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Views: 5692 Created: 2011.04.16 Updated: 2011.04.16

A difficult Exam

A difficult Exam

It was 9 am on a Wednesday morning and already the radiology office was busy. We schedule our Barium Enema exams for the morning so that our patients don't have to starve themselves all day long following the prior day's prep. So far its been a usual morning. "alright, who's next?" I wonder as I check out the appointment book. "Sharon" I call out to the people in the waiting room. She is a girl who is 18 and she stands up. "I'm Sharon" she says. "Ok, come with me" and I escort her into the hall way to one of our changing closets. She is dressed in a white blouse with a blue skirt that falls just above her knees. With long blond hair and blue eyes and what appears to be a nice well rounded figure. "Have you ever had a barium enema before?" I ask. "No," she replies with a slight hesitancy in her voice.

"Ok, I need for you to remove all of your clothes except for your bra, then put on the gown. it opens in the back. Slide open the door when you are ready.." Alright she say as I slide the door closed. She is pretty nervous I can tell and I must say I don't quite blame her. This test can be really rough, much worse then the ease of the exam as it is portrayed on the net. And when you multiply it by the anxiety people tend to have when they know what it is all about, it really spooks them. Unfortunately, I have several people scheduled for this exam this morning and I don't have any time for hand holding.

A few minutes pass by as I go to the X ray room and prepare a 4 quart BE solution, hanging the bag with the clear attached tubing and inflatable nozzle on an IV stand in the corner of the room. I then go back to where Sharon is changing but to my consternation she hasn't opened the door. "Sharon are you about ready? You've been in there for a while and we have to get going." "Just a moment" she says as I hear her moving the clothes hangers around. A few moments go by, then the door opens with Sharon dressed in the white gown with the upper and midback ties securely tied together, with the fabric falling just below her knees, exposing her porcelain white calves. "come with me" I say as I lead her down the hall and inth the X ray room. She is tugging on the back of the gown, trying to keep the lower edges of the fabric closed behind her. "Now get up on this table and lay on your back with your head on the pillow. Did you follow the prep as directed?" I asked. "I did, but nothing really came out and I am still having cramps." "Ut oh," I thought, I'd better check this out. I don't have time to clean her out if she isn't clear now. "Now Sharon, I want you to hold your breath for a moment while I X ray you. Breath, now don't breath" as I click on the X ray machine. "Now don't go anywhere," I say. I head to the development lab and sure enough she isn't clear at all. Oh boy, I hate to have to do this, but I have no choice. I walk back to the X ray room. "You are still dirty inside and the doctor can't shoot the x rays of you like this. You wait right here!" I hear her trying to explain that she did follow the directions as I walk out of the room but it doesn't matter because I know what I have to do.

I walk through the doorway to an adjoining room about 8X10 in size where a gurney is resting with a small restroom and doorway on the side. On to the gurney I toss and arrange a large white sheet that covers the entire platform. I am going to have to double up the glycerine soap for this soapsuds enema to hurry the cleansing process. "Let's see" I say as I grab a clear disposable fleet enema kit with the balloon and enema tip attached. I dump 2 quarts of tepid water in it and toss in two packets of liquid soap, shaking the mixture so that it turns golden. "Good, that should get her going" I think. I go over and grab an IV stand and extend the hanger so that it is 7 feet off of the floor to maximize the flow into the patient, then attach the enema kit to one of the hooks. Before I go back through the side door into the X ray room I grab a tube of KY and some gloves from a drawer and lay them on the counter. I then walk back into the X ray room where Sharon is still laying. "Ok, now come with me" as I help her off of the table and escort her into the treatment room. Her eyes get real big as she surveys the scene. "Because you didn't follow directions, I am forced to give you a soapsuds enema to clean you out" "Oh no" she says. I securely close the door between the two rooms. "Now don't be difficult, I don't have time to argue with you young lady" I always like to take on the dominant role and besides I don't have much time to get her ready for the exam.

"Get up on this gurney and lay on your back with your head on the pillow." "Oh, do e have to do this" she cries as she gets on the bed. I pick up the globes and KY and lay them down on the edge of the bed, right next to where Sharon''s hips are after she settles on to the platform. "Now I want you to role on your left side and face the wall, keeping your left leg straight out while pulling your right leg up to your breasts" I order her. I slip on the gloves and carry the KY to the foot of the gurney, unhooking the enema nozzle and tubing from the IV stand. As i begin applying the KY to the enema nozzle, I look up and can see that Sharon has positioned her legs as I requested, pulling her top right knee up to her chest with the bottom leg straight out. But she has also trapped the gown underneath her so that her buttocs are totally covered by the tautly pulled fabric, exposing her only from the pointer her upper right button and thing meet, down to her feet, with just the faintest sight of pubic hair showing. I walk up behind her. "Let go of that gown young lady" I say as I yank the fabric out from under her, tossing completly over the top of her right shoulder, exposing her from her neck to her feet. She has a tightly rounded with just a hint of a tan line. And she is really tense, puckering her bottom and pulling her inne folds together. she had better not fight me on this because I'll win. "I want you to take in a eep breath and when I tell you to slowly breath out." I bring the hose with the nozzle attached just up behind her. As I separate her top and bottom buttocks with my left hand, using my forefinger and thumb I tell her "Breath in, now breath out as I place the tip right on her anus an begin applying slow pressure to insert the tip. but she is really fighting this. "Sharon" I bark "quit tightening up. It will only make this hurt worse." I apply more pressure on the nozzle, slipping the tip into her for about half an inch but she has really clenched her rectum together, drawing herself away from me, an I am afraid that I'll do some damage to her anus considering how tense she has become. Wait, I know what she needs. A Rectal Exam!. That'll let me get a large amount of lubricant in her while I stretch her rectum, allowing me to ultimately get the nozzle in properly.

I back the tip out of her rectum and lay it behind her bare buttocks. Let's see. I need a lot of lubricant as I slather a substantial amount of jelly on my globed index finger. I'll bet she has never had one of these before. "Oh, I know this is going to hurt" she whimpers in the background, expecting that she is about to get the nozzle reinserted. I get back up behind her and lift her top buttock apart from her bottm with my left hand while placing my right index finger on her anus. "Don't move!" I say. "What do you mean..." as I slowly force my finger into her rectum. "Ohhhhhh" "Quiet" I say as I slide my index finger through her anus, pushing to the back of her rectal wall. She starts to pull herself away from me, so I hold on to her l hip with my left hand as I manipulate my finger inside of her. boy,she is really tight. "Sharon, stop holding yourself in" but she starts whimpering again, so I know she is not quite ready for the nozzle. "Alraght, I'm going to give you some more of this" I then pull my index finger out of her, applying a substantial amount of KY on both my index and middle finger, piling on the KY as if it were shaving cream. I have to get control of this girl. "alright young lady" I again lift up her top buttock with my left hand while I force both fingers through her rectum pushing and pulling her rectum and anus as high and as hard as I can. (More to come)

"OH, OH, Oh, NOOOO" Sharon cries out as she tightens up around my fingers. "Tightening up will only make this worse" I say as I massage her internal rectal area, alternatingly pushing both fingers as high as they will go and then withdrawing them, tugging on her anal walls. "As soon as you relax your anus around my fingers, I'll pull them out." You now have plenty of lubricant in you but you have to stop fighting me." A few seconds go by. "Ok, I'll be good" she sighs and relaxes her rectum as I slide my fingers out of her.

I pick up the nozzle again, regreasing it with additional lubricant. By now I know that she must be sore, and we haven't even started. She is not going to like the double doses of glycerine that is going to flow into her irritated areas, but it's her fault for fighting me and she is going to have to take it. Sharon continues to lay on her side completely exposed from the gown being open below her neck where the ties have remained together, her right leg pulled to her breasts, exposing her clearly irritated rectum. I again lift up her right buttock with my left hand and place the nozzle at the edge of her anus. "Now take in a deep breath. Now let it out." As she breathes out i drive the nozzle straight into her with a single motion, fearing that if I do it slowly I won't be able to get the 8 inches of it in her. "OWWW, OHHHH, that really hurts!" as she starts to cry. "I know" I reply. "I'm going to inflate a small balloon in you to keep the soap in you, so you are going to feel some pressure." I squeeze the pillow inflator once knowing that the balloon is now expanded to the size of a golf ball inside her rectum. "OWWW" comes Sharon's breathy response. I tug on the implanted nozzle just to make sure the seal is good. "Ohhhh" says Sharon. (more to come)

I then walk to the foot of the gurney, placing my hand on the clmap that has sealed the contents in the bag from her. Without saying a word, I release the clamp, letting the glycerine soap and water begin to flow into her. She begins to protest so I walk up behind her and hold the back end of the nozzle that is buried in her. "Try to breath, innn, ouuuut, in, ouuut." The water slowly begins to flow into her. "Oh this feels funny." "That's the soap working its way into you. Try to relax" I say. "Oh I don't feel good. I'm feeling uncomfortable. Can we stop for moment?" "No, now try to relax" I say. "But this burn inside and I really have to go to the bathroom." "Not until we get the rest of thte soapsuds into you." The glycerine continued to work its way into her, disappearing out of the bag, flowing through the clear tubing into her waiting colon. "Please, please stop this I can't take anymore. I think I'm going to throw up." "We're almost done" I say as I see the remnants of the fluid disappear through the hose and into her rectum.


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