Month: March 2017

Old Timer – The Crohn’s Saga Part 21

I was diagnosed with Crohn’s when I was 11, so I’ve been at this for a long time. I think a lot of people in my situation will relate to this. You sit in the waiting room and an older person comes in and talks to you like you’re a kid. Then, their mind is blown when they discover you have a ton more experience at this than they do. They usually don’t like that. It seems to happen every time I have a colonoscopy, small bowel MRI, or even blood work. It’s not my fault that what’s new for you is old hat for me.

Now, for the curious:

What is a Small Bowel MRI?

As I mention in my page About Crohn’s Disease, a small bowel MRI is a pretty standard test used to diagnose Crohn’s Disease and to measure the severity of a flare. Basically, you drink a contrast liquid (barium I think), get into an MRI machine, and then technicians take images of your digestion for an hour or so.

How do I prep for a Small Bowel MRI?

In terms of tests for Crohn’s, this one really isn’t too bad. You fast for 6-12 hours ahead of time, so try to schedule in the morning if you can. Once you arrive, you’ll be asked to disrobe, then drink 3 containers of the contrast. It tastes kind of like seawater. Unpleasant but manageable.

What happens in the test?

After you drink the prep, you’ll be guided to an MRI machine. This is basically a giant magnetized tube. They may insert an IV, then you’ll lie down and be moved into the tube. You have to try to be as still as possible. It is very loud and confined, so those with claustrophobia are sometimes drugged. You’ll lie there while the table moves back and forth, and you’ll occasionally need to hold you breath so they can get a good image. That’s pretty much it. Pro tip – try to find a hospital that will pipe in music.  Mine provides headphones and Pandora. It helps keep me calm and prevents me from getting too bored.

Final Exam – Let’s Go to School in Belgium

All of my exams in Belgium were one-on-one oral exams. Each class usually had no homework or papers, so this final oral exam was 100% of the grade for the class. If you were having an off day, too bad. If you prepared for 99% of the topic, but got asked about the 1% you were unsure of, too bad. It was tons of pressure, but I loved it. It made me solid at giving presentations, thinking on the spot, and feigning confidence. Professors would start with easier questions to make sure you knew the basics. Then, once they knew you would pass, they would continue to ask you more difficult questions until you were stumped. I swear this happened exactly as depicted. I ended up with an A out of sheer luck.

Prednisone Part 3 – The Crohn’s Saga Part 22

So much to share about prednisone. It’s common knowledge that prednisone gives you energy and increases your appetite. It is not as well known that it also can stimulate hair growth. So why isn’t it marketed and used as a treatment for that? Easy. It’s poison that destroys your body with longterm use. Prednisone also bloats the face and, even though Crohn’s patients typically lose weight, if they are on a high dose of steroids but can’t exercise, they get fat. It’s just a lousy situation overall.

At this point, I’d like to reiterate that I am not a doctor, but here’s some information about prednisone that I’ve learned from experience:

Why is prednisone used to treat Crohn’s Disease?

As mentioned in my previous comics about prednisone, prednisone is an anti-inflammatory steroid. During a flare, it is commonly used to help stop inflammation and boost other drugs so they can get a foothold.

How long will I need to be on prednisone?

It depends on how quickly you start to recover. In my experience, at least 4-6 weeks is typical. You usually never want to go beyond 3 months. The longest I’ve had to be on it was 8 months and that was hell. Be aware that you cannot just stop prednisone. Instead, you’ll need to taper down, usually by 5mg per week. So, 40mg to 35mg and so on.

What are the side effects of prednisone?

Short term: Uncomfortable amounts of energy, restlessness, decreased attention span, insomnia, aggression, increased appetite, weight gain, bloated face, nausea, bloating, acne, dry skin, hair growth, easy bruising, and an increased amount of time required to heal from bruises and wounds.

Long term: Thinned/brittle bones.

Any tips for dealing with these side effects?

For brittle bones, my doctors have always recommended calcium supplements. For insomnia, I’ve usually taken either melatonin or ambien. Regarding uncomfortable amounts of energy, restlessness, and weight gain, if I’m healthy enough, exercise will take the edge off. I once had a flare where I’d do 200 pushups and situps, and 100 pullups a day. However, if you are too sick to exercise, you’re going to gain weight. There’s also nothing that can be done about the bloated face (sometimes called moon face), acne, short attention span, or the rest. In my experience, it is best to let the people around me (family, friends, bosses, and sometimes co-workers) know what’s going on to try to get some leeway for my unpredictability.

Damned M&Ms – The Crohn’s Saga Part 23

“Damned M&Ms” brings up two common topics with Crohn’s Disease – self care and what should I eat during a flare. Let’s dig in:

Self Care:

With the pain, stress, and frustration of Crohn’s, self care becomes critical. When I have a flare, I try to eat right. However, I’m human. During a flare, I can’t exercise, drink, or enjoy most of my other outlets for stress, so I need to treat myself every once in a while. I need comforts to remind myself of why I’m going through all of this. Should I have eaten those M&Ms? No. Did I regret it? No. Did my fiancé understand? Absolutely not. During a flare, it can be difficult to balance of taking care of yourself and enjoying your life. It gets taxing.

What should I eat during a flare?

Experience is the best teacher here. Doctors will tell you to avoid nuts, seeds, and popcorn since they can get caught and cause complications. Spicy foods can cause irritation and pain. Raw fruits and vegetables can be difficult to digest. I also personally have the most trouble with oily and greasy foods. In terms of what works, my go to’s are peanut butter and chicken. Seriously. Creamy peanut butter and grilled chicken. I’ve heard that peanut oil is good for digestion. I’m not sure if that’s true, but I do know that peanut butter always processes smoothly and is a decent source of protein. Chicken is a non-stringy protein that is also easy to digest. And no, I have not been paid by either the peanut butter or chicken industries for my endorsement.

Philosophy Dog – All Sorts

They say that pets take after their owners. My fiancé got a dog a few months before we started dating. When we first met, the dog was happy, spry, and full of energy. Now, after almost 4 years of living with me, she sleeps a ton, gets moody, and is often contemplative. I hope I’m not totally responsible for that. At least she’s kept her sweet disposition.