Hello All - My Crohns Story with Surgeries

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Joined
Mar 13, 2010
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Hi Everyone,
I've had Crohns for over 20 years now. It started for me when I was 20 years old. Back then it started as a blockage in the duodenum. My mother has Crohns so we were not strangers to it and my journey started! After a couple years, I got burned out by the inability of docs to really help my symptoms. I can also remember an upper GI endoscopy without sedation! (don't let that happen to you!) My main problem became diarrhea, gas, and urgency. I usually never had any pain. Looking back now, that was probably a bit of a curse. Not having pain let me ignore my condition and just "do the best I could". For about 15 years I stopped seeing a GI doc and just dealt with my symptoms.

About 4 years ago, I had a yearly checkup with a family doc, and he read me the riot act. Said I was "in denial" and that I should be under a GI's care. After my initial anger, I realized he was right, so I reentered the world of GI docs.

During a colonoscopy 3 years ago, the doc found a mass in my transverse colon. He seemed a bit freaked out by it. I was too! The biopsies came back negative, but he said it really had to go. I used a top surgeon at Mt Sinai and left myself in his hands. In Oct of 08, I had an extended right hemicolectomy. They removed about 1/2 my colon and ileocolic valve. Looking back now, I wish I had pressed the surgeon on exactly what he was going to remove. Since that surgery, my diarrhea has gotten much worse. I had never been woken up by diarrhea, but now it was common to awake 3 to 5 times a night. What a nightmare. I know the hemicolectomy was the proper protocol for my case with suspected malignant tumor. Since my tumor and colon came back completely benign, I just wished they had just done a simple resection.

I recovered from that surgery but was never really the same. The lack of sleep and constant diarrhea were really wearing me down. My local doc would do all he could, but nothing worked to stop the diarrhea. I did my own research and would even recommend things to him, like Questran. Nothing worked. I even tried LDN and the Specific carb diet. I was also on Humira before my surgery and stopped it for the surgery. (I'm back on it now).

About a year after my first surgery, one day I just was not hungry. This was unusual for me. Pain developed and later that night I went to the Emergency room. They admitted me and started the torture. Drink the CAT scan solution when I told them I could not eat anything. One mean nurse just could not understand that! She might as well asked me to run a mile. Anyway they admitted me, and the next day while walking around the floor, I had the worst pain I have felt in my life! Yes, it even beat an old dislocated knee which was the former #1. I barely made it back to my room - probably screaming all the way. That is all I remember until after emergency surgery and I woke up the next day. It turned out to be a perforated and gangrenous small bowel. Go figure, this was completely out of the blue.

They removed about 1 foot of small bowel and sent me home after about 5 days. Once home I did not do well and ended up back in the hospital. My guess is that I was having withdrawal from Dilaudid. That is one powerful pain drug - and I was really enjoying it in the hospital. I read online that one nickname for Dilaudid is "hospital heroin". At home, I was not able to eat much, and was having extreme chemical smell sensitivity, and recurring disturbing nightmares. Not typical for me. Anyway, time and getting some IV fluids in the hospital did the trick and I was released after 2 nights.

About a week before this emergency surgery, a colonoscopy had found some low grade displasia in my colon, with "foci" of high grade. So I was thinking of that during my hospital stay and getting pretty depressed. It was one area of dysplasia out of about 12 biopsies.

A coworker of mine recommended Dr Present in NYC for a consultation. I think my case was getting complicated for my local GI doc. And that is what Dr Present said as he read my sad file. "Complicated". I had read that he does not rush to remove the colon when low grade dysplsia is detected. He recommended a chromoendoscopy with his partner, Dr Marion. Chromoendoscopy is a colonoscopy where they use blue dye to help better detect dysplasia.
I had that done one week ago and I'm waiting for the results.

He also recommended low dose codeine for my constant diarrhea. My local doc received his letter and started me on 15mg. Finally something that worked for me. It gave me control of urgency and I would only wake up at night once or twice instead of 4 or 5 times. But during the day (at work), it really made a difference. No more accidents and close calls.

Ah, I'll also mention I had a seton procedure about 4 weeks ago. I had been living with a fistula and "on and off" abscesses for a very long time. Like my other symptoms, just dealing with it as best I could over the years. I had learned to sit on one cheek for so long it is now a habit! So finally I mentioned this to the colorectal surgeon who had just performed my 2nd surgery. He recommended a seton, which I never heard of. It turned out to be a drainage seton (as opposed to cutting) and I have two of them. I read all I could before my procedure so I knew what to expect. I read that some folks were surprised and horrified to have an open wound after the procedure. The surgeon did not mention that, but I did have one - it was about the size of a quarter, with the seton string coming out. The surgeon also reported that I have proctitis.

Now, 4 weeks later, I'm glad I did this. But the 1st two weeks were so challenging and painful. The slightest tug on the seton string would bring extreme pain. So you can imagine sitting and shifting, and bathroom functions were difficult. I also did not take any time off work, and I sit all day, so that was hard.

So now I wait for the biopsy results - more dysplasia and/or definite high grade dysplasia probably means a total colectomy and Ileostomy. Maybe if the results are similar to before, with just low grade, I'll just play the waiting game with another chromoendoscopy in 6 months.

Anyway, that's my story. I'll follow up in the next few days on what the biopsy results are. Thanks for reading! I'm happy to hear any advice or your thoughts.

-Joe (43)
Prednisone - 7.5 mg (weaning - trying to get off this finally)
Humira - 1 shot every two weeks
Asacol - 12 a day
Protonix - once a day
Codeine - 15mg - 5 times a day
Cortifoam - twice a day - (Dr Present just prescribed this - instead of Rowasa enema)
 
Hi Joe

Good God! I feel so humble, I feel so shocked, all these things you have been through is truly inspiring to all the people with Crohns! There is nothing I can say to you that you don't already know, only I'm so glad to have you here, you will be a great asset to this forum!
Your story has really touched me in terms of I feel like I moan for nothing, about little stupid things that are immaterial! irrelevent! and downright petty!
I haven't had any Crohns surgery, yet! fingers crossed, but just wanted to say
Way to go Joe!
lotsa luv
Joan xxx
 
Hi and welcome,
Thank you for your story.......
wow it sounds like you have had an unbelievably tough 20 years!!!
You are a true veteran of this disease.
I am glad to hear you seem to be finally getting somewhere with it.
I'm sure you'll find a lot of helpful advice and support here.....

Stay strong

m
 
Hello Joe,

Another 20 year+ survivor here. I too had an extended medical hiatus after surgery. In retrospect, not a good decision.

Welcome to the forum.
 
Hi Joe -
Glad you found us. I have never heard of low dose codeine to control D, but a friend of mine says that his D gets better when he is on Vicodin. (Those are similar, yes?) The only problem I see with that is that codeine is an nsaid (I think) and nsaids are not supposed to be taken by people with Crohn's.
Anyhoo - I guess it's another tip to keep in the back of our minds, so thanks for sharing it.
You're right - that is a complicated story you've got there. I hope your results come back favorably.
Welcome to the forum!
MBH
 
Welcome to the forum Joe! I had a colostomy in December and it turned out to the best thing for me! Hopefully if you have to have surgery (again) it will bring you relief. Good luck!
 
Thanks for the warm welcome everyone!

About codeine, yes it's similair to Vicodin in that both are opiates. The 15mg dose is very weak compared to the hydrocodone in Vicodin. So, still some dependancy issues but not like the stronger drugs. I don't notice any effect besides the diarrhea relief. If you have tried everything for diarrhea like Imodium, Lomotil, Questran, etc, with no relief, it's worth a try.
Only trouble is, it only lasts about 4 hours, so I'm taking it 5x a day (including a 3am dose - ugh).

-Joe
 
Hi Joe:

Welcome to the forum! Your story is really interesting - you have been a though a lot in 20 years! Good luck with the biopsy results. Fingers crossed for good news.

-Amy
 
:welcome: Joe. Sounds like you really have had a challenging type of things. Hope your biopsy results come back with good news! Thanks for sharing your story with us all. I think you'll be a great asset to this forum as well.
 
Well, I finally got my results. I was expecting bad news so I was not surprised. The doc said things don't look good. He wants me to come in for an appt with my spouse. He said it gets emotional. I guess so, but like I said this is not exactly a shock.
So I'll go in, he'll probably tell me to have my colon and rectum removed, and recommend a surgeon.
I was just reading the uoaa ostomy forum and it sounds so horrible. People talk about the smell, leakage, sounds, and on and on. I just don't know what to think.
I can imagine some good things, like no more colonoscopies, and no more rushing to the bathroom. And maybe I'll sleep thru the night for the first time in 2 years.

Here is my Pathology report: samples A to G
A,C - Mildly active chronic colitis.
B - Mildly active chronic colitis, positive for low grade dysplasia
D - Mildly active chronic colitis. Indefinite for dysplsia.
E - Severely active chronic colitis with ulcer.
F - Severely active chronic proctitis with ulcer. Indefinite for dysplasia.
G - Severely active chronic proctitis, positive for low and high grade dydplasia.

Thanks for any comments, advice, or support. I just had surgery back in Oct, so the thought of another so soon is a real downer! And I keep thinking about having a bag as I go through my day. Sitting on the couch, what would the bag feel like, would it be uncomfortable, would I be thinking about it? Playing with the kids, would I always be worrying about them jumping on it, etc.

Bummed out in NJ,
 
Hi Joe,

I have a bag, and once you get used to it, you don't even notice it's there. I haven't had any problems with leakage, or smelliness (I put a splash of mouthwash in mine and that works wonders!), I do however make sounds that at first were mortifying....lol If your friends and family know that you have a bag and you explain that you can't stop the noises, it becomes pretty commonplace and people stop mentioning it. Plus, I found that if I put more than one layer of clothes on (ie. a pair of spandex shorts under my pants) that the sound is muffled and can barely be heard. That also flattens the stoma out a bit so it's not noticable under your clothes.

In regards to leakage, if you're having a colostomy you shouldn't have problems with that, as your stools should be very well formed. I think people with ileostomies tend to have that problem more often as their stools are not as formed (could be wrong there, feel free to correct me!). Mine are actually so hard that I don't have to use the paste around my stoma anymore as nothing gets under my flange whatsoever :) It's been pretty good that way.

About worrying about kids etc, you do have to be careful that they don't go crashing into your stoma as it can get damaged. I have a 9yr old and a 4 yr old in the house, and I just told them that they can't jump on my tummy anymore. Besides that, everything else has been normal. It hasn't affected my movements or anything like that. I will admit that at first I was very conscious of it...but it's been 3 months since I got it and now I barely think about it.

The best thing for me about getting the bag has been the immense relief from the disease. The first night that I slept right through was amazing! I hadn't done that in about 2 years. I also like the fact that I'm not on any meds anymore (not for Crohn's anyway). I may have to go back on them at some point, but as of now my doctor says it looks good and we'll keep off them for the time being. I do have to go back and have another surgery at some point to get my rectum removed (they kept it in in case I wanted to have my ostomy reversed, which I don't), but I'm not overly worried about that either.

By the way, they can do a colonoscopy with a stoma...they just don't do it often as you can damage it.

If you have any questions, feel free to contact me...as you can see I love talking about Oscar!! lol (yes, I named my stoma)

Good luck!
 
Thanks for the encouragement Nyx! Your positive attitude is amazing. Did you at least go through some depression when you first got your ostomy, I mean Oscar?
Have you experimented with different brands, etc?
 
I didn't have time to be depressed! It was an emergency and when I got out of the hospital and felt soooo much better, depression didn't even cross my mind! Since my stoma's permanent, I've just decided to embrace it and make the most of it. Fortunately, it hasn't taken that much effort! I'll admit to being shy at going out at first, but I got over that fairly quickly too; I'm not much of a hermit so that helped alot as well. And it was a bit weird in regards to intimacy, but my bf's been soooo supportive in that area that it hasn't been too much of a problem either (I had a problem way more than he has...I was shy to show him the 'new me' at first).

As to experimenting with different brands, yes. Get your ET nurse to give you the 800 numbers for the ostomy appliance companies. They'll send you free stuff to try - it's fantastic! I started off in the hospital with a one piece bag, which I hated! As soon as I got out, I called Coloplast, Convatec, and Hollister and got them to send me samples of 2 piece bags with vents and I've been trying the different ones since then. So far, my favourite is the Coloplast - not only is it the cheapest, it's the most comfortable and seems to have the best locking system for the bag (I can yank on it and doesn't come off...lol). It's also the best flange if you want to go swimming or in a hot tub...it's kind of plasticky rather than fabric and seems to stick better than the other ones. All you have to do is blow dry it on low and it gets sticky again so you can stick it back in place. I've also bought a latex cover for the stoma for bathing/showering, but it was a bit of a disappointment - because of the placement of my stoma it doesn't quite fit right, but it's ok for just showering...I can't remember the name of it right now, but I can post that for you later if you're interested.

I guess I've rambled for long enough...lol..any more questions..feel free! And again, good luck to you!
 
I had an illeostomy when i was 16, for 6 months and then they reversed it.

I remember initialy i was looking forward to the reversal, but when came the time, i was hesitant, i was already very comfortable with it. Its a plus not having to run to the bathroom, and taking less time to empty your bag than to urinate.... its alot of time saved and its convinient.

8 years ago there were 2 brands of supplies available available to me. The are slightly diffrent one from another, but i felt much better using one brand over the other. I was explained the product options after my surgery and they show you the best techniques as to how to put it on. There are specialised nurses for this called stomeotherapeute.
Most people, like you see on this board, are very happy with their stoma. And I might consider putting it back in the future. I would suggest not thinking about it too much before the surgery, everything falls in place afterwords. For me it was a liberating experience. It does not put limitations on your life, its the oposite.

You were woried about how 'fragile' that thing is in regards to playing with your kids and stuff.... I dont see any problem of having your kids jumping on you at all, maybe not the first week after surgery. Everyone has their own sensitivity. But my friends didnt even know at the time I had a ileostomy, it's that discrete, and we played basketball and stuff... The only thing i was worried about is my friends fiding out and me having to explain.

Back then, my doc told me about one of her teenage patients who was a competing Balerina Champion................ with a stoma!
 
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My Update:
Today was my appt with Dr Present in NYC to hear officially that I need a total protocolectomy. That was anticlimatic because I have been preparing myself with you nice folks! Also, its probably easier at 43 to accept the inevitable then when I was 20.

He recomended a surgeon (Dr Bauer - anyone use him?). Then he asked if I had time to see him today? Humm, we're already in NYC, why not? So, off we go in a taxi to his office. His office was pretty busy, and I waited about 1.5 hours. But hey, I didn't really have an appt.

Once they called me , the nurse said he wanted to examine me, than talk. I don't know about you, but I hate the surprise examination. Next thing I know, it's roll over onto your side and he was probing my least favorite area to be examined. But, he was very gentle and caring.

He was very concerned about the high grade dysplasia and told me I should take care of it sooner than later. Like how about the next week or two.
Thanks to this board and some others, I did have some questions in mind and he took the time to answer them. I was getting a pretty good feeling about this surgeon so next thing I know I'm signing on the dotted line.

I'm scheduled for April 15th at Mt Sinai. Sooner than I was thinking, but lets get it done, right?

One thing that was a bit troubling was that he explained that with my level of rectum inflamation and fistula, he would normally elect to do a colectomy, and then wait 3 to 6 months to remove the rectum. But, with my dysplasia in the rectum, he feels that we should remove it right away, rather then potentially let a cancer grow. The downside is a 30% chance of delayed healing in the perianal area. I've read some horror storied about perianal incisions that take months to heal, so that is scary.

All in all, I'm feeling pretty positive about this. Which is surprising to me.
 
Thanks for the update Joe...I hope it all goes smoothly for you! I wish they'd have removed my rectum at the time of my surgery (I'd have rather had only one surgery rather than two). I think I'd take the chance of delayed healing if it was me...but that's just my opinion.

Good luck!!
 
Hi Joe
Good news!

Fingers crossed that this will be the one! And your quality of life improve
Future cancers is the main reason why I opted for a total hysterectomy many years ago, they wanted to remove an ovary, and I asked for it all to be removed in one go, why have something inside you that's only gonna shrivel up and become diseased and cancerous later? I made the right choice.
Good luck Joe
xx
 
Joe, I just want to wish you the best of luck!!! Hopefully this will be the ticket to getting you healthier in the long run!!!

Take care -

Candace
 
Joe, good luck! Dr Present and especially Marion are some of the best ain the business. Mt Sinai is as good as they get and have tons of experience.
Please keep us posted
 
Hi Cindy, I have a question about Oscar: do you have empty it during the night?
Have you taken a flight with Oscar? did it behave?
thanks
 
acg101..I don't have to empty it at night most of the time (only had to once, but I had an upset tummy). I try to change my bag just before I go to bed, and I rarely have any activity during the night. I'm actually very regular now! Right after lunch, and between dinner and bedtime are the times I have the most activity.

I just recently had a flight from Barrie, ON to Calgary, AB (which is about 4 hours) and Oscar behaved fairly well. It was the time of day where I have the most activity, so I did have to empty the bag on the plane, but it wasn't that bad...just not enough room in that damn bathroom! lol I find emptying my bag pretty simple because my stools are so formed, it's not messy at all.

Hope this answered your questions :)
 
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