Kelsey had been home for a couple of days, and Meghan was glad to have her sister home. Mitch had his hands full at times with the two invalids, but Meghan was glad that she was independent enough to be helping her sister with some of the household responsibilities, like folding laundry and doing a lot of the cooking.

Meghan had gone to her room that evening and was sitting with her back propped against the headboard, reading, when she heard noises coming from the exam room. She ignored them for a few minutes, thinking it was Mitch rummaging for some supplies, but when she started hearing the giggling, she went to investigate.

The exam room door was partially open, so she knocked on the doorframe. The giggles stopped briefly, but she heard Kelsey say something. “Come in, Meghan.”

Meghan pushed the door open a little wider and entered the room. She was taken aback to see her sister naked, lying on the gynecology chair, legs in knee supports. Mitch was seated on his rolling stool, positioned in front of her naked bottom. “I’m sorry! I heard noises…” Meghan drifted off.

Kelsey motioned for her sister to come closer. “No need to be sorry, sis. Mitch was just about to help me with a constipation issue from all of the pain meds. We try to make it a fun experience.” She smiled and winked.

Meghan was feeling very confused and a bit embarrassed. “I don’t want to interrupt. I could leave…” she made as if to leave, but stopped when Kelsey placed a hand on her arm.

“No, stay. I’m comfortable with you being here.” Meghan glanced at Mitch, who nodded. Meghan sighed.

“So how do you treat constipation? This obviously isn’t Mom’s prune remedy.” She sat down on a stool that Mitch had pulled up for her.

Kelsey looked at her sister kindly. “No, it isn’t. Mitch is going to give me an enema, probably two.”

Meghan looked at her sister askance. “An enema? I didn’t think anyone did those anymore.”

“How much do you know about enemas, Meghan?” Mitch asked, as he got a blanket out of the warmer and draped it across Kelsey’s upper torso.

Meghan watched him closely. “Not a whole lot. I remember reading stories and nursing manuals that referred to a ‘3H’ enema.”

“High, hot, and a hell of a lot!” Kelsey chuckled. “Yeah, that’s what I thought of when Mitch first proposed one to me when we had just gotten married.”

“But?”

“But, he showed me that it can be gentle, and it’s definitely effective. Unlike a laxative – or prunes – you know when it will work and don’t wind up with the surprise when the medication finally decides to work, often at the most inconvenient time.” Kelsey glanced over at Mitch. “And Mitch has a way of helping with the cramps that happen, but it’s not an overly painful thing.”

Mitch smiled. “If you don’t mind, Meghan, why don’t you help me and watch while I give Kelsey her enema? Then you’ll know what it is.”

Meghan debated this in her mind for a minute, Mitch and Kelsey giving her the space to think it over. She sighed. “If you don’t mind, Kelsey? The medical nerd side of me is curious.”

Kelsey laughed. “I don’t mind at all, sis.”

Mitch beckoned Meghan over to the counter space of the room. “You will get to be my assistant. Go ahead and grab some gloves,” he said, indicating the wall dispenser, “and I’ll show you how to set this up as I go along.”

She grabbed a couple of pairs of small gloves, tucking one set into her pocket out of habit. Returning to Mitch’s side, he smiled at her and started opening cabinets. “Now, to administer an enema, you need a bag, some lubricant, your enema solution – in this case, I’m using this liquid soap – and water.” He grabbed the supplies from their various storage locations and arranged them on a Mayo stand. “Now, let’s assemble the bag and get it filled.” He attached a nozzle to the end of the enema bag, squirted in a bit of the soap, and hung the bag from the IV stand. He wheeled the stand over next to the sink and adjusted the temperature of the water. “I prefer to use water that’s just a little warmer than normal body temperature. It doesn’t have to be a precise measurement – just think of how you’d test a baby bottle on the inside of your wrist – so something that is nice and warm. Then you fill the bag the rest of the way with water. Make sure you’ve got the clamp on the tubing secured. I learned that the hard way!”

“What is the soap for, and is there ever a time you’d want warmer or cooler water?” Meghan asked. She was starting to relax with the methodical teaching approach Mitch had been using on purpose.

“Not every enema utilizes soap. Soap acts on the colon as an irritant, thus stimulating peristalsis, which helps to move the stool down and out of the rectum. After this enema with soap, Kelsey will be getting a second one with just water to help rinse out the rest of the soap and make sure she’s cleaned out.

“Now as far as water temperature is concerned,” Mitch paused to hang up the now-bulging bag on the IV pole and wheel it next to his wife’s bottom, “it’s not recommended to do a really hot enema because of the risk of burns. However, cold water enemas are an option when you have a patient with heatstroke, for instance, and warm enemas are also likewise a treatment to bring up core temperature in the case of hypothermia.” Mitch sat down again between Kelsey’s legs and beckoned Meghan over.

“How are you doing, Kelsey?” he asked. He reached for a pair of gloves and donned them.

“I’m fine. Let’s do this!” She raised her head to grin at her husband, and then put it back down.

“Meghan, would you put a little lube on my finger?” He held out his hand in her direction. Meghan picked up the tube of KY and squirted a small bit on his finger. He smiled kindly in her direction. “A little more, please.” She applied more. “Good, thanks. Okay, Kelsey, you’ll feel me touching you.” He placed the pad of his finger against her anus and started rubbing small circles. “Relax your bottom, hon.” He slipped the digit into her rectum as he felt her relax.

“The first thing I do is a quick rectal exam. I’m looking for any impaction or issues such as hemorrhoids, and I’m lubricating her rectum at the same time,” he said, as he did a 360-degree sweep with his finger. He removed it from her bottom and removed the glove. He snapped another one on his hand and reached for the tray but didn’t find what he was after.

“Meghan? Could you bring over the thermometer with a clean sheath on it? I forgot to bring it over.” Meghan nodded and retrieved the instrument. “Actually, do you mind taking Kelsey’s temperature? I need to go to my office for a minute.”

“Ah, sure thing, Mitch.” She watched him walk out the door and looked at her sister. “Am I right that red cap means rectal?”

Kelsey nodded. “Remember to lube it, and insert it after it does its initial beep.”

Meghan squirted some lube on the tip of the probe, wiped it all over with her finger, and gingerly inserted it into her sister’s bottom. As she waited for it to register, she tried desperately to come up with some sort of small chat, but her sister saw right through it.

“C’mon, give. What are you wanting to ask?”

“Well, ah, y’all mentioned something about cramps. Are they really bad?”

“No, not terribly. Not any worse than period cramps. Besides, there are ways to help minimize the cramping.”

“Such as?” The thermometer beeped. Meghan slid it out of her sister’s rectum. “Looks like you’re 99.2 degrees. If I recall correctly, that’s normal?”

“Yes, it is,” Mitch pronounced, returning to the room. “And did I hear a question about cramping?” Meghan nodded. “Abdominal massage helps to work the fluid higher into the colon, and also helps with the cramping. Also slowing down the rate of flow can help, plus some people also include sensual touching to distract from any cramps. In the interest of full disclosure, I do sometimes play with Kelsey’s ‘lady bits’, as she calls them, to help distract her from any big cramps.” He noted the blush that came to Meghan’s face but didn’t acknowledge it.

Snapping on a new pair of gloves, he sat again between Kelsey’s legs. “Okay, let’s get this started before the water gets cold. Meghan, could you lube up the nozzle? Just like you did the thermometer.” Meghan smeared some KY on the nozzle and passed it to Mitch. “Good job. Kelsey, honey, relax your anus for me so I can insert the nozzle.” He massaged her anus with the nozzle’s tip until he felt her relaxing and slowly inserted it until it seated itself in her bottom. He reached over for the tubing, found the clamp, and opened it. He adjusted the flow rate and watched his wife as the water started entering her. “Okay?” She nodded.

Half the bag had emptied before the cramping began. Kelsey started moaning softly, and Mitch began massaging her abdomen with his left hand. As the cramping sessions continued, they got a bit worse. Meghan's eyes widened when she saw Mitch’s right hand reach down to touch Kelsey’s vulva and start massaging her clitoris. She suddenly realized what Mitch and Kelsey had meant by Mitch’s distraction technique!

The bag finally collapsed in on itself, and Mitch clicked the clamp shut on the tubing. “It’s all in, hon. How are you doing?” He removed the nozzle from Kelsey’s anus carefully.

Kelsey looked a bit uncomfortable. “I’m okay. How long?”

“Let’s try for 15 minutes. Let me know if you can’t manage it.” She nodded.

“Fifteen minutes for what?” Meghan wanted to know.

Mitch set a timer and it started ticking. “In order for the enema to really have a chance to work, she needs to hold it for a bit, 15-20 minutes being the norm. When we do her second one, she won’t need to wait as long.”

Meghan watched as Mitch cleaned up the nozzle and rinsed out the bag while Kelsey waited. Meghan moved to stand next to her sister.

“What did you think, Meghan?”

“It’s definitely not what I thought it was,” she answered truthfully. “How big is that bag, anyway?”

“That’s a 2-quart bag. I’ve seen a few online that hold up to 4 quarts, but that’s not a typical size for anyone.” Kelsey could see her sister’s eyes widening. “It’s not that bad of an experience, and usually the cramps aren’t even this much of a thing. I’m just all stopped up from the meds.”

“Do you do this often?” The question flew out of Meghan’s mouth before she could stop it.

Kelsey chuckled. “Not every week or something, no, but usually about once a month. The warm water can actually feel pretty nice when I’m crampy around my cycle.”

“Like an internal hot water bottle?”

“Yes. Hon,” Kelsey directed her attention to her husband. “I think it’s time.” Just then, the timer went off.

Mitch chuckled and returned to his wife, hitting the button to lower the exam chair. He removed her legs from the supports and helped her up. She made a beeline for the bathroom and closed the door behind her.

“So there you have it: one soapsuds enema. It’ll probably take her 10-15 minutes to expel everything, as it always seems like it comes out in waves. When she’s done, I’ll administer her rinse enema. Any questions?”

Meghan thought for a bit. She shook her head no, and Mitch wisely didn’t press her. They made small talk while waiting on Kelsey, Mitch answering some questions about a medical article Meghan had recently read.

Kelsey finally emerged from the bathroom and walked back towards the exam chair. “How are you feeling now, hon?” Mitch asked, pressing a kiss to the top of her head.

She hugged him. “Better now, thanks.”

“Ready for round two?”

Kelsey nodded and sat down at the end of the chair. Mitch helped to lower her down, then raised her feet and placed them in the leg supports. He grabbed her hips and pulled her back down into place, butt hanging off the end.

Meghan, anticipating Mitch wanting her assistance, had already donned gloves and was holding the tube of KY.

He looked at her for a moment, then nodded. “Meghan, take a seat here. You’ll be administering this one.”

She shot him a surprised look but allowed herself to be seated in front of her sister’s vagina and rectum.

Mitch filled up the bag with plain tap water and hung it on the pole. “It’s easy. I’ll talk you through it. Let’s start at the beginning. Let’s lube up a finger and do a rectal exam.” He placed lube on her gloved finger and she brought it to her sister’s anus.

“Deep breath, Kelsey, and let it out.” She slowly inserted her finger completely, feeling the tightness of her sister’s sphincter around her finger, before rotating it around one way, then the next, and removing it.

"Good job. You shouldn’t have felt any masses or impactions: the first enema should have taken care of that. Now change your glove,” he said, holding out a new one. Meghan stripped off the dirtied glove and regloved her hand. “You’ve already taken her rectal temperature, but if this was the first enema, you’d do that now. So here’s the nozzle. Lube it up and insert it like you did your finger.” He squirted some KY on the nozzle and passed it to Meghan. She spread the lube around on it and placed the tip at her sister’s anus.

“Another deep breath, Kelsey. Good.” She advanced the nozzle into her sister’s rectum until it was seated. She removed her gloves and reached for the clamp. She unclicked it open and adjusted the flow rate. “About halfway, right?” Mitch nodded.

She placed one hand on Kelsey’s abdomen and looked at Mitch, wide-eyed. “How am I supposed to do this?”

He smiled, seeing the nerves. “All you need to do is massage in a counter-clockwise direction. This will move the water further up and help to ease the cramps.” He placed his hand over hers and guided it. “Not too deep… there, that’s good.”

He let Meghan massage Kelsey’s abdomen when the cramps hit, knowing they would be few and mild. With a bit of extra coaching, Meghan was doing a wonderful job. Still, he could see she was relieved when the bag ran dry. “How long…”

“Only ten minutes this time. You did a fine job, Meghan.”

Kelsey smiled at her sister as Mitch eased the nozzle from her bottom. “You did fine, sis. Tell me, were you this nervous when you learned how to give IVs?”

Meghan shook her head. “No, because we started on a dummy arm. No blood to spurt, and it can’t reach around and slap you if you miss the vein!”

This set Mitch off, and soon everyone was laughing.

They joked around until the timer went off. Mitch again helped Kelsey off the exam chair and she quickly made her way into the bathroom.

Meghan watched her go and made up her mind. She was having her own issues with the bathroom, and it didn’t seem like such a horrifying procedure, but she was terrified none-the-less. She sank down on a chair in the room and watched Mitch cleaning up.

He was halfway done when he glanced Meghan’s way. He noticed that she was pale, and was biting her bottom lip. “Meghan? Are you all right?” He stopped what he was doing and started for her.

She nodded jerkily. “Um, Mitch, could… Would you mind if…” she haltingly pointed to the IV stand.

Suddenly it dawned on him what she was trying to ask. His expression softened, and he came next to her, crouching down to be on eye level. “Would you like me to give you an enema?”

Meghan nodded, though no words came out.

“Are you constipated? How many days?”

“Four,” she said softly. She lowered her head and looked at her hands in her lap.

He could see the white-knuckled grip she had on the hem of her shirt. “I won’t hurt you,” he assured her.

“I know, Dr. Branston,” she replied.

“…but you’re still scared,” he stated.

“Terrified,” she confirmed.

He stood, pulled over his stool, and sat, pulling her towards him a bit in the chair and wrapped her in a hug. “You saw how it is done. I’ll be as gentle as I can be, and you’ll feel so much better afterward, I promise.”

Kelsey emerged from the bathroom and saw the two of them together. She grabbed the robe she’d left on the bathroom door and carried it over. “Hey,” she said softly.

Mitch eased back and helped his wife into the robe. “Meghan asked for an enema,” he said by way of explanation.

Kelsey hugged her sister close and stroked her hair with her good hand. “Are you afraid?”

Meghan leaned into her sister’s embrace. “Terrified.” She sighed. “But if it’ll help I’m game.”

Kelsey smiled fondly at her sister. “It’ll help. I promise.” She pulled back and held out her hand. “Come on, no sense letting time drag on – that makes the unknown seem worse than it is.” Meghan took her sister’s hand and reluctantly stood.

Mitch, who had been standing back, cleared his throat. “Whenever you’re ready, Meghan, you’ll need to disrobe.”

Meghan refused to look him in the eye. “Do you need me naked, Dr. Branston?”

He came closer. “You can keep your top and bra and your socks if you want, but everything off below the waist. Do you need help with the splint?” He had picked up on her hiding before formalities again, wishing to get her comfortable again but knowing it might take a bit of doing.

She shook her head no. “I’ve got it, thanks.”

He considered her for a moment. “I’ll leave while you undress, Meghan. Kelsey can let me know when you’re ready. You can wrap this sheet around you while you wait,” he said, handing her a cloth drape. He waited until she nodded, and left the room with a meaningful look at Kelsey, closing the door behind him.

Meghan made no move to undress, holding the drape in her hand. Kelsey looked at her with concern and came up behind her, giving her sister a hug. “What’s got you so terrified? Is it the cramps?” Meghan shook her head. “What, then?”

“He masturbated you through the cramps.”

Kelsey nodded, the light dawning. “And you’re thinking he’ll do the same to you?”

Meghan nodded. “It’s… I don’t know. I mean, you’re his wife, so of course, it’s okay for him to be touching you, but I’m…”

“Not,” Kelsey finished. “Listen, if you don’t want him to, I can discreetly say something to him and he won’t touch you. He’s a gentleman, Meghan, and I think you know that. But I will also say that you might be surprised how a certain touch can really help. He’s not going to hurt you or do anything that should embarrass you. He just wants to help.”

“And you’re okay with it?” Meghan asked.

Kelsey came around and put her hands on Meghan’s shoulders. “If I wasn’t, I wouldn’t be standing here trying to convince you to give it a shot if he so chooses. Just remember to relax into the feelings.” She smiled. “Now, we need to get you undressed.”

Meghan sighed and nodded. “I think I might take everything off like you did. Is there another blanket in the warmer?”

Kelsey went over and checked. “Two more in here, and we’ll restock it afterward.”

Meghan removed her clothes and piled them neatly in a chair. She sat down on the exam chair, drew a shuddering breath, and released it. “Okay, let’s do this.”

Kelsey gave her sister a smile and headed out the door. She knocked on Mitch’s office door and entered. “She’s ready. She’s still a bundle of nerves, but she’s there. She is concerned about your relaxation technique, but she said she’s game,” she explained. Mitch nodded in understanding and motioned his wife out of the room.

Knocking first, Mitch and Kelsey entered the exam room. Meghan sat naked on the exam chair, slouching a bit, but the cold air of the room had her nipples standing up. Mitch smiled kindly. “Let me get you a blanket.” He grabbed one from the warmer, unfolded it to make it a bit bigger, and draped it over her shoulders and overlapping her chest. He could see her relax some from the heat and weight. “Lie on back, and I’ll help you get into the supports.”

Meghan lay back on the chair, and Mitch raised it up to a better height. He guided her legs into the supports and had her scoot down to the end of the chair. “Give me just a minute to set up, Meghan.” He left her lying there, exposed, while he filled the bag with sudsy water. He grabbed the lube and the thermometer, placing them on the tray, and positioned everything next to Meghan. He sat down on the rolling stool in front of her bottom and pulled on gloves. He saw her flinch a bit at the sound.

“Okay, Meghan, you’ll feel my finger at your bottom. Relax for me.” He waited for her to relax before inserting his finger. He felt around carefully, then removed the digit. “You feel full, but I’m not feeling an impaction.”

He switched out his gloves, and she heard the sound of the thermometer probe being removed from the machine, followed by a beep. “Relax again. This is the thermometer.” She felt the slender object being passed into her rectum, slightly deeper than his finger had been.

The thermometer beeped, and he removed it. “99.9 degrees. A little high, but still normal.” Setting the thermometer aside after disposing of the probe cover, he reached for the lube and the enema nozzle. He lubed it up and positioned it at Meghan’s anus.

“Meghan, I’m going to insert the nozzle now. It will probably feel really big, but it shouldn’t be too uncomfortable. I want you to relax and bear down for me.” He waited for her to eventually relax, and when he saw the outward movement of her anus, he gently pushed the nozzle into place until it seated itself inside her rectum.

Meghan felt like her rectum had been invaded as he inserted the nozzle, but was surprised that she quickly became accustomed to the feel.

Mitch stood and looked at her. “I’m going to unclamp the bag now, Meghan. You’ll probably feel the water flowing into you. Let me know when you cramp, and I’ll do my best to help you through them.” He reached over and unclicked the clamp, adjusting the flow.

Meghan felt the water whoosh into her colon, then slow down as he adjusted the flow rate. It was a unique sensation, one she didn’t mind… until the cramps hit. “Ow!”

Mitch, however, was on top of it. “Breathe through it, Meghan.” He started rubbing her abdomen, working the water deeper into her colon. The cramp eased, and Meghan relaxed. “See? Not so bad.”

Mitch took his time administering that first enema, slowing the rate way down, coaxing her through the cramps, and being a gentleman throughout the whole administration. When the bag finally gurgled dry, he clamped it but left the nozzle in. He knew Kelsey had practice holding the fluid; Meghan was new to everything, and he was sure that any accident would be mortifying to her. “Good news, Meghan, the bag is empty!”

She glanced over at the bag. “And the bad news?”

He gave her an encouraging smile. “You need to hold this for 15 minutes. I’ll leave the nozzle in, for now, to help you hold it.” She nodded.

Kelsey came over and stroked her hair. “You did great, sis. The next one will be easier.”

Meghan groaned as another wave of cramps hit. “Ugh.”

Mitch looked at Kelsey, then at Meghan. “Meghan, may I try a different distraction technique?”

She locked eyes on him, then looked away. “Yes.” She nodded, then grimaced.

Mitch kept up his massage of her abdomen but slipped a finger lower to her pelvic mound. He started teasing her labia lightly with his finger, tracing around them. He could see her hips shift and knew that his touch was distracting her from the cramping. Mitch kept sporadically coming back to her labia as the cramps came and went, stopping when the cramps subsided.

Finally, Mitch lowered the exam chair and helped remove Meghan’s legs from the supports. He assisted her in sliding off the chair into a standing position. “Bend over for me, Meghan, and I’ll remove the nozzle. Then you’re free to run for the toilet.” She turned around and bent over so he could remove the nozzle. Once out, it was a quick walk to the bathroom.

Mitch set about cleaning up the nozzle and readying for her second enema. Kelsey joined him at the counter, and they conversed in low tones.

Twenty minutes later, Meghan emerged from the bathroom. “How do you feel?” Mitch asked.

“Better! I may have just lost 20 pounds,” Meghan joked. She looked at the chair and sighed. “Might as well get the second one over with.” She headed to the chair, sat down, and laid down. Mitch helped get her into the leg supports and her bottom off the table as before and raised the chair height again.

Mitch prepped the bag for the fourth time that evening. “Meghan, this one is the rinse. It should flow in faster, but there should be a lot less cramping, and those will be milder. I’m going to lube up your rectum with my finger,” he said, placing his finger at her anus. “Relax.” He inserted his finger and made sure to spread lube around well before removing his finger. “I think we did a good job with that first enema, so let’s get the soap rinsed out with this one.”

He readied the nozzle and positioned it at her anus. She bore down, and he inserted it fully. “Here comes the water.” He released the clamp and adjusted the flow to a little faster than her previous enema.

She felt the water entering her, and he was right – the cramps were much milder and fewer than before. She emptied the bag quicker this time, and the hold time was shorter. After 10 minutes, Mitch removed the nozzle and helped her down from the chair to make her way to the bathroom.

Mitch watched her go and started cleaning up. Kelsey came over close to him and spoke in low tones. “You know, I’m sure that Meghan was instructed for bowel prep prior to her surgery next week.”

Mitch raised his eyebrows at her. “What does that usually entail?”

“If it’s the prep I suspect, it’s a couple of laxative pills, a bottle of mag citrate, and finish with an OTC saline enema like Fleets.” Kelsey grabbed the cleaned thermometer unit and hung it on its docking station on the wall.

Mitch made a face. “Effective, but definitely not pleasant. I’ll give Meghan a couple of days to process what we just did, and then broach the topic with her.”

Kelsey nodded. “Or maybe I should talk with her. It might be easier coming from me.”

Mitch nodded in agreement. “Sure, hon. I just want to be sure that Meghan knows she has options.”