Julieanne,
They didn't want Angelo to go more than 3 days without a BM. I don't know if this is different for everyone, but the nurse should be keeping track. If she is still eating she obviously needs to get rid of the waste. The problem with narcotics is that they need as much liquid as they can get to be effective. If they don't get it from added water to the diet, they will literally suck all moisture it needs out of the body, hence very hard stools, and without any moisture are very hard to pass (constipation). If she feels like she needs to go but can't that is a warning sign to either try the lactulose or enema. Once it gets to that point, the senna and stool softners are of little help because they are designed to help to softnen stool as it is formed not after. The bowels will start slowing and eventually shutting down, as she eats less and less. But fluids are still very important.
There is a SQ (sub qutanious) pump available that we found very helpful. It gives the medicine 2 ways...There is a basal rate which is a set amount of medicine that the patient gets every hour. and there is an option to get a Bolus rate for those times when they need a bit more they (or you)can press a button and get it.
It comes with a fanny pack which makes travelling alot easier, and the ups and downs of pain control are a thing of the past.
Here for you,
Karen