Bottoms Up: A Peri Care Story

I was diagnosed with chronic myelogenous leukemia in 2011. Having an autoimmune disease means trying to avoid infections wherever we can.

My fellow blood cancer patients can relate.

Getting to the bottom on infections

When I think of an infection I think of Covid, or influenza, or viral pneumonia, maybe. I never really considered that infections can come from inside the body too. Seriously.

During an assessment before a scheduled colonoscopy, the surgeon was not impressed. After testing a sample (ahem) he told me we had to get to the bottom of things. I squirmed in my seat.

Out of balance fungus

Test results showed increased candida, a fungus that exists for all of us, but for me it was out of balance. My doctor explained that for patients treated with certain SMKIs there is an increased risk for invasive fungal infections, and other opportunistic pathogens that can cause disease. That imbalance inside our bodies can lead to infections we need to avoid.

My doctor warned me of perianal dermatitis. My doctor described it in no uncertain terms. It’s not to be tolerated, but avoided entirely. A real bummer.

Irritating symptoms include rash, itching, and sores. That oh-so-sensitive area can be swollen, painful, and littered with microscopic cuts. These are kind of like a papercut, only THERE.

Broken skin gives pathogens a direct path inside the body. My doctor called it an "opportunistic infection." For someone with blood cancer it can escalate to a terrible situation where a hospital stay and IV medications are warranted.

No ifs, ands, or butts about it

From my surgeon’s point of view that sensitive area needs proper attention. If we were to get that kind of dirt on another part of our body would we just wipe it with dry TP and go about our day? Would dry tissue paper replace a shower or bath? Good questions.

Stinks just to think about it

My doctor told me that there are problems with a deep “tissue” massage when we use paper products. Toilet tissue used on sensitive, easily infected skin can dry and irritate the area, breaking it down. Wiping with too much TP, or too roughly, can perpetuate hemorrhoids as well as anal fissures. Little bits of tissue can stick to the skin after wiping, making the issue worse. My surgeon had his speech well rehearsed. I could tell he’d seen things.

It’s not that easy to find alternatives though. Tissue paper of all kinds line the grocery store aisle from end to end, ranges of ply weights, puffs of tiny splinters, breaking down into fibers that pierce the skin.

If you are still with me, I can tell you don’t crack under pressure.

Let's get to the bottom of things

Cleansing means using soap right? Not so much. My doctor warned me, soap is a culprit to avoid using on particularly sensitive skin. It’s a harsh product that can dry out the area with repeated use. Soaps can contain dyes and perfumes which leads to a host of other problems we are meant to avoid.

So wet wipes it is! Not entirely. Wet wipes may have ingredients that interfere with the good bacteria we need there, especially when some wet wipes contain alcohol. Imagine that sting! A real downer for the derriere.

My doctor told me to look for dermatologist tested, pre moistened cleansing cloths. Some even contain aloe vera to protect that area’s bioflora. If needed, a spray perineum cleanser can be added. These are specifically designed, ph balanced, and dermatologist recommended.

When it comes to a confident clean nothing beats plain ole water. The surgeon described a sitz bath as an easy, non pricey thing to consider. It’s like a shallow bowl and can provide relief, ease pain, and keep that area safe from infection.

The fanny ain’t fancy

My doctor mentioned that hand held bidets can be used to spray the area with warm water. Dab area dry with a soft cloth. Something to consider is a bidet installed in the bathroom, but the cheaper hand held options can be just as effective.

Products of this status are often marketed as “ incontinence care” or “bedside care” or “alternate care” and we can find ourselves searching some dark corner of the pharmacy wondering what we are doing there. Truth is, we don’t have to be incontinent or need bedside care to avail of these products for ourselves. Think of it as a luxury rather than a deficit. Top tier heinie hygiene.

Go ahead, be cheeky about it.

My colonoscopy results were good and my surgeon gave me the advice I needed to avoid his emergency room. If these infections are opportunistic, then it’s up to me to remove that opportunity. Challenge accepted!

I wonder if my fellow blood cancer patients have needed to reconsider their bathroom basics? Let me know in the comments below. Thanks so much for reading.