It took about five minutes for the suppository to melt. As soon as my nurse new it was fully dissolved she slowly slipped her finger from the patients rectum. When the patient felt the nurse's finger slip out of her anus she uttered a sigh of relief. My nurse looked at the finger of the soiled glove. And quickly removed the soiled glove first before the patient could see it then the other glove throwing them in the waste can.

My nurse looked at me and told me doctor the suppository has melted. I looked up from the patients chart and told my nurse good. And then observed the female patient her right leg was still drawn up to her chest leaving her exposed, from where I was standing I could see her vagina as well as her anus. Her vagina had become slightly swollen and was glistening with arousal fluid, her anus still had Vaseline smeared on it from the nurse inserting the suppository, and it appeared slightly dirty. I asked my nurse to cover the patient with her gown and get her comfortable. There was no need to clean the patient up yet. I told the female patient my nurse and myself where going to step out of the room and let her lay there and relax. We asked if she were comfortable? or if she needed anything? and one of us would check on her in about twenty minutes, if she needed anything sooner to let either of us know. We would be just down the hallway.

We walked down to my office which was only just a little ways down the hallway. I sat at my desk and my nurse took a chair against the wall. We made some small talk and she quietly asked me if I thought the suppository was going to work? I told her I thought it would help but that it wouldn't work completely that the patient was to impacted. That we were still going to need to give her a enema. But I didn't think that we could even give her the enema without removing some of the impacted stool first. There wasn't enough room in her intestines for the enema solution. My nurse looked at me and said I knew it was pretty bad. But not quite that bad. I told my nurse she should go hang the office is closed sign on the front door. We didn't want anyone walking in off the street adding anymore embarrassment to the patients situation. She looked at me and said yes doctor right now.

Like I said earlier this is a small rural town and the people who live here like to know what is going on with there neighbors. And I really didn't want them to know what was going on with my patients. So on occasions like these if it was possible to close the office that's what I did. The office is closed sign had a emergency phone number on it and everyone in the area knew how to get a hold of me. By the time my nurse had gotten the sign up, and had walked back to my office we could hear the patient asking for one of us to please come to the exam room.

When I heard the patient calling for someone I glanced at the clock. It had been twenty five minutes since she had been given the suppository. My nurse went to check on her and came back about five minutes later, saying she was starting to get some mild cramps and was passing a little gas, my nurse said she put a bed chuck under her. And told her to try to wait until the cramps were stronger. Before trying to use the bathroom. I told my nurse when the time comes and she needs the bathroom to go with her, and observe to see if she is actually going, and not to let her flush the toilet, I wanted to see what she is passing. My nurse looked at me and told me no problem doctor.

About ten more minutes passed by and we could hear the patient calling again, this time in a more panicked tone of voice. My nurse went to see what was going on with our patient. I could her my nurse helping her down off the exam table and walking her across the hallway to the restroom. The restroom was very small, only room for a sink, a toilet and a small stand up shower mainly for chemical decontamination in a emergency. There wasn't room for two people to be in there and also shut the door. I heard the patient asking my nurse so you are going to watch me go to the bathroom? My nurse replied nonchalantly, I am just following the doctors orders. I then heard the patient reply YOU HAVE TOO KIDDING ME!! you are going to watch me poop? My nurse told the patient she is just doing what the doctor told her to do. And she shouldn't be embarrassed. Working as a nurse she has seen it before. By now the patient was starting to accept the idea, then I heard a moan and then PFFFFTT then another moan and a loud grunt and then PFFFFTT then I could hear a couple of small splashes in the toilet water. Then it was quiet for a few seconds and then I could hear the patient grunting and then a big splash, and my nurse telling the patient to try some more. Then I heard a couple of more grunts and then my nurse telling the patient that it was ok. I could hear my patient telling my nurse she couldn't push anymore out. Then heard my nurse telling the patient that she could wipe herself, but not to flush the toilet, then let's go see what the doctor has to say?

I let my nurse get the patient back into the exam room, and situated, on the exam table. I made my way down towards the exam room, I stopped and looked in the toilet, there were a few pieces of hard feces in the toilet bowl one round piece about the size of a small chicken egg and a couple of more pieces that were a little larger. The suppository had helped but it hadn't worked.

I knocked on the open door of the exam room and entered. The patient was sitting on the edge of the exam table waiting. She looked at me and asked well what can we do now? I told her I didn't think the suppository had worked, that it had helped but it hadn't done the job. Then I asked if she was feeling any better? She said she was feeling a little better. I asked her if she thought she was feeling good enough to go home? She said her stomach still hurt a little. Not as bad, but it did still hurt. I asked her what she thought we should do? The patient told me she didn't want a enema she had been given enemas before and she didn't like them. And then she asked me what else I could do for her? I told her I could do the manual disimpaction if she wanted me to. She looked at me and asked me how I would do it? I told her I would have her turn around on the exam table and then have her get on her hands and knees. My nurse would spread her bottom open and I would insert two fingers into her rectum and break up the hard stool and pull it out with my fingers. She looked ill when she heard me tell her this, her face went limp, she lost all expression on her face. She looked at me and told me that would be worse than getting a enema. I told her it wouldn't be any fun, it would be very uncomfortable. I then told her I realized that a enema is no fun either, but considering the two choices the enema would be the least drastic. She nodded her head yes in agreement. And told me ok you can give me a enema. I told her that was the best thing to do. That she needs to get this taken care of. Then I told her that I would go get what I need. That she should lay down on her left side and bring her right knee up to her chest. And I would be back in a few minutes. I looked at my nurse and asked her to please help the patient get positioned and comfortable.

I left the room to go get what was needed. I walked down to the supply closet and grabbed a iv pole then found a new enema bag, it was still in the box. I had bought a couple of these bags at the drugstore in town. They were the old fashioned red bag with the white hose and the white enema pipe and douch nozzle. They had a few in stock and I bought two of them thinking I might need one some day. I walked back up the hallway to the exam room I put the IV pole against the wall and walked across the hallway to the restroom to fill the bag. When I had the bag filled. I went back in the exam room and hung the bag on the IV pole. The patient twisted her head around trying to see what I was doing. She saw the bag and let a low disappointed groan out of her throat. I told her it was a two quart bag and she would need to try to take as much of the water as she possibly could. She said she would try but it looked like a lot. I had attached the douch nozzle to the hose instead of the enema pipe. The douch nozzle was longer than the enema pipe and would help get the water farther up the patients rectum. I had everything ready. I asked the patient if she was ready for this? She said she guessed so ? I told her I would give her the enema. This way my nurse would be free to help her if she needed anything. She told me thank you doctor. I told her she was going to be fine this is simple procedure. It will just be a little uncomfortable. She twisted her head to look at me and rolled her eyes. I walked over to the counter and picked up the jar of Vaseline and walked back to the exam table. I brought the IV pole with the enema bag and hose over so that the hose would reach. And annouced to the patient I was ready, was she?

She told me that she was as ready as she will ever be. My nurse looked at the patient and myself and smiled. I put on a pair of gloves with a snap and raised the patients gown exposing her bottom. With her right knee drawn up to her chest, her vagina was exposed it was glistening with moisture her labia were slightly swollen. I spread her cheeks and looked at her anus. Her anus was slightly dirty, it was red and irritated from passing the hardened stool. I opened the jar of Vaseline and stuck my gloved finger in the jar getting a big glob of petroleum jelly on my finger. I told the patient I was going to smear the petroleum jelly on her anus, and then gently insert my finger into her rectum to lubricate her. She didn't say anything, just nodded her head yes. When I touched her anus she flinched. I told her I was sorry, I know that she is sore, she just nodded her head . I told her I was going to try again. This time I touched her and applied a little more pressure with my finger. She flinched again and yelped and told me it hurts. This time before I started I looked at my nurse and nodded my head in the direction of the patient. My nurse knew that meant that I was just going to do it. And that she was going to need to comfort the patient. Now my finger was just resting against the patients anus. I looked at my nurse and nodded my head, my nurse reached out and took a hold of the patients hand, when my nurse was holding the patients hand. I told the patient now I was going to insert my finger, and then I pushed my finger all the way into her rectum. She tightened her buttocks trying to stop my finger, and then arched her hips trying to pull away from my invading digit. My nurse saw her bottom squirming and held her hand tighter telling her the doctor is almost done. The patient was telling my nurse her bottom felt like it was burning, that the doctor's finger, it was making her bottom hole burn. I told her I was sorry I hurt her. And now I was done. She could feel my finger sliding out of her anus letting out a sigh of relief. She kept telling my nurse her bottom felt like it was still burning. I told the patient that was because she had passed the big pieces of hard stool and it had irritated her anus. I explained the nozzle was smaller than my finger and would not hurt as bad, that I would use a lot of Vaseline on the nozzle, and I also had heavily lubricated her bottom with my finger.

I took the douch nozzle and uncoiled the hose. I released the clamp and made sure all the air was out of the hose. I took a some more Vaseline out of the jar with my clean glove and generously greased the nozzle. I asked the patient if she was ready? That this would not hurt as bad as my finger did, and I would be very gentle. I placed the nozzle against the patients anus and very slowly pushed it in until the nozzle was fully inserted in patients rectum. I told the patient that I was going to release the clamp and she would feel the water starting to fill her intestines. She nodded her head yes while looking at my nurse. My nurse gave her a sympathetic smile and patted her hand. As the water filled her intestines she made a few soft moaning noises. From where I was standing and holding the nozzle in place. I could see her vagina had become a little more swollen and was getting slightly wetter It looked like the patient was becoming aroused from the enema. The patient was breathing heavy taking long deep breaths in and out. She had taken about half the bag before she started to complain about feeling uncomfortable. She said was starting to get bad cramps, and she felt like she needed to go to the bathroom. I told her not yet, she needs to take a little more water first. She took another little bit of water before she started moaning louder and telling my nurse she really needed to go to the bathroom. I told her if she could take just a little more water, I would stop the flow of water. But once I stopped the water she needed to try hard to hold it for fifteen minutes. She was starting to plead with my nurse telling her please! please! I need to go. My nurse calmly told her, to try and hold it so the enema will work. I reached up and snapped the clamp shut. She had taken most of the bag. I told her I was going to remove the nozzle and started to slowly pull the nozzle from the patients rectum. I saw that her labia had become very swollen, her vagina was extremely wet and slightly open. When I first noticed the patients heavy breathing and swollen genitals, I wasn't sure but it was obvious now the patient was becoming sexually aroused from receiving the enema. Just before I had the tip of the nozzle completely out of her rectum. I told her she needed to clench her anus tight, and also that she needs to keep it tight so she doesn't leak the water. When I felt her clench, I popped the nozzle out. The nozzle was very dirty the white plastic nozzle was streaked with dark brown feces, it was very dirty, the patient was still very impacted at this point. I wiped it clean with a paper towel and threw the towel in the trash can. I hung the nozzle on the IV pole. By now the patient was becoming agitated and starting to need the toilet. My nurse was trying to calm her telling her she needed to wait. She was telling my nurse she couldn't wait she's was going to go, she couldn't hold it. It had been almost ten minutes since I stopped the water. I looked at my nurse and nodded my head yes. The patient had leaked a little water, it had ran down the insides of her thighs on to the chuck pad. And I wasn't sure she would be able to hold it much longer.

My nurse and I helped the patient sit up on the exam table. Then we helped her stand, my nurse took her arm and walked with her across the hallway to the restroom. My nurse told the patient if she no longer wanted the gown on she could take it off. She asked my nurse to please untie it she didn't want it on while she was using the toilet it was in the way. My nurse untied the gown and then pulled it off tossing it on the floor of the hallway. Now the patient was just dressed in her t shirt and bra. My nurse helped her get seated on the toilet and told her that the doctor, and herself would be across the hallway in the exam room. I heard her ask my nurse if she was going to watch her this time? My nurse told the patient no, it wouldn't be necessary. I could hear the patient thank my nurse, telling my nurse it was very embarrassing to have her watch before! My nurse told the patient she was going to leave the door half open, so if she needed something we could hear her. My nurse left the patient on the toilet, picking the gown up on her way back to the exam room. My nurse walked in the exam room tossed the gown in the corner on the floor. And then told me she was going to clean up and change the chuck pad while she waited. In a quiet voice I asked her why she didn't want to stay with the patient. As I asked this I couldn't hide my smile. She wrinkled up her nose and grimaced her face, this made the both of us smile.

It wasn't long after the patient was left alone on the toilet. Before we started to hear the sounds of the enema beginning to work. We heard the patient moan and then a short squirt of water being expelled, then a couple of longer squirts of water. Then we heard a loud half moan half grunt and then what sounded like quite a hard few hard chunks of stool being expelled. Then a big sigh of relief. Then it was quiet for a few minutes before we heard the patient make a low gutteral grunt followed by what sounded like solid stream of liquid sludge being forced out her intestines then a huge sigh of relief. By now the stench had made it's way into the exam room. The enema was working very well. This continued for twenty more minutes before we could hear a couple of wet squirts followed by a PFFFFTT!!! then it was quiet again for a few minutes. Then we could hear the patient asking for my nurse. My nurse looked up from what she was doing looked at me with a big smile and went to help the patient. I heard her asking if the patient if she was alright? then I heard the patient telling my nurse that she thought she was done? My nurse asked if she needed help wiping? she told my nurse no she had already wiped herself. My nurse told her then we can go back to the exam room. The doctor is waiting to see how you are feeling now.

I was waiting by the counter when they entered my nurse helped the patient take a seat on the exam table I walked over and asked how she was feeling? She said she was feeling good and that, that was the first time she had went to the bathroom in probably five days. I told her I knew it had been at least three. She said no it was probably more like five. That she had lied to me when she was getting her physical done. I gave her a serious look and told her she shouldn't lie to her doctor. She looked embarrassed and told me she knows that now. I told her, I thought the enema had worked and if she felt like it had, and she felt safe, she could go home. My nurse would help clean her up and she could go home.

I went back to the counter and wrote some notes in her chart. My nurse asked her to lay down on her back. And then went and got a pair of gloves and some adult wipes. My nurse put the gloves on and then explained that she was just going to clean her whole lower half from her knees to her stomach. I turned my head and watched as my nurse took a wipe and began wiping from her right knee to her mound. Then took a new clean wipe and did the left side. Then another new wipe, and went from her knee up to her mound doing the inside of her thighs when my nurse got to the patients crotch, the patient without being told willingly spread her legs, my nurse paused for a second, caught off guard by the patients eagerness to cooperate. My nurse began wiping the patients vagina in a slow circular motion causing the patient to stiffen her legs and moan. I saw that this surprised my nurse she looked a little startled. She didn't say anything or react, she just kept cleaning the patients legs and pelvic area, repeating the process on the other side taking her time moving gently. Then she asked the patient if she wanted to turn over on her stomach and she would clean her bottom. The patient smiled at my nurse telling her thank you, and rolled over. Then my nurse started back at the patients knees working her up towards the patients bottom. When my nurse got to the patients crotch. The patient spread her legs even wider accommodating my nurse, allowing my nurse better access to her vaginal area. My nurse looked at the patients backside and began wiping the patients inner thighs working her way towards the patients vagina in a circular motion, once she had wiped the patients vagina she moved her fingers up towards the patients perineum and her anus. This caused the patient to arch her back and push her vagina up and towards my nurses fingers. My nurse moved her fingers back down and continued wiping the patients vagina. Before moving her fingers over the patients perineum, when the patient felt my nurses fingers touching her perineum her body involuntarily stiffened her whole body tensed and she let out a low gutteral moan. Now I think my nurse knew what was starting to happen. She took a clean wipe and started back on the patients vagina using a circular motion but this time working her way to the patients anus wiping in a slow circular motion applying some light pressure with two of her fingers when my nurse touched the patients anus, the patients body jerked and stiffened. I was watching not saying anything, I was becoming curious as to what was going to happen? The patients legs were spread far enough apart I could see her vagina, it was swollen and open and very moist, there was a small wet spot of arousal fluid on the paper covering the exam table. When my nurse reached for another wipe, I could see the patients anus was also relaxed and slightly open. This time my nurse covered two of her fingers and her thumb with the wipe. She started wiping the patients vagina with her two fingers, and then placed her thumb on patients anus and began wiping it at the same time moving her thumb back and forth across the patients anus. This caused the patient to lose control of body she curled her toes and moaned, her body stiffened, while a low drawn out guttural grunt, escaped her throat, then her arms tensed up, and she curled her hands into fists, her body spasmed and her legs started to convulse. Once the patient had stopped convulsing and her body had relaxed. I looked at my nurse her face had a look of disbelief on it. She was well aware of what had just happened, that the patient had just orgasmed while she was cleaning her up. My nurse didn't say anything, she gave the patient a few seconds, before asking if she was ready to sit up? then informed the patient that she was done cleaning her up. And if she would like she would help her down and then help her get dressed. My nurse removed her gloves and then helped the patient sit up and climb down off the table. I asked the patient if she was ready to go home, she said yes. And thanked me, She looked directly at my nurse but dropped her eyes to the floor to avoid eye contact with her. The patients face was flushed and turning a even brighter shade of red. She told my nurse she was sorry for what had just happened. That she couldn't help it, it just happened. That the nurse's touching her just made it happen. She thanked my nurse for cleaning her up.Then the patient told my nurse that she was very embarrassed by what had happened and she was very sorry. My nurse gave the patient a very warm and affectionate smile. And then told the patient it was ok that she didn't need to apologize and shouldn't feel embarrassed.

My nurse told the patient she would help her get dressed. And when she was ready she would walk her out to the front desk. The patient told me she was sorry for being so uncooperative. I told the patient there was no need to apologize. I understood how embarrassing and uncomfortable this can be. Once the patient was dressed my nurse walked her to the front desk. I could hear them chatting as they made there way to the office. I heard my nurse telling her goodbye, I could hear the patient telling my nurse goodbye and thanking her for making her feel better.

Once the patient had left, my nurse made her way back to the exam room. She walked in and smiled, telling me she would help me finish cleaning up the exam room, and then she would go clean the bathroom. I looked at her and thanked her. She looked at me asked me, if we could wait until tomorrow morning to talk about this? I looked at my nurse who was now back to being my receptionist and told her that would be just fine with me, it had been a long day let's finish up and go home .