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» » Kelly Part 1 « «
Kelly was really happy. She’d just had a new bike for her 14th birthday, it was the start of the summer vacation, so no school until Fall, and she’d been shopping for some summer clothes with her elder sister in the local mall. They were cycling back home when it started to rain. It hadn’t been forecast, so both girls were surprised. Still, it was the fine drizzle rather than heavy rain. Kelly’s older sister, Karen, called to her, "Race you home!" They were at the top of the hill leading to their house which was just round the bed at the bottom of the hill, or rather more of a long slope really. Kelly had long blonde hair which was flying out free behind her as she sped down the hill. She was a pretty girl who was well into adolescence and aware of the dignity which adolescents seem to have so strongly.
Karen was in the lead as she swung her bike around the curve at the bottom of the slope with their house in view. She’d done this many times, but perhaps today she was a little further out from the sidewalk or it may have been because the metal sewer cover was damp, but her front wheel slid as she rode over the cover causing her to fall. She felt herself flying over the handlebars so naturally put out her arms to stop herself. As she fell, she could feel one leg had got tangled in the bike frame, then she hit her head and, perhaps fortunately for her, remembered no more. Her sister was frantic for her. After checking Kelly was breathing and her airway wasn’t obstructed (as Karen had been taught in the American Red Cross classes), she rushed the last few yards home to get her mom to dial 911 for an ambulance.
Kelly knew nothing of her trip to the local ER by ambulance, nor the X-rays of her arms and legs, as well as the CT scan of her head to look from brain damage as she hadn’t regained consciousness by the time she’d arrived at ER. The ER doctor had intubated and sedated her as her breathing was shallow which caused him to worry that there was brain damage. Fortunately all tests were negative except for two broken arms and a broken leg, bruising, some grazes, but nothing more. After she’d been to the OR to have her arms set and her leg pinned, she was taken to the children’s orthopedic ward to start her recovery. She’d woken briefly in the recovery ward, but had been sedated for her pain as soon as the recovery nurse was happy that her responses were normal following Kelly’s surgery.
It was the next day that Kelly started to emerge from the fog caused by the morphine she’d been receiving. She opened her eyes and guessed, correctly, that she was in the local hospital since she’d remembered falling from her bike. A nurse came hurrying over to her, seeing that she’d started to wake. "Hello, Kelly, my name’s Sue, and I’m one of the nurses looking after you this shift. How are you feeling?" ""I hurt all over and my head ached," Kelly blurted out, with the honesty which sedation produces. "Now you’re away, I can give you some Tylenol for the headache. Do you feel sick at all?" "Just a little nauseous," said Kelly. "That’s OK, pet. The doctor wrote you up for some anti-sickness drugs too. I’ll give you that through your drip. You’ve broken both arms and your right leg. Your drip is going into a vein in your left foot as both of your arms are in plaster." "That’s why my arms feel so heavy and I can’t move them, is it?" Kelly asked. "That’s right, pet. You’ve got plaster casts from arm pits to finger tips. No, don’t try to sit up, it may make you sick, just lie back. You can look later." Kelly had indeed tried to sit up to survey the damage and had felt both sick and dizzy, allowing her head to fall back onto the bed even before the nurse’s admonition that she shouldn’t try to sit up.
While the nurse went to get the injection of anti-emetic, Kelly laid there reviewing herself. She could feel the pain from where she’d banged her head, her arms in the casts hurt where her bones had been broken and set, her leg throbbed where that had been broken, cut to insert the pins and stitched closed. Her review of her body suddenly focussed on her hips. She felt damp between her legs as well as the feeling of warm cloth around her hips and bottom. She tried to sit up to look, forgetting the nurse’s warning and desperate to find out if she’d accidentally wet the bed, but the concussion reasserted itself by causing a blinding pain in her head. The nurse came back with the injection, shaking her head sadly, "I warned you not to try to sit up. I bet that hurt!" As she spoke to Kelly, she flipped up the port on the cannula in her foot and injected the anti-emetic. "Nurse," Kelly asked, blushing a beetroot red at the shame of having to ask such a question, "Have I wet myself. I feel damp between my legs," then, continuing in a rush of embarrassment, "because, if I have, I’m ever so sorry!" The nurse smiled at her, "No, pet, you haven’t wet the bed. You’re wearing diapers and plastic pants. You wet your diaper without realizing it because you were sedated after your operation to fix your leg and arms." As she said this, she pulled the curtains around Kelly’s bed to give her a little more privacy. "Oh!," Kelly, said, rather thrown off course and thinking rapidly, "I’m not sedated now, so presumably you could take off the diapers now I’m not sedated because I’m not a baby and I don’t wet the bed when I’m not sedated." "Sorry, pet, "the nurse replied, as Kelly winced at her use of the babyish calling her ‘Pet’, "all the patients in this ward are in diapers and you’ll be in them as long as you’re a patient here." Kelly started to raise her head off the bed to argue with what the nurse was saying, but the nurse raised her hand to forestall her objections and said, "Wait a moment before you start to protest that you’re too grown up to wear diapers. Some of the adults in orthopedic wards wear them too and you’re younger than they are. Let’s look at your situation. You certainly won’t be able to walk to the toilet for at least a couple of months until your plaster comes off - that alone would stop you sitting on the toilet. For the same reason, you can’t be lifted out of bed to sit on a commode at the side of the bed. The alternatives for passing urine are to be lifted onto a bedpan with a couple of nurses there in case of problems because you don’t have the use of your arms. You couldn’t wipe yourself afterwards anyway. You’d find that possibly even more embarrassing than the diapers. You could have a catheter, but those would cause you to get a urine infection for the length of time you’d need it which might cause damage to your kidneys, or you could be in diapers. Hospital policy, after reviewing the possibilities for children on this ward and from asking patients here in the past, is that all the children are to be in diapers. That way there’s no problem with some being treated one way and others differently. No matter how old or what is wrong with them, all the children on this ward are in diapers. You are in popper pants since we can’t pull pants over your plaster cast on your leg. The boy over there who has a broken arm and concussion following a similar accident to yours and he is wearing the pull up type. The girl next to you also has a broken leg so is in the plastic popper pants. You get the idea?" "Yes, but that means I’ll have to wet myself every time that my bladder is full!" Kelly wailed. ""Yes, that’s the idea," said the nurse. "We come to change you before each meal and just before you got to bed. It’s up to you, but, if you can wait until we start the diaper round, you won’t have to be in wet diapers all the time. But that’s up to you. Quite a lot of our patients here find it more comfortable to have wet diapers than a painfully full bladder. As I said, it’s entirely up to you, but you stay in diapers no matter what." Kelly’s mind was racing at the implications of this. "Nurse, what about when I need a b.m.? Do I get sat on a bedpan then?" The nurse laughed, "No! That’s why you’re in diapers. It saves work for the nurses this way, and the patients on the whole find it less embarrassing that having to be helped so intimately by the nurses. Again, you might find it more comfortable if you can wait until just before you’re due a diaper change. Listen, pet, don’t fight us, you really will find it isn’t as bad as you think when you come to do it. In your case, you would really find problems because your concussion means that you would find being pulled around uncomfortable and going to the toilet using a special fracture pan isn’t at all easy or pleasant. Honestly, the diapers are the best option. Now you’re awake, I’ll get you a drink." With that, the nurse left her to get her a drink.
Kelly laid there with very mixed feelings. As a child, she had been taught that the ultimate crime was to wet the bed and she must always use the toilet and never embarrass everyone and herself by wetting her pants. She knew she was wearing a diaper, but the thought that she’d already sort of wet her pants distressed her. Not only that, but the iv. fluids being added through the drip in her foot was working its way around her bloodstream and through her kidneys was also filling her bladder. She was aware that she desperately needed to pee and the only was she could do that was into her diapers. She realized that the nurse has been telling the truth when she said she would be kept in diapers all the time she was on that ward. The pressure in her bladder had turned into a real pain and she decided that enough was enough. Despite having wet herself while sedated, she found that it was harder to break her conditioning when she was toilet trained. Eventually, she managed to start as the hot stream of urine flowed out into her diapers and spread out under her buttocks as the diapers absorbed all the fluid. As she laid there, she thought that perhaps she could get used to using her diaper when her bladder was full, but she really didn’t fancy having a b.m. in her diaper. That would be really yucky!
The nurse came back with an iv. bag connected to some tubing and something in a kidney dish. The nurse hung the bag of water form the iv. stand attached to the head of the bed and clipped the ‘thing’ in the kidney dish to the head of the bed so that it was suspended over the side of the pillow. Kelly looked at it in horror. It was a tube with a baby bottle type teat at the end. "I’m not using that!" Kelly said in disgust. "I keep telling you I’m not a baby!" "Hush, pet, and listen," said the nurse. You have both arms and hands in plaster so you can’t use a buzzer to call us, so you’d have to shout if you wanted a drink as one of us would have to hold it for you. You aren’t allowed to sit up for several days yet because of your head injury, so you’d either have to use a cup with a spout - like a bay’s drinking cup, or a baby bottle. This way you can have some water whenever you like. If you’d rather have fruit juice or something, let us know tomorrow and we’ll fill it with that, but today the doctor wants you to stick to water and no food at the moment." Kelly could see the nurse’s point and, as she really was thirsty, she inclined her head to one side so that the teat entered her mouth and started sucking so that the cold water came into her mouth. She sucked greedily as she found just how thirsty she was, not caring that whatever she drank would soon be ending up in her diaper. "Hey, slow down, pet, you might make yourself feel sick if you keep drinking like that," said the nurse. Kelly paused for breath, and turned to the nurse, "Sorry, I was thirsty, but please don’t call me pet!" "Sorry, said the nurse, "but I call all my patients ‘pet’!"
During the course of the day, Kelly drank all of the water and had her diapers changed when the other children were got ready for their meals. The drip came down as she was drinking for herself. Having her diapers changed wasn’t as bad as she’d thought. The two nurses were very matter-of-fact about it and didn’t make any comments about ‘babying’ her or commenting that she’d wet herself. Kelly realized that the nurses must be used to very patient being wet anyway. By the end of the day, she found that she could see why she was in diapers as it was really quite easy for the nurses to un-pop her plastic pants, open them flat, remove the wet diapers, wipe her with, and she had trouble with that part, ‘baby wipes’, dry her with dry wipes and then put her in a clean diaper, popping her pants closed afterwards.
Just before the lights were turned out for the night, all the children were put in extra thick diapers for the night which were pinned carefully in place and all the cloth tucked under the edges of the plastic pants to prevent wicked which would wet the children’s beds. Kelly woke in the morning to find that she was wet. She couldn’t remember having woken in the night needing to empty her bladder, but she had been given an injection of something which had made her drowsy so perhaps that was why she hadn’t remembered waking and wetting her diapers.
The next day, she surprised herself by finding that she quite liked the sensation as she let her bladder empty with the warm urine spreading around her bottom and between her legs. Just before breakfast time, all the other children had a wash and a diaper change and were then given their breakfast. It was a different team of nurses that morning and Kelly was glad that the ‘pet’ nurse wasn’t there that day. She really hated being called ‘pet’. Just before the nurses started the ward round of diaper changes and washings, two of them wheeled a large trolley piles high with cloth diapers with both pull on and popper plastic pants in various sizes. Kelly hadn’t been allowed to sit up to see her plastic pants, but she realized that they must be clear plastic as all the plastic pants on the trolley were clear plastic. The cloth diapers were held in place with large diaper pins which were contained in a clear plastic pot on the trolley. The nurses wheeled this into the middle of the room to use it to collect the clean diapers and to deposit the wet ones and plastic pants into bins at the bottom of the trolley. One of the nurses called to her, "Don’t worry, Kelly, we’ll come to you while the others are having their breakfast."
True to her word, that nurse came back with two others wearing plastic aprons to cover their uniforms and rubber gloves. They pulled the curtains around Kelly’s bed so that she experienced the delights of a bed bath for the first time as she was washed from face to her one exposed foot. the nurses were extremely thorough as she even had the toes peeking out of the plaster on her injured leg washed. Finally, a waterproof pad was pulled under her diaper and pants, and the pants and diaper removed. Two of the nurses lifted her enough so that the third nurse could wash her diaper area and dry it. They continued to support her while she was creamed under her buttocks and over the whole of her diaper area with protective cream. All the time the nurses chatted to her about everything except what they were doing. Kelly realized with gratitude that they were trying to distract her to stop her thinking about what they were doing to her. When she had clean diapers and plastic popper pants on, a clean gown pulled over the casts on her arms, but not fastened behind he so she wasn’t lying on the knots which normally fastened those horrible hospital gowns, as well as a freshly made bed with clean sheets, she turned to all three nurses and said, "Thank you for washing me and cleaning me." They smiled at her and one said, "It’s a pleasure, Kelly! We appreciate that you didn’t make a fuss. I’ll come back when I’ve washed and you can have some breakfast!"
Kelly liked her as she didn’t treat her like a baby. When she came back, she had a trolley with various things on it which Kelly couldn’t see as the top of the trolley was above her eye level. The nurses had left the curtains drawn around her bed and Kelly wondered why. Her answer soon came. "Kelly, I need to talk to you first, then I’ll give you your breakfast. As you’ll need feeding, I thought you might appreciate a bit of privacy." Kelly gave her a beaming smile, "Thank you! That is very thoughtful of you." "OK, Kelly, how are you getting on with your diapers? I’m sorry, but, as a new patient, we have to ask. You didn’t make a fuss when we washed and changed you, so are you becoming used to wearing them?" "I’ve thought about it and I can see how much easier it is for you nurses and probably for me to be in diapers, and I don’t have any choice anyway, do I?" Kelly said, with a smile to show she wasn’t complaining. "Thank you, Kelly, for being so grown up about it!" Kelly was amazed. To be called ‘grown up’ when wearing diapers just so amused Kelly that she grinned at the nurse, saying, "I know I’ve got to wear them so I suppose I’ll try to make the best of it. But I really don’t want to have a b.m. in them." "It’s partly that I need to speak to you about. You’re had morphine and other drugs which will tend to make you constipated. You must try to have a b.m. as soon as you can, but I realize won’t be easy for you lying there on your back. If you don’t ‘go’ in the next couple of days, we’ll have to try to clean you out in other ways which can be messy and unpleasant for you. You could try a laxative now to avoid that, but it isn’t compulsory. That’s your choice. if you think you can manage without, then don’t, but if you think you won’t be able to have a b.m without help, then you’d be better taking the laxative. It’s not a strong purgative which will give you cramps. It’s a stool softener which should help and allow you to stay in control. If you do need our extreme measures, they can include strong laxatives which will leave you without any control at all while they’re working. It’s called lactulose and it has a sweet taste, but, don’t worry, it isn’t absorbed so it is effectively zero calories." Kelly thought about it for a moment and realized that the ‘grown up’ thing to do was to take the laxative, especially as she didn’t like the sound of the strong purgatives. "I’ll take the laxative." The nurse went to the trolley and fetched a bib which she put round Kelly’s neck. Kelly was about to say something when she looked at the nurse’s face, saying, "I suppose I need that as I’m lying down, don’t I?" The nurse smiled at her, "Yes, you do. I’ve got to try to get this into you without spilling it. It’s more to do with me than you!"
The nurse got the bottle of lactulose and poured a small measured glass full of it. She went over to Kelly and, lifting her head slightly off the pillow, managed to get it all inside Kelly with just a dribble down her chin which the nurse wiped off with the bib. "Good job I had the bib on," Kelly smiled at her. The nurse then asked Kelly whether she’d like some breakfast cereal. Kelly was hungry by now and chose her favorite which the nurse carefully fed to her, spoiling some despite her efforts not to. "Sorry, Kelly, I warned you that the bib was to protect you from me! Would you like some orange juice now?" Kelly said that sounded great, so the nurse poured some into a wide necked glass bottle and looked at Kelly. "We’ve got rubber and silicone teats as you need to drink this from the bottle. which would you prefer? The rubber ones are like you used to use when you were much younger (as the nurse winked at her), but the silicon ones have no taste." "Oh, I’ll try the rubber one first, then I can try silicone later if I like." "Good choice," the nurse grinned at her, as she screwed the teat onto the bottle. She held it while Kelly emptied the bottle, and the second one which she’d asked for as well. The taste of the rubber teat took Kelly back to when she was being cuddled by her mom and given a bottle of water or milk, sitting on her lap with her head on her mom’s breast. The memory came flooding back to her as she suddenly found that her bladder had released a warm puddle in her clean diapers as well, The nurses smiled to herself as she saw the yellow stain appear through the clear plastic pants. After all, that was why they were clear plastic so the nurses could check on them!
Kelly decided that she’d like just water in her drinking teat, so the nurse made up her water with plenty of ice in it to keep it cool for her. Just before leaving her to help the other nurses, she turned to Kelly, "I should warn you that some people who have lactulose have problems with internal wind. If you find that you do, we can always try something else for you." "Gee, thanks," thought Kelly, "Now she tells me." Still there was no pint in making a fuss as she’d taken the stuff now and the nurse had warned her, rather than leaving her to possibly find out for herself.
Three days later, Kelly was almost unaware of when she was wetting herself. She’d not bothered to try to wait until just before a change. She reasoned with herself that, since she was in diapers, she may as well use them when she needed to. However, despite the lactulose which had given her awful wind, wind was all she’d passed. In fact, sensible girl that she was, she was quite pleased about wearing the diapers as the cloth and plastic pants muffled the noise of her passing wind.
However the nurses had noticed that Kelly hadn’t been passing stool as she should have been. She’d not been eating a lot since the accident, but the nurses knew that she needed to have a b.m. soon. After discussion, two nurses went to change Kelly’s diapers just before lunch. "Kelly," one said, "you haven’t had a b.m. yet so we’re just going to check you internally. I shall lubricate my finger and then gently push it into your back passage to feel if you are constipated at all. I know it is a bit embarrassing, but we need to do it." The nurses put a clean diaper under Kelly and the nurse carried out the examination. The nurses both looked away so as to embarrass Kelly as little as possible. The nurse had a good poke around which wasn’t exactly comfortable. Indeed, she made Kelly gasp at one point. When she’d taken her finger out, she told her, "You’re full of hard stool don there and we need to get it out so you can ‘go’ normally. I’m going to put a couple of glycerine suppositories in you so try to hold them during lunch. They might be enough to soften things up a bit for you before we have to resort to more uncomfortable methods." With that, she pushed two suppositories up into Kelly’s back passage. Two diaper protector liners were placed on top of the diaper to ‘catch’ the stool to make the next diaper change easier. Kelly was fed her lunch by one of the nurses, aware all of the time of the irritation being caused by the suppositories trying to do their work in her back passage. After the nurse had finished feeding her, sitting up a little now, but still needing the bib as Kelly had realized that being fed was a messy business, Kelly just had to get rid of the suppositories. She was aware that all that had happened as the liquid glycerine had trickled out of her back passage. She told the nurse. "Oh dear, Kelly. I’ll go and get the next stage for you. It will be a phosphate enema, but, somehow, I suspect that you’ll have to have the more drastic treatment. Taking away the lunch things, she came back later with a clean plastic apron, rubber gloves and a kidney dish. Putting the dish down on the bed, Kelly saw the bottle of the enema with its nozzle, soon to be plunged inside her, and a tube of KY jelly with some wipes. The nurse unpoppered Kelly’s plastic pants and pulled the front down, unpinning her diaper and repeating the same to leave her exposed. She explained to Kelly what she was about to do and why, then lubricated the tip of a finger with KY and applied it to Kelly’s rosebud, even though the liquid glycerine had already left that moist. Once Kelly had relaxed, she pushed her finger gently into her back passage to dilate the anal sphincter, before replacing her finger with the nozzle of the enema. She squeezed the container until all the phosphate solution had entered Kelly’s rectum, She then removed the nozzle, instructing Kelly to hold onto the solution, put the bottle and soiled glove in the kidney dish, changed into a clean glove and pinned up Kelly’s diapers over her front, followed by pulling up and poppering closed the plastic pants and making sure that all the diaper material was tucked in. Another nurse gave a verbal ‘knock’ at the curtains at this point and, when Kelly invited her in, helped the other nurse to slide a disposable incontinence pad under Kelly’s plastic pants in case of leaks. "Hold onto that enema for as long as you can. ten minutes is good, fifteen minutes is even better and 20 minutes is best of all. I know hat you’re due next so the better the chance of that working, the less chance there will be of having to do something more drastic to unblock you. I’ll leave the curtains closed to give you some privacy." With that, both nurses left.
Kelly struggled to hold onto the enema as the phosphate solution drew water from inside her colon and also irritated the colon lining. After 17 minutes she couldn’t hold out any long and discharged the brown fluid into her diapers. She didn’t want to soil herself in this way, but knew she had to pass the stool. She was very aware that she’d failed to pass anything but fluid. After twenty minutes the nurse came back. "Any success?" "No," Kelly told her, "I think I’ve just passed liquid." "I’ll get another nurse to change you and then we’ll go onto the next stage this evening."
That evening, the curtains were drawn around her bed again after two nurses had come to her bedside with a trolley and equipment. Kelly was washed clean and very thoroughly creamed and her diaper changed, but not pinned up. Again the procedure was explained and she was asked to raise her good leg and move it to give the nurses more space between her legs. Her rosebud was lubricated again and ‘violated’ by one of the nurse’s fingers as she both lubricated her and dilated her. A double balloon silicone catheter was inserted and both balloons pumped up to make a seal around her back passage. Kelly really didn’t like this as she felt very uncomfortable with the balloon pressing against the wall of her rectum. She felt that she really wanted to have a b.m but couldn’t. From a jug of warm water, one of the nurses removed a container of arachis oil The nozzle of that was connected to the catheter and the contents squeezed into Kelly’s back passage. Kelly was told that her diapers would then be pinned on to leave the oil time to work in softening her stool. Pinning her diapers around the catheter which had been clamped off made rather a bulge in her diapers but the plastic pants were big enough to cover all of it. The nurses then left her and came back later with the same trolley, but different equipment. "Kelly, I’m going to sit you up as I need to put a tube up your nose, down your throat and into your stomach." The other nurse worked the controls of the electric bed to sit Kelly up. Her diaper region felt strange with the double balloon catheter end curled up inside her soft cloth diaper. A bib was placed around her neck and a nurse asked her to open her mouth. The other nurse gently inserted a dental gag to hold her mouth open. Lidocaine was sprayed into her nose and the back of her throat. When the nurses were satisfied that Kelly’s throat was sufficiently anesthetized, the gag was removed and the nurses passed the naso-gastric tube up her nose and down into her stomach, checking that it was in the right place by aspirating some stomach fluid which was tested with litmus paper, showing it was acid when the paper turned red. The tube was taped around Kelly’s nose. "Not the most elegant of jewelry!" one nurse remarked. The naso-gastric tube was connected to a large bag of plain water. Kelly was given an orange colored drink with a salty aftertaste from a large bottle with a teat for her to suck on. She was told it was Picolax - a very powerful purgative laxative to expel the, hopefully, softened stool. The bag of fluid was to make sure that she didn’t dehydrate overnight. Her diapers were removed and replaced with a much thicker layer of several cloth diapers and a pair of larger plastic popper pants. Before pulling the diapers closed, a kidney dish was placed under the tail of the double balloon catheter so that the oil could be drained out. Once all of the oil had drained, the balloons were deflated and the catheter removed. The ordinary hospital gown was replaced by a top which wouldn’t even cover the top of the plastic pants. "So we can see how things are going during the night, Kelly" Just before her diapers were pinned closed, one of the nurses gave her an injection of a sedative in her butt to help her to sleep, at least until the powerful laxative started working. One of the nurses said, "I’m afraid you may not get much sleep tonight, Kelly, once your bowels start moving, so try to get off to sleep as soon as you can. We’re doing this at night so that any smell is gone by the time the rest of the children wake up in the morning. We’ll let you sleep in the morning to catch up for sleep you’ve lost tonight." Kelly’s diapers were done up tight and the plastic pants carefully poppered closed around them. Pillows were propped either side of her to support her upper body and the fluid was started to drip through the naso-gastric tube to keep her hydrated when the laxative started to work. A young candy striper came through the curtains, after knocking verbally, and said to Kelly, "I’m Susan, and I’m to sit with you tonight to keep an eye on you." "Hello, Susan!" Kelly replied, "Thank you everyone. I’m sorry I’m such a nuisance." "Hush, now, Kelly," one of the nurses answered, "This isn’t your fault and we’re here to look after you!" With that the nurses left her, leaving Susan to keep an eye on her. Kelly settled her head back on the pillow, trying to go to sleep but worried about the events which the night would bring as the laxative worked inside her, robbing her of dignity and control."
What happened overnight? How did Kelly recover in hospital and afterwards? You’ll have to wait for the next installment!
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