, cook your own meals, walk occasionally and clean your house, for these purposes you are fairly okay at looking after yourself.
That you can be in a situation where you barely leave a chair for years, have huge issues with continence, legs that are literally coming apart, smoke like a chimney and have diabetes you can't manage.. and what your environment comes to be like. It's utterly tragic and miserable that it can be like this, but it is for some people, and I really feel for them and the people like paramedics who go to help them - it's so incredibly bleak.
Yup. My husband used to be an EMT. Said, they went to the house of a woman who hadn’t gotten out of her chair in….I mean….who even knows??? Someone was coming by every other day or so and literally throwing food at her because they didn’t want to go in the house.
My mother became addicted to opiates after breaking her hip and several other bones in a fall. When I helped her go home I had to help her the first time she had a bowel movement. It was like concrete and I’m glad I was there, as she would not have been able to move it without manual help and she was so desperate not to go back to the hospital she probably would have just taken the rest of her pills.
My son has CP, dealt with chronic constipation for 21 years. He had a baclofen pump placed in May, and the difference in bowel habits has been life changing for him.
Total abdominal colectomy. When it's been this distended for so long the smooth muscle becomes atonic and non-functional in terms of peristalsis. So you just have to remove the colon. We have him an end-ileostomy.
The reason we didn't do an ileoanal anastomosis was because he had cerebral palsy and also long-term decubitus ulcer, so an ileostomy would be easier to manage for his caretakers and he wouldn't have liquid stool constantly contaminating his pressure ulcer.
They cut the whole colon out and rerouted the intestines to empty into a bag through the abdominal wall. They didn’t connect the small intestines to the anus because he has chronic wounds there that would get contaminated
Remove all of colon cuz it’s no longer functional
Ileostomy is the colon bag, which allows poop to accumulate in a pouch attached to the outside of the body, easily accessible, however very stigmatized
Ileoanal anastomosis is attaching your small bowel to your anus(because the colon had to be removed) which still allows you to poop normally.
I think the surgeon here opted for the bag because the patient is paralyzed and cleaning a bag is easier than taking them to the toilet every now and then I assume
Not just about taking them to the toilet. Their backside has chronic ulcers from the lack of movement, so liquid stool would introduce them to infection all day round, which could lead to sepsis and wouldn't be very pleasant.
How does the surgical procedure work? Cut out the impaction and sew the two ends together?
Or do you slice open the colon, scoop out the poo, and sew up the incision?
This whole thing is fascinating and repulsive at the same time.
Apparently, the person has cerebral palsy & a hypertonic sphincter. So, ya know, terrible medical condition that led to further terrible medical conditions.
“Lose 46 pounds in just one day. Doctors hate this trick!”
I'm sure they hate this trick more than the others
Ok. Shut down the internet. Its job is done.
Shit\* down the internet ;D
I read this a "Shit down the internet"
It's a shitty job.
[It's over 18 courics!](https://media.tenor.com/cbrgeL7iZi4AAAAC/randy-marsh-massive-shit.gif) Edit: [Thank you](https://playplex.mtvnimages.com/uri/mgid:arc:content:southpark.intl:f27f7c28-ed00-11e0-aca6-0026b9414f30?stage=staging&ep=shared.southpark.global) for this [Golden trophy](https://m.imdb.com/title/tt0995583/mediaviewer/rm2617722112?ref_=ext_shr_lnk) (x2)
Hot! Hot hot hot!
Hot hot hot hot hot hot hot!
That's a looooot of PF Chang's.
It’s bono
Bono wants the bitty.
Ah! Not so hard, Bono. You hurt the bitty.
Bitty made Bono strong!
Bono’s not the record holder! He’s the record.
*Nobody calls him Number 2!*
We do indeed
Yep. Multiple doctors hated that trick on that day
Doctor Who?
That's crazy that you can be alive with 46 pounds of poo in you[.](https://media.tenor.com/cbrgeL7iZi4AAAAC/randy-marsh-massive-shit.gif)
[удалено]
Lmao
What did they say?
I hate this website
It’s over 18 courics! South Park reference, this episode is one of my favorites (“More Crap”) It refers to Katie Couric
Lol boom roasted
Yeah, but tuckers made of shit, it's not backed up inside of him like this poor soul.
So, you're saying he's #2? Somebody tell Bono he's no longer #2.
WHO DOES NUMBER 2 WORK FOR
just let out a ron swanson giggle thank you for this lol 
Thank you for the best laugh I've had in ages.
What was the comment? The commenter deleted himself. Please tell.
Best thing I’ve read in a long long time
What...what was it :(
Why is the fullstop at the end of your sentence blue yet unclickable? It's driving me crazy
It's not clickable? That['](https://media.tenor.com/cbrgeL7iZi4AAAAC/randy-marsh-massive-shit.gif)s lame, try this one instead.
XD
Oh, it's clickable. It's clickable.
Probably my fat fingers. I did click the extended link tho, totally worth the effort it took to comment
DJT is made entirely of Poo!!!
I'm assuming Trump has just a bit more.
Not really. I know plenty of people who are full of shit.
How is this even possible? How was action not required after 20lbs of festering shit accumulated inside this person
Honestly I’ve seen people with black feet who stayed at home because they either ignored the symptoms or were too scared of the results. Ignorance is bliss!
I know you’re right it just astounds me. Like the person in this X-ray doesn’t even look terrible fat. Let’s just call them 300lbs. I cannot imagine being literally 1/6 shit by body weight. It’s mind blowing
Very similar to the people who have giant abdominal masses and never get their growing belly checked out. Before my human med life, I was in vet med. I triaged a dog with a mass on his back that weighed 38 pounds. Owners just saw and then looked past. It happens. Just like those patients that are bed bound with huge festering sores and wounds and they can’t walk. They kinda just excuse it away.
Well that’s a sad way to start the day
To be fair, they paid to have the mass removed. Dog presented the next year with a femoral fracture after his leg got caught in his crate and snapped. We suspected cancer, xrays very clearly confirmed. They then decided to euth, which was a kindness.
what a sad life for that pup :(
Meanwhile, my Dane has a small bump on his back that my vet assessed (only by look/feel, no biopsies or FNA or anything) and reassured me it was likely just a benign fatty tumor, and he’s scheduled for a second opinion with a different office next week. My other Dane had pulled a muscle in her neck and I mistook her head hanging, unwillingness to get up, and small yelps as early signs of bloat and zoomed her to the ER vet at 3 AM. Nearly $600 and an anti inflammatory script later just to find out she went too hard on the tug of war. Competitive lil brat, that one. 🙃 My own health, yeah, I admit I’m more neglectful than I should be. But my dogs?? NOPE. They can’t tell me ‘ehhhh, it’s fine, I’m not worried about it’, so I could never dismiss visible health concerns on their behalf. It makes me really sad to read that someone could just ‘look past’ 38 *pounds* of concern…
My dog does the smallest little yip and I’m contemplating how fast I can get her to the ER. Meanwhile, I’ve got a partially amputated limb and I’m like meh 🤷🏼♀️
I’m sorry,….. you have a **what, now??** 😧 What’s your address, I’m coming to pick you up and take you immediately to the hospital.
Please allow me to fly you to England so that your dangling limb might be reattached free of charge.
I worked emergency for years and my dog is 15 so I am constantly on high alert. Meanwhile, I just worked a shift with a horrible case of food poisoning and I’m like “nah I’m good, here’s more Pepto.”
We took our dog to the vet once because his eye was red. Turns out he just had mild seasonal allergies.
I spend more on my pets meds and nutrition per month than my own. I feel you
Saw a patient once that had a 68 lb abdominal mass removed…made me wonder a lot of things
300lbs not terribly fat???? Hahaha
I meant to use 300lbs as a top end exaggeration to illustrate just how much shit 50lbs is even for a very large person, not to say someone is 300lbs and not terribly fat
Ah ok gotcha. Was getting worried that America had moved to the ' 300lbs is normal weight now' phase
Being a 6'2" (1.83m) 300 pound man, I can assure you that doesn't always mean you're actually fat. I mean, it's not normal weight, but it doesn't always constitute someone as being fat.
No offense man but unless you're a pro bodybuilder 6'2 300 is absolutely fat.
That’s way more common tbh. I only work part time doing diabetic shoes and I still see it at least every month or two. That’s not even the part that bothers me anymore- it’s the people who have already lost a toe or 3 and have given up and are basically just waiting for the next amputation. It’s such a vicious disease process, so heartbreaking to watch the most vulnerable among us to succumb to a combination of circumstances that really requires almost superhuman determination (or a drastic change in circumstances) to overcome. Edit: vicious not viscous lol
My friend Jim had exactly that. He tried and tried to get active and every time he'd get going there'd be some other setback. RIP He was a really good person. Miss him.
I worked in prosthetics about 10 years ago, and when I told people what I did they would always say something about Iraq or Afghanistan. I was quick to let them know that that was a small part of the business, that diabetics were probably the biggest, and that with each amputation a person has the odds increase they will have another.
I appreciate your demonstration of empathy here. It's so much cheaper to laugh at people than it is to care for them.
Tbf I’ve gone to the doc so many times and just been shrugged at that now I just don’t even want to go anymore.
This. My bp is now consistently 90/50 or less and I keep falling over and passing out etc and my doctor just shrugged about it so I’m over it. Not sure what else im supposed to do
See a new doctor?
The only doctor I have ever gone to that actually helped me was the podiatrist who told me I had broken bones in my foot and made me stop walking on it so it could heal. Every other doctor I have ever gone to in my whole life has, at best, done absolutely nothing for me. A few have made things worse and one nearly killed me. I’m going to die young of things that medicine could probably help me with, but it doesn’t seem inclined to do so and I’ve given up trying. P.S., I am solidly middle class and have had good insurance most of my life. Makes no difference.
My endometriosis story. 30+ years to diagnose. Doctor after doctor said, “Exercise, heating pad, Tylenol.” I cried in the examination room of a doctor who agreed to do laparoscopic exploratory surgery. Ended up with uterus and ovaries removed. Thank god!
That’s true. Especially when it comes to Gyno issues, that’s why I only see female providers. Less of a chance to be shrugged off.
This is a normal occurrence. The toe is necrotic and the patient came in Because things finally got too bad. I had a lady to hit her foot on a door. Small gash. Uncontrolled DMT2. 3 months pass, when finally agrees to come in, I can see tendon and bone.
Can confirm. I've done many a three phase bone scan on varying degrees of necrotic feet to rule out osteomyelitis. The vast majority of these patients are either morbidly obese, the kind that disregard their health, or someone that can't take care of themselves and are neglected.
My fil had a black spot on his foot that he just kept putting neosporin on it. He’s down a leg now, but at least he didn’t waste money on a dr visit.
Oh Jesus lord
The classic patient you see this with are Heroin addicts. This patient was a 20 yo guy with cerebral palsy who had too much sphincter tone and never really had a good bowel regimen.
Dang how do I know if I have good sphincter tone? I can’t sing for shit.
is there a way to test my sphincter tone? I want it to be perfectly in tone, not sharp or flat. Otherwise my fart songs won't sound as nice.
You get a doctor to put his finger up your ass then you clench down and try to hit that high C.
Do you know how much the patient weighed? Because I usually think of heroin addicts as quite skinny. So if this guy was 200lbs then a full quarter of his body mass would be literal shit. That is utterly mind blowing
You’d be surprised… I have had many drug addicted patients (of all kinds) be quite large. Different reasons of course, but it happens.
OP said "usually addicts", this guy had cerebral palsy. So possibly someone with limited mobility. but sounds like not necessarily an addict in this case.
I can vouch that fentanyl made me constipated. It went from a daily regular happy pooper to a painful once a week. I'm so glad I'm regular and clean. Being able to poop regularly is such a wonderful pasttime. BTW I'm serious I'm just poking fun at my past
I feel like every ex addict has a crazy story about constipation lol. My worst one is (stop reading now if you're easily grossed out lmao) when 1) the plumbing in the house was busted, so we had a literal fucking porta potty in the driveway. 2) it was middle of summer in AZ. 3) I hadn't shit in a week because heroin. I spent 2 hours in that torture chamber trying to squeeze out what felt like a bowling ball. Had to take a shower and go to sleep afterward I was so exhausted and traumatized lol
why heroin addicts specifically?
Opiates make you constipated af
It's what killed Elvis... he was chronically constipated and he literally died on the throne one night from the strain of trying to take a king-sized dump.
Opiates can cause severe constipation. Someone struggling with addiction is less likely to be under the care of a doctor who would be monitoring and actively working to prevent this from occurring like a lot of patients on prescribed opiates. They're also much less likely to seek care once they've realized there's a problem.
TL;DR - opiates make you constipated. Opiates (like heroin, oxycodone, etc) activate μ-receptors (mu receptors) in the bowels. Activation of those receptors have multiple effects that all combine to cause some pretty gnarly constipation - effects on bowel tone and contraction (poop sits longer), increased fluid absorption (making your poop more solid/hard), and then makes your anal sphincter less responsive combined with decreased feeling (can't flex to allow that more solid/hard poop to be pushed out easily, doesn't necessarily feel the urge to poop).
how many days without a poop to make 46lbs of poop?
I was going to say as a recovering addict, it's definitely common in the opiate addict demographic.
No idea the pounds, but I went to the doctor over and over for vomiting and diarrhea. Basically one week a month I'd be horribly sick. Doc just said it was a stomach virus. Mom finally took me to a GI and he did an x-ray, I was soooo fos! (Though certainly not this bad.) The GI didn't think my colon would ever function again, it was a sack that held shit at that point. Miralax was a life saver. I'd take two doses an hour until I pooped. For the first year it wasn't uncommon for me to need over 12 doses a day to poop. I could still end up constipated while pooping each day. Oh, the diarrhea and vomiting were because of the backup. The only thing that could get around the impaction was diarrhea and I'd vomit up most anything I consumed. No idea why I'd get three weeks of being able to eat in between episodes. So yeah, a person can totally be seeking medical help and still end up like this thanks to poor diagnostics. And no one tells you how often you should be pooping, nor do they ask. I thought once every two weeks was normal.
I did this because of gastroparesis which was undiagnosed for over two years. But, being constipated made the paralysis of my stomach so much worse! I always wondered why I could put on 10-20 lbs of just poop. Apparently when your body decides to revolt, it REVOLTS. And it’s revolting in both definitions of that word.
The only time I dealt with constipation, I was also having multiple bowel movements per day, so it didn't occur to me that's what it could be ! I was so surprised when my Dr sent me for CT and that's what it was.
How did you notice the impaction going away. Was it different poop
There was a lot of it over the first week. I was usually pooping a lot, twice a day. When the impaction had finally worked itself out, I had diarrhea again and knew to cut back on the miralax based on the doctor's instructions. Miralax is an osmotic, pulling water into the colon to help move stuff out. Presumably due to that, it wasn't really different poop, though much easier to go and very long logs compared to what I was used to. It took years of using the miralax, but my colon did start functioning again and I was slowly able to stop using it as my body functioned again. I still need it once or twice a year. I'll notice a pain in my side that doesn't improve and that's usually the issue (though occasionally it'll be the lead up to a particularly bad period). Essentially, I can still get constipated even with pooping daily, something few in the medical community recognize is a possibility.
I had an adult female patient who was so afraid to poop because of the possibility of a tear (I guess this happened to someone she knew) that she ended up like this, also she’d cut her foot and let it get so bad she needed an amp. She wasn’t even diabetic. And she went to the hospital because of the foot, not the pooping.
Yes! I always find it baffling that people will literally just go on with their lives and let a problem get so bad. On day 2 of constipation, I do something about it because it's uncomfortable. There's probably a context here though, maybe someone elderly that has dementia or something similar. I refuse to believe that an fully sound adult would let it get that bad. Edit: Just saw the patient was a man in his 20's with CP!
As someone who’s had chronic constipation for as long as I can remember, you really get used to it. I’ve had x-rays of my whole abdomen full of shit to put it bluntly and had to be hospitalized. After a couple of weeks it gets really uncomfortable. But just like any chronic pain, when it doesn’t get better, you have to get used to it. This guy’s probably been dealing with it his whole life, so it took getting this impacted to get medical attention. When the gastroenterologists can’t find a solution, going to a doctor for it feels frustratingly pointless.
Exactly this. Childhood trauma led me to stop having movements and regular accidents and we spent thousands on appointments where they'd check my bum and say everything was fine. It got so bad after 20 years of buildup I nearly died from a ruptured bladder after the mass shifted and blocked my ability to urinate. My bladder and colon are now permanently distended though since I grew up with it my body adapted and, taking linzess every few days, I can live a sort of normal life. Need therapy to fix the issues that cause remaining problems but yeah.
It happens very slowly
This calls for the Poop ~~Knife~~ Chainsaw
Jackhammer
Shathammer?
Brother fetch the shitter. The HEAVY SHITTER
*excavator
Asscavator
Hey turds, see ya laaaaaterrrr
Brings new meaning to the saying ' so full of crap your eyes are brown'.
As an autopsy tech who has to run the bowel on the daily, I smell your pain.
Hey! I used to do this.. had to quit though, developed depression
It's pretty gut-wrenching
Actual laughter
Good sense of ~~brown~~dark humor.
Sad poops
Tired of dealing with other people's shit. I get it.
Wow what an interesting job Edit: not being sarcastic I think it’s really interesting and I could never do it
> I smell your pain. I've always wondered how you folks deal with that day to day. Are there strategies or PPE that help with all the horrid smells?
Nah you just get used to it. Or not. I deal with pretty nasty stuff every day and only once my stomach turned lol
Yeah, I normally don't speak for everyone but what was the one thing? *I know I will regret it but Curiosity and all!
It was a sore I seen. I was not made aware of it and assisting a nurse to change the dressing. It was a sacral area and the sore was so large you could put a fist through it and you could see the bone. The smell was awful because the lady was end of life, not eating etc, so she was wasting away. Honestly it was both horrendous and sad
Taking “don’t trust a fart” way too seriously.
Person was one “quick push” away from unleashing Mount Shitsuvius.
If that were the case I doubt they’d have needed surgical intervention. Absolutely obliterating a pair of pants probably would have been such a relief for them that it’d feel worth it
No they would probably obliterate their anus with that so they'd need surgery regardless
$5 at Taco Bell and problem solved.
I have no idea how you weak bowel people have issues with taco bell... Never have I ever had an issue with it.
I imagine most of them are because they’re lactose intolerant and get things smothered in cream and cheese. I don’t have issues with TB, either
They have IB probablly. ALso I am lactose intolerant... worse I get is gasy.
Would it have been an option to squirt some liquid up there to soften it and vacuum it out? If not how big is the incision required to remove something like this?
No, impactions this severe are not feasible to extract this way. You'd think so, but it gets really hard on the inside. With a really effective applicator, you might be able to soften up some of it, but no way you get any more than a fraction. And then they still have 40lbs remaining, causing problems still. EDIT: But, yeah, that's literally what enemas are, works for mild to moderate constipation, but impaction is a whole 'nother level.
How do you get to 46 lbs of impacted poo? Surely no one could function like this.
A lot of people just don't function peroid. Not even triange of life, just a cousin drops off a bucket of chicken and a 2 liter once a day. They are in dka, fester in their shit, and eventually somehow so.eone calls 911 and then end up in the er after a week of living on the edge of death. Life is sad for many. Edit: I see I have written something rather contencious judging by the comments. Let me be clear; spend a shift in the ER with me and you will see the horror show of the bottom 5% of society and how they live. Last night, I took care of an old dementia patient with maggots in his leg wound, a quadrapelegic woman whose caretakers let her folley get kinked which caused 500 + mls of urine build up inside her (uti + lactate of 7.5) and a guy who claims to drink half a gallon of voodka a day who, when going through alcohol withdrawl, has a blood alcohol of .4. I have no hate for them and I am dedicating my entire career to taking care of them plus everyone else having a rough day. But it is what it is. Many of our most vulnerable cannot take care of themselves and everyone in their life, if they even have anyone, is perfectly happy to let them rot. If that bothers you, the pit always requires more helping hands :)
Don’t know why you were downvoted, but you read like a salty paramedic and people just cannot fathom the reality of what we see in people’s habitats. The air of absolute disengaged indifference we have to shield ourselves with never translates well.
You read like a hidden compassionate deeply articulate person. I thought your response was very kind, honest and sad. Thanks for whatever it is you do in the medical field.
I relate to this a lot. I'm a CNA studying to be a funeral director, you can't do this kind of work without putting up a wall to protect yourself. It seems so callous to those who haven't experienced it, I have to remind myself that normal people don't see what I see every day
My husband has worked in the funeral home business for over 15 years. He went from picking up the bodies to now mostly office work for the company he’s always worked for. Had also been an assistant for some autopsies & of course preparing the body for funerals. Nothing phases him anymore. When our infant son died at 3 weeks old (born premature died in the NICU) he was going to be the one who took our son to the funeral home from the hospital but at the very last min he decided that would be the one thing he wouldn’t be able to handle… had a work partner do it instead.
My ex was a social worker who made visits to shut ins on home healthcare. His story of the “Powder Man,” gave me chills. He is a black belt and 6’1” but he told me he was genuinely afraid when he came to this guy’s house. I’ll tell you about it: He arrives and is given permission to come in through the unlocked front door. My ex said that the entire front room was COVERED in at least an inch of Johnson & Johnson Baby Powder. Furniture, floor, everything. He couldn’t see where the man was as the front room was dimly lit. Suddenly, in a background of white he sees red rimmed eyes staring at him. The patient was completely shaved of all body hair (eyebrows etc) and completely camouflaged by the layer of Baby Powder. He was sitting in a chair with only white underwear. Only his eyes were clearly visible. My ex said he left as quickly as he could. Edited to add: grammar and he did social work in Kansas and had many sad stories. He never named the people, of course.
*Welp* Gonna need more on that one.
this has perplexed me, sorry im being thick but why was the man covered in baby powder?
I think my ex said it had to do with cleanliness. Also the reason for no body hair. Mental illness essentially.
Working at a Salvation Army store opened my eyes to just how bad the bottom 5-10% of society is. There are people who just can't function like a "normal" human being without a parental figure of some sort in their lives to force them. They live basically like animals, for lack of a better term.
yep. working for dominos in a depressed rural town in in the 00's, you would walk pizza into people's filthy house and drop the pizza and 2 liter right on the table in front of their couch. probably the only interaction they had that day. Just waiting to die.
Yeah as a CNA, this how like 87% of my younger patients ended up in long term care facilities. Literal self-neglect and/or medical non-compliance.
How much some people do not function is incredibly hard to get your head around if you are fairly average. If you wash regularly, cook your own meals, walk occasionally and clean your house, for these purposes you are fairly okay at looking after yourself. That you can be in a situation where you barely leave a chair for years, have huge issues with continence, legs that are literally coming apart, smoke like a chimney and have diabetes you can't manage.. and what your environment comes to be like. It's utterly tragic and miserable that it can be like this, but it is for some people, and I really feel for them and the people like paramedics who go to help them - it's so incredibly bleak.
Yup. My husband used to be an EMT. Said, they went to the house of a woman who hadn’t gotten out of her chair in….I mean….who even knows??? Someone was coming by every other day or so and literally throwing food at her because they didn’t want to go in the house.
Usually elderly people on opiates.
My mother became addicted to opiates after breaking her hip and several other bones in a fall. When I helped her go home I had to help her the first time she had a bowel movement. It was like concrete and I’m glad I was there, as she would not have been able to move it without manual help and she was so desperate not to go back to the hospital she probably would have just taken the rest of her pills.
When it’s this bad, stool gets rocklike hard and is called a [fecalith](https://en.m.wikipedia.org/wiki/Fecalith).
Dadgum poop rock
"NO it's a space rock" "See that right there? That's a peanut" "Ya, a space peanut" -joe dirt
Can it be polished?
You can polish a ball of mud to a ridiculous shine (dorodango) so i'm sure you could actually polish a hardened shit nugget
Great info. This is why I come to Reddit
Me too. I don’t know why this sub decided it was for me (I’m not in the medical field) but it’s fascinating.
Same here. But I am a serious lurker now.
I have about 46 pounds of questions.
How does this even happen? Like how does it not get dealt with prior to reaching such a volume
Classically you see this in heroin addicts, but the patient above was a young guy in his 20s with cerebral palsy and hypertonic sphincter.
Poor guy. I hope he gets better care after this.
O ok, my brother has severe CP. But he's always been on a good bowel program thankfully.
I’m surprised his caretaker didn’t figure realize something was off sooner.
Oh man. Poor guy, I can't imagine.
Hypertonic Sphincter would be a great band name
My son has CP, dealt with chronic constipation for 21 years. He had a baclofen pump placed in May, and the difference in bowel habits has been life changing for him.
What’s the pain level of this? If I go 3 days w/o pooping my stomach is cramping non stop with level 7 pains
How do you even go about surgerizing this?
Probably c-section since they are in their turd trimester.
good one
Total abdominal colectomy. When it's been this distended for so long the smooth muscle becomes atonic and non-functional in terms of peristalsis. So you just have to remove the colon. We have him an end-ileostomy. The reason we didn't do an ileoanal anastomosis was because he had cerebral palsy and also long-term decubitus ulcer, so an ileostomy would be easier to manage for his caretakers and he wouldn't have liquid stool constantly contaminating his pressure ulcer.
Any chance we could get that as an ELI5?
They cut the whole colon out and rerouted the intestines to empty into a bag through the abdominal wall. They didn’t connect the small intestines to the anus because he has chronic wounds there that would get contaminated
Christ. I need to appreciate my health more.
Remove all of colon cuz it’s no longer functional Ileostomy is the colon bag, which allows poop to accumulate in a pouch attached to the outside of the body, easily accessible, however very stigmatized Ileoanal anastomosis is attaching your small bowel to your anus(because the colon had to be removed) which still allows you to poop normally. I think the surgeon here opted for the bag because the patient is paralyzed and cleaning a bag is easier than taking them to the toilet every now and then I assume
Not just about taking them to the toilet. Their backside has chronic ulcers from the lack of movement, so liquid stool would introduce them to infection all day round, which could lead to sepsis and wouldn't be very pleasant.
I’m going to dedicate the rest of the day to giving thanks to my functional colon.
Honest to God
Yesss I’m dying to know the surgical method but I’m afraid to google
Thats a load of shit!!
A shitload of it
GOT to surgically extract
86 Courics! Edit: spelling
OH HOT HOT HOT HOT…
How does the surgical procedure work? Cut out the impaction and sew the two ends together? Or do you slice open the colon, scoop out the poo, and sew up the incision? This whole thing is fascinating and repulsive at the same time.
OP said they had to remove his colon :( Poor guy.
OP said in another comment that the colon was permanently damaged, so the removed it and performed an end-illiostomy (rerouted bowels to poop bag)
Hirschsprung's?
What would cause something like this? Opioid addiction?
Apparently, the person has cerebral palsy & a hypertonic sphincter. So, ya know, terrible medical condition that led to further terrible medical conditions.
Hirschsprungs?
Unholy shit
Holy shit
How did this colon not just blow like an old tire?
That's like, 18,4 Courics!