Weight loss and sleeping a lot: Crohn's or College life?

[xmdmom]

My son weighed himself today and he lost 5 pounds since Sept, which he attributes to not eating regularly. In addition, his sleep is off and he's been sleeping a lot. Today he woke up at 5 pm. That has to be some kind of record!
He's away at college so it's difficult to know everything that's going on. He has had more "gas" but otherwise ok. He went down on budesonide to 6 mg a day about 1 month ago and continues on naltrexone 4.5 mg. I'm wondering if he should get a blood test (CRP), go back up on budesonide or just monitor. He's 125 lb and 6 ft so I'd hate to see him lose anymore or have a flare. He has 2 and a half weeks of stress until the end of the semester, or possibly more if he takes an incomplete, which is a possibility.

 

[Clash]

My non IBD daughter is at college and will be a junior at the end of this semester. Her eating habits and sleeping schedules are horrendous! I know hers is due the college life. She called this weekend to say she had lost 6lbs in the last two weeks or so and wasn't trying. She says it is so hard to find time to enjoy a meal and finds she is often not hungry. I'm chalking it up to college fun, semester end stress and a new work schedule since she has no other issues. But since it is your IBD'er having these issues a quick labwork check wouldn't hurt.

Hope it is just the college grind and all is well!

 

[AZMOM]

I'm with Clash.....a blood test will either give you piece of mind or let you know that it's time to "baby" your college student.

Hoping it's just typical college sleeping.

J.

 

[Brian'sMom]

XMDMOM, Do they not have anything to protect crohn's kids in college like they do in elementary/junior high/high school? Like a 504? I don't think they should be able to give him an incomplete when he's at a disadvantage compared to a kid without this horrible disease.
I also agree a blood test couldn't hurt. Its easy to do and tells what is going on.

 

[Patricia56]

What does your son say about what he thinks is going on? Does he feel like he's getting sick?

My son (almost 17) generally knows how he is doing.

So I would be at least partly going off what my son said.

The other thing would be if these would be typical symptoms of a flare for him. If he normally just loses weight and gets tired then I can see doing labs. But if his typical symptoms are diarrhea and fevers - well then I think it's just stress and poor self-care and the lab would be a waste of $$.

Stress can elevate your CRP levels so you may get a "false" high read due to that.

And I would be checking with his GI before changing dosage of meds.

 

[jmckinley]

Could be either one. I agree with everyone. When in doubt, do bloodwork. It doesn't hurt anything and will relieve your mind if it comes out okay. If he's not eating regularly, he's probably not eating well either. I'd ask what he is eating. That could be causing the gas even if things are okay and there's no flare.

I hope you get some answers soon. Tell him to take it easy for the next few weeks. If it's just college life and no flare is going on right now, he doesn't want to bring one on with the stress.

 

[DustyKat]

My daughter is away at university and is solidly in remission. Our academic year is from January - December so from September through October 2010 and 2011 (the winding up of Semester 2) she went through a stage of weight loss that was accompanied by a loss or reduction in appetite, disrupted less and generally feeling unwell. I also was concerned that this was Crohn's rearing its ugly head again but in her case it turned out to be stress and once things settled all returned to normal.

I personally would have them run the full gauntlet of base line bloods and also include inflammatory markers and Iron Studies, Folate, B12 and Vit D.

I hope things settle for your son soon Mum. What a worrying time for you...:hug:

If you are interested this is an old thread about my concerns that covered that 2 year period...

http://www.crohnsforum.com/showthread.php?t=12549

Good luck!

Dusty. xxx

 

[xmdmom]

Thanks everyone!

Brian's mom- he is registered with disabilities. An incomplete is an extension to finish work; after the work is completed, the grade is changed. Unfortunately, all work must be finished within 3 weeks of the end of the semester.

Particia- my son is not sure if he's getting a flare. He thinks he feels a little worse since decreasing budesonide. When he was diagnosed in the spring, he had weight loss, sleeping but also diarrhea and abdominal discomfort.

He decided to increase the budesonide to 9 mg w/o checking with his doctor. Yes I did tell him he should email to ask or at least tell his doctor what he did.

I can tell him to get a blood test or email his doctor, but he may or may not do any of those things. He's very busy and he sometimes forgets or has other priorities. He's 19 and has ADHD which makes it challenging for him (and me too.)

 

[izzi'smom]

Ahhh, the challenges of having an older IBDer...forever wondering if they are doing with their medical care what you would want them to do. I don't envy you, and I am not looking forward to those days one bit.
I'd also get bloodwork. It may be a bit of both. Hoping his weight loss stops either way. (((HUGS)))mama!

 

[Tesscorm]

yes, I'm learning that having an older IBDer comes with new challenges! :ybatty:

xmdmom, I agree with all the great advice already given... I agree that school could very well be the culprit now but I, too, would encourage blood tests (if only for peace of mind!).

One other thing, I know this has come up before (perhaps, you've said he doesn't really like the drinks???) but using Boost, Ensure, Carnation Breakfast as a regular supplement would certainly help with his weight, energy and nutritional levels. I know it's hard getting 'kids' this age to comply (Stephen's at home, where I can nag him freely :emot-cop:, and I still struggle with trying to get him to follow certain things!) but maybe you can just try to suggest it... (By the way, if he doesn't like the milkshakes type of drink, there is a brand that makes a juice-type drink, I believe it's called Breeze??? and Nestle also makes a nutritional 'pudding' - you can find it if you google Nestle nutritional products.)

:ghug:

 

[Patricia56]

Xmdmom -

My experiences with the "adult" MALE IBDer is the reason I responded the way I did. My male IBDer has been in semi-open rebellion since he was 14 so I've had some time to get used to the shift in power that comes with advancing age. (The whole process has left me feeling older that's for sure.)

What he thinks is going on is what is important as a general rule - not what I think is going on.

The problem with increasing his budesonide is that it is likely to make him feel better just because it's a steroid and that's what they do. Yes it's systemic effect isn't as strong as pred but up to 21% has been systemically absorbed in studies of normal folks. So it might confuse the question of whether he's just generally run down with whether he's having IBD symptoms.

But from your son's perspective I'm sure it's an easy fix.

As long as he's not on Entocort long term - more than about 3 months total - he's unlikely to have any significant systemic effects. But long term use is associated with the same kinds of loss of bone density as prednisone.

If he's already been on pred mulitple times or for long period and now budesonide I would strongly encourage him to ask his GI for a DXA scan (unless he got one from his Ped GI recently) to check his bone health. He doesn't need a spinal fracture on top of starting college.

As for running labs, I have become sensitized to the cost of indiscriminately running labs. Here it costs over $2,000 to run the full set of labs my son's GI normally orders. Our HMO covers it completely but I got a bill once by accident that showed the part the HMO paid and I was blown away. That is a heck of a lot of money to spend every time my son feels run down.

At one point the GI wanted them done every month and then every 2 weeks. When I told him what it was costing he was shocked and backed way down on the number and frequency. Clearly he was ordering based on his ideal fantasy not what he truly "needed" to make clinical decisions. So I have become more conservative where it comes to running lots of labs. Run what is needed to target the suspected problem or that will screen for most major problems. Then I get the doctor to decide what to do next.

 

[Daisyduke]

I'm in school as well and since I've been sick I have calmed down but before I barely slept. I was at school first thing in the morning would be done by noon. Try and get some homework done before having to be at work at 2, get off work at 10 and go out with my friends till 2 and start all over again the next time. Alot of the times I would forget to eat and I wasn't getting the proper amount of sleep. And I know alot of college kids have the same life style. But who knows he could need a higher dose in his medication or needs to switch. I agree with everyone that seeing his doctor would be the best thing for both of you.

 

[Farmwife]

Weight loss and sleeping?:shifty:
GREAT, Grace joined college and didn't tell me!

Hugs to you both!:hug:
No advice just support. A mother's job is never truly done!:kiss:

 

[Sascot]

Hope your son is just stressed and not having a flare! So hard to tell when they are not in the house to keep a strict eye on - I am dreading when my kids are away from home. My daughter seems to feel the need to tell me everything she is doing, even going to the toilet - I have visions of her phoning me in years to come, just so I know she is going to the toilet .
It might be worth seeing if your son will go for a blood test just to see what's happening, although I would imagine that would take some persuading!

 

[upsetmom]

Sascot your daughter sounds a lot like mine...she tells me absolutely everything..:ylol2:

 

[kimmidwife]

Just wanted to say I agree with the others and getting some labs cant hurt!