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[Denise]

My name is Denise and I was just recently diagnosed with Crohn's at the beginning of May. This was done with a colonscopy (prep for that was horrible). Doc found a granuloma (can't remember where was I was overwhelmed with the CD dx as I really thought it was in my head and was going to be nothing) so we know for sure it's CD. I am now awaiting (impatiently) for a video endoscopy (PillCam). He told me it would be done in 2 weeks it's now 4. *sigh* No meds until then.

I have had symptoms since 2003. Had a barium enema and swallow at that time with no conclusive results so I was diagnosed with IBS. Symptoms changed in Dec 2010 with much more pain and blood. So that's how the colonscopy got ordered.

A bit fearful that I have CD in my SB as I do get thin stools and constipation at times and then bursts of D.

Oh and I'm 30 with two little wonderful boys (3 yrs and 1 yrs) and a super fantastic and supportive husband!

That's me.

 

[bruscar]

Welcome aboard Denise !!

 

[Astra]

Hiya Denise
and welcome

Good luck with the tests, hopefully they will start you on the appropriate med regime soon,
It's great that you've got a good support system too!
Let us know how you get on
lotsa luv
Joan xxx

 

[David]

Greetings Denise! I'm glad you found your way here I'm also pleased you finally got that colonoscopy so that they can get a proper diagnosis and hopefully get you on medication that will get you in remission!

That's fantastic you have a supportive husband, that'll make a world of difference and we're here for you any time you need us.

*hugs*

 

[Denise]

Thanks everyone!

 

[lulu2]

Hey Denise! Join the club!

Ok I'm gonna ask quite a retarded question (esp given my job lol)... but you said that you're worried crohns is in ur SB cos of constipation, thin stools and bursts of D.... is that typical of SB crohns? I know I've shared with you similar experiences and certainly my crohns is SB (and possibly R colon but colonoscopy couldnt get to there) but I was always under the impression from my own reading with my course and of course my clinical experience that such symptoms are unusual for crohns.... so where did you hear this? I'm really intrigued....

Thanks

Hope you're feeling well today!!!!

Lulu
xxxxxxxxx

 

[Denise]

Lulu

There is no retarded questions (only the ones that aren't asked). But I completely understand why you feel that way. It's hard of health professionals to ask questions because we feel we need to know everything or need to know the answer to the question before we ask it. I am a Registered Nurse with my BScN (Bachelor of Science in Nursing), since 2002 and I have worked in ICU, gen surgery, cardiac surg, palliative, and occupational health. So I also think I should`t have questions either!

So I read that constipation can be a sign of CD in the SB (Crohn`s Disease and Ulcerative Colitis: Everything you need to know by Fred Saibil MD 2009 edition). I believe that is because of strictures in the bowel or narrowing caused by active inflammation.

So this is my theory and I do tend of overanaylze (my husband says it`s a curse and blessing to know so much about the body and how it works). So if you have a stricture or active inflammation there would be decreased diameter size and stool would pass much slower there. (the SB diameter is only about 3 cm normally) This could lead to constipation or because of the smaller size of the bowel this would lead to the pencil thin stools. So I think that the body is like why aren`t things moving faster stool is backing up, so the bowel overreacts to get the stool out. Then you get the cramping and pain because I guess the stricture and stool in the stricture would be like a partial bowel obstruction or maybe just act like one. So you pass these thin stools but your bowel is still hyperactive trying to get stool out, so then you get the bursts of diarrhea. The mucus and blood would be from the stool hitting and rubbing against inflamed areas. But this is just my own personal theory. The only thing that I have medically found from a valid source is that constipation can be a sign of CD in the SB due to strictures or narrowing of bowel.

So that`s my theory. Please let me know what you think about it, even if you think it`s the most crazy thing you have heard. :redface:

I hope that you feeling well too! :hug:

Denise

 

[margie]

Welcome Denise,
I am glad that you are getting the tests that need to be done. And hopefully soon, the doctors will have you feeling better with the treatment that you need. I am also glad that you have such a supportive husband. That is great!!

 

[lulu2]

Denise, your theory makes sense to a point.... but surely any pencil thin stools formed in the small bowel are reformed in the large bowel (which we know in my own case on the LEFT side is healthy - the scope couldnt get past my splenic flexure as it was too tight and oh my word it hurt, i cried. I actually wanted him to continue but he wouldnt whilst i was crying and i couldnt help crying!!) so therefore surely any pencil thin stools should be coming from the large bowel?! This is where my confusion with the theory lies...... You could still be right, Im no expert on the bowel and have only just passed finals, whereas you have a good 8-9 years of experience!!

xxx

 

[MADiMarc]

Lulu,
You are wonderful! Keep listening to the nurses...they certainly saved my bacon over the years!

Denise,
I like your theory. My SB has a stricture and my colon is so diseased I think it's has outlived it's usefulness!
Michele

 

[Denise]

Lulu,

I actually really didn't think about what the large bowel would be doing in my theory! haha That's what happens when I overanalyze a situation. I haven't even talked about this with my GI yet because I am waiting (forever!) for that PillCam. You make a very good point about large bowel and especially if it's healthly (as it is with you - which I'm not sure if I knew or not). Perhaps the bowel is so hyperactive that it actually doesn't have time to change shape in the large bowel? (I know that's a long shot because I am not an expert by any means!)

Thanks for seeing my experience, although I don't have any active experience with Crohn's disease. My only experience with CD is when they were super sick in ICU with perforated bowels, fistulas, infections, sepsis etc. (which of course made me so scared when I found out I had CD as this was only experience with patients with CD) So we really didn't focus on what their bowel were doing. I wanted your thoughts because (as a doc) you guys do know more indepth knowledge then I do. We work best as a team!

Michele,
Thanks for your words. My theory makes sense for my symptoms. Because I do (at times) have normal looking stools and they are only pencil thin when I flare or when I get extreme pain at my navel area.

Thanks all!

 

[lulu2]

Michele, most of the nurses are fab and I know when i first start work in august and Im terrified and new the nurses are gonna be my saviours! Also whilst training, many a nurse was lovely to me, one day in the past yr I was v busy helping out the Drs cos we were short staffed and I didnt get a break, at the end of the day one of the nurses came in, saw we looked really tired and fetched me a lollipop and a carton of juice - LOVE that nurse!!! The ward Im on atm all the nurses are LOVELY - well actually except one of the student nurses who seems to have a bit of an attitude :-s but u get that everywhere!

Denise, you may still be right and I may be right also... I dont know if ALL my colon is healthy, my GI suspects the right side is not so we'll see....... I think rather than speculating we're prob best asking the experts.... as a junior doc this is WAY too specialised for me, I can manage an acutely ill patient and know enough to do that, but the details such as this is exactly what consultants are for!!! I honestly don't have a clue, but perhaps your theory is right... we'll see!

Im sorry you were so scared when you got diagnosed tho - remember the cases you've seen on ICU are at the most severe end of the spectrum and MOST people with CD manage to live relatively healthily and dont end up on ICU! It must be a scary place.... one of my jobs next yr is in anaesthetics and I'm told i'll do some (very supported and supervised) ICU time and Im looking forward to the challenge!

Nice to meet another medically person on here tho. I think its nice for everyone cos when ur patient its easy to feel so detatched from medical staff and we're just people who get sick and vulnerable too. In a weird way I'm kinda glad I'm sick.... I mean obv Id rather not be, but I DO think it makes you more empathic! I know how it feels to be that frightened vulnerable and v sick pt in the hospital bed, how powerless you feel and how sick you feel. I know how it feels to be very very sick, I've had a bowel obstruction, I've felt 10/10 pain. I'm glad I understand how my patients feel and how horrible it is to be stuck with needles endlessly and have everyone want to come poke your belly and listen to your heart. It sucks BIG TIME. But it makes me understand more and for that I'm glad! All I've ever wanted to be in my life is a GOOD Dr, ever since I was a kid, I think being ill helps me a little with that! I sound so naive LOL......

Hope you're all feeling well today!!

xxxx

 

[Denise]

Lulu,
Yep! Like I said it's only a theory based my knowledge of the bowel (which of course is nothing compared to a specialist).

I can totally take care of a crashing patient and those that are near death and I know exactly what to do. You will love your rotation in ICU. Yes, it's a scary place because the patients are sooo sick but it is very controlled. With the monitors, hourly vital signs, team of doctors/nurses/respiratory therapist - things don't go too wrong too quick. Just in those rare times with really really sick.

I know that what I saw related to CD was the extreme end but it is hard not to think about it and worry that you might be there too. I totally understand what you are saying that you are happy to know what it feels like to be on the other side. It really SUCKS! I was quite ill with my last pregnancy - fainting, heart palps, query PE and then hypertension (171/112). It sucked to have heparin, be confined to bed, and have stuff done to you. It does make you a more compassionate health provider for sure.

I hope that you are great today and you have to keep me update on what your docs say and of course how your residency goes. Is that what they call it in the UK?

Denise

 

[lulu2]

Your pregnancy sounds scary!! Pre-eclampsia? These experiences although awful DO make us better health care workers tho; nothing like first hand experience!

I'm pretty good today actually yeah thanks, still a bit sore but improving on 3 weeks ago (obstruction!!). In the UK its the foundation years - 2 years as junior doctors moving round rotations, 3 rotations a year. I start my first junior year this august. After that we start specialising. It's very exciting. How long is nursing school in the US?

Hope you are well today also! Keep me updated on what your GI says about the stools - I'd be very interested to know! Are you seeing yours soon? I see mine in early July.

xxx

 

[Denise]

Lulu,

Nope it wasn't eclampsia - just gestational hypertension. I never had protein in my urine or anything like that.

Your program sounds similar to the one in canada but I think that the residents (that is what we call our new doctors - R1 (yr 1), R2, R3, R4 (or chief resident)) do more rotations then 3 a year depending on their area. Then they do fellowships (but I'm not sure about that part). In Canada you have to pick your specialty right after med school and they interview you for the spot. That way they know how long to put you in each area. We always got R1 (first year residents) in ICU along with a chief resident to supervise. It was great to help them learn and for them to teach me as well.

I actually live in Canada. So the program I took is a 4 year university program where I get my degree. I have a BScN. Then you take a two day exam on top of your university program to get your RN permit. Then you can use the designation of "RN". Every year we have to do learning plans to show that we are staying current in our area.

Yikes to having an obstruction. I have seen that in patients but I don't know how it feels. That must have been scary! I am glad that you are doing better. How does it feel to be on pred? I am not lookin forward to the day I need that.

I don't know when I will see my doc. I am still waiting for that dang PillCam. So I will see him after I go for that. I am getting soooo impatient. I would like to get treatment started.

Take care! Let me know what area you are going to first.