AH> MH>  We have had to use a combination of Miralax and enemas   
   AH> MH>  to keep things under control.   
   AH>    
   AH>    
   AH>           You do what you have to do, eh?  Sounds familiar... [wry grin].   
      
   Yes.  Very true.   
      
   AH>           Glad to hear that!  In SURVIVOR we answer when we can &   
   AH> whatever   
   AH> you have to say won't be dismissed as "old news" within the next few   
   AH> days....  ;-)   
      
   Good to know.  :)   
      
   AH>           So the "transition zone" has in effect been stretched by the   
   AH> lack   
   AH> of response lower down, and now you're trying to get it to shrink back   
   AH> again   
   AH> with more aggressive use of laxatives & enemas??  I'd say it's worth a   
   AH> try....  :-)   
      
   Yes, that is exactly right.     
      
   Hirschsprung's is when there are no Ganglion cells present in a section of the   
   bowel.  Normally, these cells migrate down the entire bowel before birth.  For   
   unknown reasons, in people with Hirschrung's, the migration stops too soon and   
   doesn't go all the way to the end.     
      
   The "transition zone" is the area of the bowel that goes from having the   
   Ganglion cells (which are needed for mobility) to where there are none.  The   
   Ganglion cells tell your brain (automatically) that something is there and   
   "move it along".  Without these cells, the only way to get things moving is a   
   manual/physical stimulation like an enema.     
      
   AH>           I'm not a great fan of surgery either.  I reckon it may be   
   AH> necessary at times when there is no other long-term solution... and that   
   AH> does seem to be how things are re the portion with no nerve cells.  But I   
   AH> understand why you'd want to keep any surgical intervention to a minimum   
   AH> in   
   AH> this case.  As a parent I've balked on occasion at somebody's idea of a   
   AH> dramatic rescue mission... and eventually forced them to admit they could   
   AH> probably use a kinder & gentler way of achieving the same goal.  If   
   AH> laxatives & enemas don't work, you'll know you tried.  But once a bit of   
   AH> anatomy has been removed you can't put it back.  :-)   
      
   We just had an abdomen xray this past weekend.  The official results are not   
   in yet, but from what I saw - the plan appears to be working!  The area is not   
   only not as wide, but not as long either.  By a good inch or two.     
      
   The less that needs to be removed, the better the long term success.  There is   
   about 6 inches that have no cells that have to go.  There is another 6 inches   
   that is distended - of good working bowel.  If we can get that to maybe 2-3   
   inches, that would really help.  From what we have been told, you can have up   
   to 12" of bowel removed with no real long term side effects.  My personal goal   
   for him would be no more than 8" (since 6" is a given).   
      
   - Mark   
      
   --- WWIVToss v.1.50    
    * Origin:  http://www.weather-station.org * Bel Air, MD -USA (1:261/1304.0)