All of these posts are good!! I use the knees at a 45 degree angle method, even using a low bench in front of the toilet to rest my feet on.
This other method works great for me, and I've recently been doing this: poking my fingers at the peri-anal skin during my push, to guide the excretion out towards the anus from the outside. Usually the stool is right there, and just can't broach my sphincter muscle. Maneuvering it into place with a sustained poke at my skin only takes a moment, and it helps for it to pass.
It's a lot less invasive than trying to segment the stool with my inserted finger for easier passage. And although my hands do get wet from urine during my pushes, they're a lot easier to clean afterward than if I had to scrape feces out from under my nail. With this method, I've also been able to limit the times I do get a "blossom," a prolapse, when the rectum pokes through the anus.
Sorry for all the biology.
~nelly~
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Option which works for me... squeemish need not read--
