Sarah got everything in place for the next enema. She then sat on the bed next to him and reached up to retrieve the nozzle and held it out to show Alan. “Alan, I want to show you what I’m going to put in your rectum. I think if you see it first, you‘ll be a little less nervous. Being relaxed is really important for this to be effective and as comfortable as possible.“ She held out the beige nozzle that was slightly thicker than her index finger. The tip was enlarged into an ovoid bulb the size of a grape and with the holes around the periphery.
Alan turned his head and raised himself up onto his elbows to look. Sarah explained the features to him, “It’s nice and smooth so it will slide right it. Its not much thicker than my finger. The tip is enlarged so that once it is in your rectum, your anus will squeeze around it and hold the tip inside you.” As she said this, she curled her index finger around nozzle next to the thickened tip to demonstrate to him what she meant.
Alan nodded his head to indicate he understood and then put his head back down and sighed in resignation. Sarah, ever the perky optimist, heard this and put a positive spin on it, “Good! Those deep exhalations are great to help you relax.” She rubbed his shoulder as she said this.
Sarah got up and then knelt behind him. She got her gloves on and was lubricating the nozzle. When she looked at his protruding bottom, it occurred to her that it was somewhat unfortunate that she had agreed with Alan that she would not correspond with his mother. She would like to brag a bit on the progress she had made with Alan. Though she would have updated his mother in a professional tone, she mused about the idea of describing to Alan’s mother the situation right now in more blunt terms … “If you could only see your son’s cute little naked ass thrust up at me as I lube up this nozzle to prepare it for his tight little butthole! Then I’ll fill his tummy with warm water. Don’t worry, I’ll be gentle and take good care of him!”
She refocused on the task at hand, “Alan, I am going to put some lubricant on you now.”
The lidocaine had worn off to some degree, so Alan was able to feel the cool slippery tip of Sarah’s finger on him.
“OK, I am going to push my finger in, so bear down.” Sarah watched and waited and when she saw Alan’s anus expand and bulge slightly, she pushed her finger slowly in to him. Alan was again somewhat surprised at how she did this so deftly. The pressure increased slowly when she first pressed and then the subtle sensation of his anus giving way as she slipped past his anal ring, then just a steady smooth glide as she entered him fully.
“Alan, things are better! Your rectum is more empty. That will definitely make the enema more comfortable.“ She withdrew her finger slowly so as not to cause him to tense back up and watched his anus briefly pucker with a reflexive wink.
“OK, I’m going to put the nozzle in now. A little bigger, but you can handle it, just a deep breath in and bear down for me, ok?”
Sarah placed the lubricated tip gently but firmly against his anus and listened for his breathing. She saw him open a bit and steadily increased the pressure. She did not have the same tactile feedback as she had when penetrating him with her finger, so when she finally overcame the resistance of his muscles, the nozzle popped in more abruptly.
Alan gasped and lurched forward upon feeling the knob of the nozzle slide past his sphincter, ”Ow! Oh Ooooh! Ouch!” He felt some discomfort with this. Unlike Sarah’s magic finger, the nozzle was hard and stiff.
Sarah reassured him, “Shhh Shhh Shhhh! It’s all in, relax now.” She let go of the nozzle and stopped to let him regain his composure and breathing rhythm.
”OK. I’m going to start the water now. You let me know how you are feeling. I can stop it to give you a rest at any time. We’ll go slow. Remember, slow even breaths.”
Alan heard a click and at first felt nothing more than the plastic nozzle in his anus become pleasantly warm. After a minute or so, he started to feel some minor waves of pressure in his lower abdomen and some pressure building up in his rectum, but it was mild and not unpleasant and he said nothing and just kept up his breathing in a way that he could be sure that Sarah could hear it so that she knew he was being a good patient.
He was soon rewarded for his efforts when Sarah commented on his progress, “Alan you are doing terrific. The water is going in steadily. I think the oil enema was a very good idea so that you are not getting too much pressure in your rectum right away. Keep up the good work.” She had taken off one glove and she casually put her bare hand on Alan’s hip near the upper part of his buttock. She raised her hand so that just the tips of her nails touched his skin and she began to slowly and gently drag them back and forth over his pale bare skin. She had short nails (her nursing instructors insisted on that) but they were just long enough to do this. At first Alan was unsure how to interpret this touching, but soon the sensation started to have a mesmerizing effect on him. He closed his eyes and his breathing slowed and deepened without him even having to concentrate on it. Sarah kept this up and as she kept her eye on Alan’s bottom, she noticed that his anus started to relax a bit. The angle at which the protruding part of the enema nozzle pointed was a useful barometer of this. At first it was at a 10 o’clock tilt pointing at the ceiling, but as Alan’s anus relaxed it’s grip, it slowly tipped downward to near horizontal. There were a few tiny bubbles visible to her in the clear tubing and these quivered back and forth indicating the water was flowing into him nicely.
The motion of Sarah’s fingernails and her reassuring presence had practically put Alan into a trance, but eventually the increasing volume that had been instilled into his bowels started to cause a reaction. Before Alan made a sound, Sarah knew this was happening when the angle of nozzle reversed course and pointed upward as his anus tightened around it. She reassured him preemptively, “OK, concentrate on your breathing when you feel that pressure build in your rectum. The cramp will pass.“ The nozzle slowly began to ease back down, then jumped back up. “Easy baby, I’ll stop the flow for a bit to give you a break.”
Alan heard the click of the clamp again. He could not understand how Sarah knew what he was feeling when he had the urgent pressure in his rectum. It seemed to him that she could read his mind with some sixth sense. He heard another click as he pondered this. Sarah updated him once again on his progress, “You’re a little beyond halfway. You’re doing great. I knew you would!”
He found her words of praise and encouragement so satisfying to hear and he became more determined to please her. He was getting a bit confident in his ability to tolerate the enema when a much stronger wave of cramps started. First he felt then around his navel, but as they moved down, the pressure in his bottom took him by surprise. He felt his anus involuntarily contract but he also clenched his buttocks to try to prevent an accident. His posture collapsed and he hunched forward and to the side.
Sarah closed the clamp and steadied him with both hands. “OK, OK, easy. Breathe deeply.”
Alan tried to breath but he was still in a panic, “I have to go, I really have to go!”
”I know sweetie. Try to get back in position. If your butt is up in the air, gravity will help take away some of that pressure inside your bottom.” Sarah gently pulled him by both hips back up. She then rubbed his lower back with one hand and gently stroked his belly with the other.
”Oww! Sarah, I can’t hold it! Please stop it! Please let me go to the bathroom, please!?” This was, after all, Alan’s first enema. The afternoon had been a whirlwind, but now this — here he was pleading with Sarah to let him poop and scared that at any moment the next cramp would result in a humiliating mess. “I’m sorry, I can’t take any more!”
Sarah recognized that Alan had reached his limit and that pushing things further would be risky. “Alan, you don’t have to be sorry. I know you are trying so hard and you took about 75% of the water. You did really well. Its going to help you so much.”
”So I need to take the nozzle out of you. Its going to feel funny and awkward and it’ll be a little tricky for you. I‘ll remove it very slowly.“
Sarah got both hands gloved back up and then took a small dry towel and folded it twice into a small square in preparation. When she went to grasp the nozzle, she saw Alan had again clenched his buttocks around it, gripping it tightly. “Relax you butt cheeks Alan.” She put down the cloth and cupped his bottom with a hand on each side and gently massaged him. Her fingers were at the edge of his crease and she applied steady gentle outward pressure. Slowly he relaxed his gluteal muscles with Sarah’s gentle words of encouragement, “That’s it. Relax. I won’t let anything bad happen.”
She then firmly gripped the nozzle and with her other hand, held the folded cloth against his perineum. “Alan, start focusing on your breathing again. When the nozzle comes out, it may feel like you pooping, so be ready for that. A few drips of clean water may come out. That’s normal, so don’t get upset about it. Once the nozzle’s out, stay put for a few seconds and then I’ll help get you into the bathroom.“
When Sarah started to pull on the nozzle to withdraw it, she was surprised at how tightly Alan was involuntarily gripping it. When she pulled a little harder to the point the she could just glimpse the wider part of the tip peeking out of him, she then saw his anus respond by tightening further, pulling the bulbed tip back inside. She stopped and contemplated the issue out loud, “How are we going to get that tight bottom of yours to let go?” She let go of the nozzle and sat back on the floor behind Alan staring at the puzzle confronting her. She knew is was part neuromuscular physiology and part psychology and she was sure she could solve it.
”OK Alan, here‘s the plan. You are going to have to trust me. I know you are nervous about leaking and having an accident, but if a little of the enema leaks out, it’s no big deal. The way for you to relax your bottom is to gently push out like you are trying to poop out the nozzle. I’ll be right here with a towel, so no worries. The only other option I can think of is to use the lidocaine to numb your anus again to relax it, but that might make holding in the enema during the walk to the bathroom a little too much of a challenge. Do you understand what I want you to do?”
”Yes, I really need to go soon though. ”
Sarah knelt forward and took hold of the nozzle with one hand and repositioned the towel just below Alan’s anus. “OK, start to bear down and push out. “
Alan had a hard time with this. With the fullness in his rectum, pushing seemed like inviting disaster, but Sarah insisted, “Take a breath in, hold it and push out for me.”
He did as instructed with a profound trepidation. The exposure, urgency and Sarah’s presence behind him all told him to clench and hold everything in at all costs, but he needed and wanted relief from the tormenting pressure and, of course, he also wanted to to please Sarah.
Sarah slowly increased the traction she exerted on the nozzle and that, combined with Alan pushing, allowed a third of the bulged tip to emerge, the rest concealed by the taut pink skin of Alan’s reluctant anus. She kept up the traction and her encouragements, “Push a little more. Its ok, the towel is here. “
She saw no signs of his anus yielding further. When she pulled more, it had the opposite of the desired effect as Alan’s anus tightened back up pulling the smooth beige bulb back inside him.
” No Alan, push more baby. Your tightening up again”
”Sarah, I can’t! I’m trying, but I feel like I’m going to poop all over!” He was nearly in tears as he blurted this out.
”I know. Its going to be alright. Getting upset is only going to tense you up.“ She went to stroke his hip with her hand and as she lamented how having a glove on her hand made it hard for her to connect with her patient, she had a moment of insight. She deftly used her right hand to hold the nozzle with her thumb and index finger while at the same time, holding the towel against Alan’s perineum with the remaining fingers. She then stripped the glove off her freed left hand. She put her bare hand flat against his upper outer left buttock to let him feel the warmth and softness of her bare skin and then she raised it slightly away from his pale skin, just maintaining contact with her fingernail tips. She then began the lazy back and forth stroking of her nails that earlier had had such a salutary effect on Alan’s jittery nerves.
It worked like a charm. With her right hand she could feel the nozzle becoming looser. She saw Alan’s anus become less puckered and some of the inner pink became visible at the inner edge of the outer brown portion. She heard Alan sniffle from his teariness and then settle into a more even slow breathing pattern. She knew she had to act quickly now. If another cramp came, it would reverse the progress.
Keeping the pendulum like motion of her left hand smooth and steady as her nails slid back and forth on him, she began in a near whisper, “Alan you are my best patient. You’re so brave. I’m so proud of you.“ As she spoke, she firmly and steadily withdrew the nozzle. She could feel the resistance, but kept going until she felt it pop free. She immediately shifted the towel up and pressed firmly against his anus.
Alan was caught off guard, but that was the idea. When the sensations of what happened registered, he sprung up to his elbows and thrust his hips forward while clenching his butt with all his strength. He could feel the pressure of the wadded up towel keeping his buttocks from sealing against each other. “Oh God, Ouch that hurt! Oh! .” He was grunting and still sobbing a bit.
”Its alright sweetie, its out of you. Just a few drips of clear water. No worries.”
Alan was breathing heavily from his near panic. Sarah put her bare hand on his shoulder, “Ready to get up and head to the bathroom?”
Alan nodded as his breathing gradually slowed.
Sarah dropped the nozzle and rose to her feet with Alan, “Go slow. Do you feel lightheaded at all?
He shook his head no. Sheepishly, he reached back to take over holding the towel.
Sarah felt his hand and understood, “You want to hold the towel? There, you go.” She let go, thereby affording him a modicum of dignity. She followed behind as he walked gingerly into the bathroom. In spite of the circumstances, she couldn’t help but to notice how cute his bottom looked with the dimples formed on the sides from him tightly clenching his buttocks together. As he approached the toilet, she stopped and grabbed the plastic dispenser of baby wipes she had bought for him. She set them on the floor in front of the toilet within arm‘s reach for him, “Here, these will be more gentle on your bottom when you are cleaning up. Leave that towel on the floor. I’m going to leave the door open a crack so if you need me, holler.
”No, please close the door.” Alan was trying to wait until she left, but he had to flop down onto the seat.
”Of course. I understand.” She started to close the door, but much to Alan’s disappointment, the urge to push and evacuate his bowels was overwhelming and he could no longer resist. The rush of water was loudly audible before the door was shut.
Sarah felt like she needed to remain nearby. She sat down and could hear poor Alan whimper after each splash indicated he had painfully expelled some hard stool. She thought of comforting him from the door, but knew better than to risk pushing him beyond his limits of embarrassment.
Alan was able to tolerate the ongoing cramps as well as the pain from expelling hard stool knowing that the process was going to have him feeling so much better. He was astounded at how long his expulsion went on for and by the amount. Every time he thought he was through and reached forward to grab a baby wipe, the change in posture had him emptying himself more still. Finally, feeling completely drained in every sense, he began cleaning himself up. He was still sore, but it was better than dry rough toilet tissue. He fretted over this. How clean did he have to be? He concluded it was inevitable that Sarah would be inspecting his bottom for some reason or another, so, wincing, he wiped a few more times.
He stepped out of the bathroom and Sarah called him from the spare bedroom. When he walked in, she was tidying up the bed, “I’m sure you’re physically and emotionally exhausted. Come lay down.“ He approached the bed and saw that she had spread out some of the blue absorbent pads in the middle where his bottom would rest. He climbed into bed, pulled up the blanket only to see Sarah putting on another pair of purple gloves, “What are you going to do to me now?” he wearily asked.
“I know you’ve had enough. I just want to get some of the hydrocortisone on you after all that. Turn over onto your side for me.“
Sarah spread his buttocks apart and frowned to herself when she saw how irritated Alan’s skin was, “That poor little sore bottom hole! What a workout today. I’m so sorry Alan.”
She squeezed out some ointment and closed her fingers around it to warm it up and make it less viscous and then started gently spreading it around Alan’s bottom. She then paused, “Just like before Alan, I’m going to put some up inside you.“ She had positioned her fingertip dead center of his opening and began the now so familiar instructions, “Bear down and push for me.”
Alan had started to push before she finished her sentence. He felt her softly slide into him with an agile stealth. She had never hurt him when she penetrated him with her finger, but this time it was even more comfortable. His now empty rectum was able to more comfortably accommodate her finger. Even as she began to sweep around gently pressing on the walls of his rectum, he did not experience that unsettling sense that he had to desperately poop and might do so involuntarily.
Sarah too had noticed a difference and sounded giddy sharing it, “Alan, your rectum is completely empty! Yay!!! We did it!“ She went on, “And your anus doesn’t feel so tight around my finger. That’s good too. That had me worried when I felt it before. I think when you were so terribly blocked up, it was making your anal reflexes and muscle tone haywire.”
Alan felt Sarah deftly ease her finger back out of him. This left him with the empty sensation as it had before, but this time, it was not quite so much of a positive thing and a relief, but more associated with a vague disappointment and unmet want. He tried not to let himself acknowledge this.
Sarah peeled off her gloves and then pulled up the blanket over Alan as he rolled over onto his back and faced her for the first time in quite a while. She smiled reassuringly, “I know you feel like a greasy mess back there, but let’s leave it like that. A generous coating of the ointment will help you to heal and your skin can’t take one more wipe.”
Sarah rose to her feet and switched off the bright halogen desk lamp.
“I know you are tired and hungry. I’ll order some food to be delivered, but rest first. If you doze off, even better. Do you think your roommates might get worried if you don’t return tonight or if you sleep here?”
”No, it would take them a month to even notice. And then they’d celebrate.”
“Well, they’ll probably just think you got lucky!“ she laughed, “And they would be spot on, wouldn’t they?”