Anita's Full Distension Enema
My aunt was a Registered Nurse for nearly 30 years from 1946 until her retirement in the mid seventies. She kept detailed journals for all of those years and wrote them in the third person. After her death in 1997 I inherited all of those journals since I was her only remaining relative. I have had those journals for nearly ten years and decided to look through them and see what they held. Well there was everything you could imagine. Virtually every procedure she assisted in was written down in detail. One of which I found interesting and exotic. I relate it to you with very little exciting or corrections.
My aunt met Anita in a meeting that was called by her family doctor. At that meeting was the radiologist, Dr. Mary Haver, Mrs. Nancy ----, Anita's aunt and legal gardian, Dr. Peter ----, Anita, and Darlene -----, R.N. (my aunt). My aunt was invited since she was assigned as the x-ray nurse.
Anita was 19 years old, very pretty, weighed 110 lbs and was fully developed. She had a very pleasant smile and great personality.
The Dr. wanted Anita to know that since her mother had died of intestinal cancer several years earlier that she was prone to have a similar problem. Talking more to her aunt than to Anita, the Dr said that she (Anita} should have an x-ray examination of her intestinal system to see if anything had started. She would also need to have them about every 5 years to prevent what had happened to her mother.
The Dr then asked Dr. Haver to explain the examination procedure to them. Dr. Haver said that she was one of the few female radiologists on the East coast and that she was an expert on this particular procedure. She said that since the cancer that they were looking for was on the outside of the intestinal tract, the entire tract as well as the stomach would have to be filled with barium, the x-ray medium. The procedure was lengthy and unfortunaetly got very uncomfortable. But it was the only way to find this type of cancer.
Nancy asked if they used anesthesia. At this, Dr. Haver said that they can only use a mild muscle relaxant. The opiate drugs have a tendency to stop intestinal movement and extreme constipation results. Also an unconscious patient must be held in the various position during the procedure for the x-ray pictures thus exposing the nurses unnecessarily, and an unconscious patient must stay in the hospital an additional day.
Anita then said that she had been given large enemas from her mom as well as her aunt and she didn't see any problem with a little more. Dr. Haver did not say anything. Anita was scheduled the following week.
My aunt met up with Anita on a Wednesday morning at 9:00 AM in x-ray. She had been wheeled down from the ward where she had checked in the day earlier. Darlene looked at the records that accompanied Anita and saw that all preparations were complete. Anita was given two doses of castor oil three hours apart, two large ( 2-3 liter) soapsuds enemas between doses in rapid succession, three large soapsuds enemas between 9:00 PM and 11:00 PM last night, one soapsuds enema and two rinse enemas this morning.
Darlene asked her to change gowns in the dressing room removing everything except her socks. This gown was a short gown just going down to her waist. Anita asked why and my aunt told her that she would not want anything on her stomach during the exam. She was to use a large bath towel to cover herself for the exam room.
Darlene stated that she had assisted with this type of enema about ten times in the last two years. These were very hard and painful for patients and to make matters worse they had to retain the enema for over thirty minutes, after the long filling time. She was required to mix ten liters of water and barium at a 75/25 mixture at 110 F. This was about as thick as half and half milk. It did not flow fast so the container was held at six feet to maintain pressure. The flow was slow at a rate of 1 liter every five minutes. This would take up to 30 minutes for six liters to be given for the normal patient.
Anita got on the x-ray table and laid on her side as instructed. The air had been removed from the tube. My aunt then lubricated the inflation nozzle and Anita's bottom then inserted the nozzle deeply but slowly. She then inflated the balloon with six full pumps. Anita was then turned on her back, the towel replaced. She was asked to hold her arms above her head. My aunt said that she had a very flat abdomen in this position.
The huge barium container (20 liters) was hidden from Anita's view by a curtain panel but was in full view for Darlene and the Dr. The Dr came in and said hello to Anita made some small talk.Then got to business by reminding Anita that this enema was going to take about forty minutes to give and that she would then have to hold it for at least thirty minutes while they develop the films. It would get very uncomfortable.
Anita kodded. The Dr then said that the nurses would help her to breathe, turn her as required and hold her if she needed help. She was to breathe slowly and deeply. If it hurt too much she would have to pant like a puppy until the pain passed but the flow would not be stopped until she was full.
The Dr turned to my aunt and told her to open the clamp. The flow started and continued for about ten minutes. Anita's abdomen bulged noticeably on the right side and the Dr began to press around Anita's lower right side. Anita flinched and twisted slightly but the Dr told her to be as still as she could. At fifteen minutes Anita's abdomen looked strange. It was swollen into a dome but her right side and below her navel swollen larger into a large "C" shape as it pooched out. Anita was OK but you could tell it was getting painful. The flow continued. At twenty-five minutes and 5 liters Anita's abdomen was very distended. It domed up in an odd fashion. The area below and around the sides of her navel were greatly distended. The distension sloped down somewhat steeply to her ribs. She was extremely uncomfortable and held her head back with her mouth wide open and breathing very deep and slow.
My aunt quietly told her to relax and think pleasant thoughts. At thirty minutes and 6 liters she would gasp several times and groaned quietly. The Dr asked her to relax and breathe slowly. Anita now had tears in her eyes and was groaning louder. My aunt said that Anita cried quietly for them to stop, she couldn't take anymore. The Dr said that they were nearly finished. At forty- four minutes the Dr said to close the clamp. Anita had taken 8.8 liters. Her abdomen was unbelievable. Completely swollen out of proportion to her body.From the side it formed a huge rounded triangular shape from her ribs to her pubis the rounding peaking below her navel. From the top she was swollen round as a large beach ball. Anita could hardly breathe and when she did did so in gasps.
She begged them to let her let it out she couldn't hold it anymore. They said that they were going to hurry for her. They moved her to twelve different positions for the x-rays some very difficult for her to get into. She was groaning and cried out in pain several times. The last three pictures were the worst. They had to roll her onto her stomach with her arms above her head. She screamed and retched several times but held it down. Once in position she literally cried that she couldn't stand it and rolled to her side screaming that it hurt as she moved. My aunt went and helped her back to position and held her there while they took the pictures. Once complete they rolled her to her side and let her lay there groaning. My aunt said that she gently stroked her hair and talked to her quietly.
The film development took fort-five minutes. The total time for the exam was one hour and a half. They brought over a large bucket, clamped the hose coming from her and disconnected it from the barium container. My aunt released the barium inside of Anita into the bucket. It flowed several minutes as Anita finally relaxed. My aunt massaged her stomach which was still hugely distended. After fifteen minutes they got her up and took her to the toilet. My aunt released the air from the balloon and Anita dropped to the seat.
My aunt said that Anita was taken to the ward and given eight enemas as large as she could stand to remove most of the barium. She did not have any indications of cancer.