A Nice Warm Enema to Bring Up His Temperature

The other week when it got so cold those couple days here in the South, the water line from our meter to the house took the unwelcome opportunity to burst. Of course every plumber was tied up, so David decided to dig up the source of the leak and fix it himself. He and his brother worked all day digging that thing up and finally got a splice in the line installed at 7PM. David's brother had on thick Carhartt coveralls, but David doesn't like to work in thick clothes because he says it gets in his way. He was literally froze. When he came in the house he looked pale as a sheet. My first thought is "oh no, he's getting pneumonia." He told me he felt the coldest he'd ever felt in his entire life. His clothes were a little wet from working on the water line, so I took those off of him, stripped him down and had him get in bed naked.

I was hoping the thick comforter and flannel sheets would help get him warmed up. His teeth were chattering. I got the rectal thermometer and took his temperature to his protest and displeasure. After three minutes, his temperature was 96.4, which means it would probably have been a degree lower than that taken orally. A temperature of around 95.0 is considered mild hypothermia. We take rectal temperatures in the ER for suspected heat/cold related injuries as standard protocol, because a core temperature is important in these cases. Which means David was just above that threshold.

A lot of us have heard about enemas being a last resort for bringing down a body temperature in heatstroke cases. Well it can also be used as a means to bring the body temperature back up when someone is cold. It's not medically a normal practice, but it works. So I decided to put a quart and a half of warm saline (103.0F) in the enema bag and give it to David slowly to bring his temp back up and make him more comfortable. As with getting his rectal temperature taken, he wasn't exactly looking forward to an enema. It's understandable that it's probably uncomfortable feeling a nozzle being slid up your butt when it's coated in cold K-Y Jelly and you're already half froze. I decided instead to soak the nozzle in the sink with hot water while I filled the bag with the shower faucet. I also filled another hot water bottle with just a stopper to lay against his back during the enema.

I used coconut oil instead of K-Y to lubricate the nozzle. It's not cold and it heats up to body temperature quickly. I gently slid the douche nozzle into him and he didn't flinch to my surprise. I think warming the nozzle helped keep him calm during the insertion. I opened up the clamp to just a trickle to slowly fill him all the way up. I wanted the water to have enough time to warm him before he felt the urge to go release it. It took just over 15 minutes. He started to get comfortable and admitted to me it was the most gentle enema he'd ever been given. He told me he was warm enough to the point of getting sleepy right before the first cramp started. I rushed him to the toilet and slid the nozzle out of his butt so he could expel. He took a hot shower and came back to bed. I took his rectal temperature again, he didn't fuss this time. It was 99.2F, back to normal. He slept like a baby.

Good job Nikki! I’ve been tempted to use warm enemas for hypothermia and cool ones for hyperthermia. I treated a severe case of hypothermia (core temp 89°) with warm peritoneal lavage but after four hours of it plus concomitant CPR he developed intractable cardiac arrhythmias and didn’t make it. Cool enemas for profound hyperthermia are ineffective. I did treat two cases of heroin overdoses (temps 108°-109°) successfully with cool saline peritoneal lavage. The poor patients had shot up in the cool park in the morning and then it became very warm. Usually such cases of core temperatures 107°-110° are uniformly fatal. Excellent work Nikki! I bet he was very grateful!

When I was a child, my older brother fell through the ice in Lake Michigan one winter. Fortunately, a friend,knowledgeable about how to rescue someone from ice, was there to save him. When he got home, my mother called our doctor (this was the 1950s, you could still do that), and shortly afterward my brother was in the bathroom being given an enema. I have always assumed the cold had simply seized up his system and the enema was to relax it. But perhaps the enema was to get his temperature up to normal.

You are truly the "Good Wife " just like my wife !

@legato345 said,

When he got home, my mother called our doctor (this was the 1950s, you could still do that), and shortly afterward my brother was in the bathroom being given an enema.

It was commonplace in the nineteen fifties. My grandmother was a retired RN, and she gave us or had our aunts give us, cool rinse enemas whenever we were running a high temperature. Doctors of the era routinely made house calls and prescribed daily rinse enemas, whenever someone was sick in bed, until the illness passed. So, being given an enema for low body temperature, definitely fits the medical culture of the era.

@Nurse Nikki....it's interesting your husband said he was getting sleepy by the warming effect of the enema you gave him. I get colonics done on a regular basis, maybe one or two a month. Sometimes when I go to a session on really cold days, the warm water and belly massage makes me sleepy. The only thing that keeps me from dozing off is the intermittent abdominal cramp right before I tell Jennifer I need to release.