I have continued to give Anthony the maximum dose of stool softener each day. He finally had another bowel movement last night, five days after the previous one. We dealt with a related problem this morning, however, when Anthony soaked his bed rather than getting up to urinate. We have found that, as he becomes more constipated, he also has trouble urinating. To try to ameliorate both issues, we try to give him more water. Usually, if he doesn't go to the bathroom in the evening, we can still count on him to do so in the morning. I guess since he had a bowel movement last night, the extra water was too much for him. He still could have gone to the bathroom rather than staying on his bed. Fortunately, we are somewhat prepared for such cases, and keep a pad on his bed under his sheet. As a result, a small portion of the mattress was all that was affected this time.

I was telling a friend recently about Anthony not having a bowel movement. She alerted me to the existence of magnesium citrate as the laxative used to clean out the colon for surgery. I mentioned it to my father the next day after I had given a ten-ounce bottle to Anthony in the morning. He confirmed that it was used for colonoscopies, saying, "Oh, that stuff will give him the squirts!"

Well, Anthony drank it at 8:30 am Saturday. I was hoping for a quick resolution, but the packaging did say it could act any time within 30 minutes to six hours from consumption and, knowing the severity of the problem, I wasn't surprised when I didn't see any progress right away. I became concerned, however, when evening approached with no change. I did not want to deal with him getting up to go to the bathroom at 1am or, worse, NOT getting up. We have dealt with that extremely unpleasant development previously. Fortunately, he started acting suspiciously around 8:30pm, so I had him sit on the toilet. By 9pm, he had finally gone. Nevertheless, it wasn't the mad free-for-all that I had feared. I expected to see more the next day, but didn't. So, I gave him the maximum dose of a stool softener, a Dulcolax generic. Nothing the day after that. Same thing again with the stool softener. Finally, three days after having the first bowel movement from the magnesium citrate, he had another last night. Again, though, he is not putting out anything approaching what I would expect. I did give him the stool softener yet again last night before his bowel movement, and I'm hoping for better results. The worry for me is that I can't be sure when enough is enough. We have had a horrible "accident" in the past when I tried with laxatives to regulate his constipation, so the last thing I want is to overdo it again.

Until very recently, my wife and I had not found a medication that works to keep Anthony from getting rather violent in an instant. We are now using one called Abilify, though, and it seems to be working. We have even gone a couple of mornings with no outburst whatsoever when we get him out of bed to go to the bathroom and change his clothes.

However--and this could turn into a very large "however"--Anthony generally goes five or six days between bowel movements. Now, we are up to eleven days since the last one. The doctor did not mention constipation as a possible side effect, but the medication packaging does indeed have that on the list. I have given him stool softener a few times in this interval, with no effect. He also seems even less interested than usual in eating, which obviously doesn't help. Tonight, we made a concerted effort to give him a lot of water and as much food as he would eat. Nothing just yet.

I guess the draw to his old tune was too strong for Anthony. After I posted about Anthony having changed his melody on the electronic keyboard, I heard him playing his original song later that evening. He has turned the keyboard on several times since in the next two days, and has not deviated from that. I don't dare try to finish his tune for him again, though.

Anthony likes instruments that make noise. It can be an actual piano or a toy of some sort. Years ago, he had a Winnie the Pooh piano toy that played one of the various melodies from the cartoons when its keys were pushed. He did that over and over, to the point that my wife and I were glad when the batteries ran out. We had forgotten about that until fairly recently, when he started playing simple melodies on the electronic keyboard in our living room. He pushes each key individually, and actually created his own melody that he would play, with very little variation, at least once or twice a day. A few days ago, he started playing his little composition again. Knowing what was coming, I finished the tones vocally before he did on the keyboard. Illustrating that he does have some brain activity--and I don't mean to be facetious, but we unfortunately don't see much of it--he actually looked at me mid-melody after I did this, stopped playing, and turned the keyboard off. Maybe he didn't like me finishing his song! Evidence supporting that idea came subsequently when he actually changed the tune; we haven't heard the previous melody since, although the ending is still the same.

His interest in the keyboard reminded us of the Winnie the Pooh toy, which we no longer have. We are regularly looking for something that will interest him when he is in his own room as well, so we dug out a Blue's Clues toy that our youngest child outgrew a few years back. The player pushes a picture on a grid of items in Blue's house, and "Steve" gives the player clues. Anthony isn't interested in (or perhaps doesn't understand) the intent of the game, so we regularly hear, in rapid succession, "It's in the living room", "It doesn't talk", "You can put things in it", etc. Sometimes, he pushes the various pictures so quickly that we hear only snippets of each phrase. He eventually pushes the picture that was the object of the search, and "Steve" will say, "You did great! Let's play again," and the sounds begin anew. We wish we could adjust the volume.