Deep Breath

September 28, 2011

Since I last posted, I’ve not been feeling my best. Despite everyone’s best efforts to lift my spirits* etc., etc., the fact is that I seem to have stressed myself into a real live flare, and it isn’t going away just because I’m starting to process this new information. It makes itself worse, because I’m too wiped out to do any of the things I need to do (never mind the things I want to do, haven’t been to the gym since August), but then I have to do them anyway which just fatigues and stresses me more, so that the next day I want to get up and go to class and work even less.

*A big shout out to my roommate, my parents, my sister, my manager, and very good friend from home. Thanks so much for your support, you guys make it so much easier.

One quick solution to this is that I’ve cut my hours at work to only two shifts a week. Besides the obvious “more time to rest,” I also get a few days in between shifts, so I don’t have to deal with the stress of many days in a row where I feel like I just left when I have to come back. This is helping. I now have far fewer days where I don’t get to come home from dawn until long after dusk (like normal), and this is really much nicer.

Even so it hasn’t fixed everything and I’m still feeling pretty bad. Yesterday I went to my voice lesson and explained what was going on to my teacher, who really got how much this was affecting me and decided to tone down the intensity of what I’m working on. The awful thing is how offended I got when she told me she had an easier song for me, with less ornamentation, that wouldn’t be as difficult to learn and sing. How dare she think I couldn’t do the harder song! But she’s right. I need a break. I want to sing, but it isn’t helping to push myself so hard. My pride and drive to be good at simply everything are normally what push me to keep improving myself, but now they’re working against me. I hate to say “I can’t,” but right now I can’t do all the things I want to do. I can’t read all the Greek and learn all the history and work out every day and teach myself to sight read right now.

So I’m going to try to be good to myself. Do what I have to to stay afloat in school and at work without sacrificing my health. I keep telling myself that once the colonoscopy is done, once I get my meds sorted out, it will all be better and I’ll be able to be myself and do everything again. And I really really hope that turns out to be true.

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Paradigm Shift

September 19, 2011

Now that my weekend of self pity has come to an end, it’s time to get back on the blogging horse. I’ve been MIA since December for a number of reasons, chief among them that I was abroad in Egypt* and then traveling until the end of June. These travels are documented at One if by Camel, Two if by Carpet. One blog is really all this girl can handle. After that I’ll be honest and say it was just lack of motivation.

*A word to the wise: you will get Pharaoh’s revenge if you go to Egypt. This is not fun when you already have Crohn’s.

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When I finally got back to New York and tried to get my prescriptions transferred over here (always a hassle and a half) I found out that I had managed to go almost a year without seeing my GI and they couldn’t keep prescribing me immunosuppressants without checking in and getting some bloodwork. Oops. Unfortunate side effect of traveling for six months. I’ve been meaning to switch to an adult GI in New York for a while now but never quite gotten around to it because the pediatrics hadn’t bothered kicking me out and I could always schedule my appointments for school breaks.  But I’m not back in Boston until probably Thanksgiving, so this time I had to switch.

I had an appointment for the morning of September 14th, but apparently they switched the doctor’s schedule and didn’t bother to tell me, so when I showed up it was “your appointment is tomorrow, Miss Flowers.” What?? Really now. And to make it worse, they didn’t own up to having messed up. The girl just kept explaining to me how the schedule had been changed like I was too stupid to understand, and not like they had forgotten to call and ask if I could even make the new time. It happened could make it, and it was even a more convenient time for me, but I had already worked my whole day around the old time! I finally got the girl to tell me that the secretary was supposed to have called me but must have forgotten, which is fine. Annoying, but humans make mistakes, which I am happy to be understanding about. Just don’t pretend you were totally in the right.

When I finally got to see the doctor I was much happier. The reception was a disaster, but he (and his two associates I spoke to before him, I can only assume they were junior staff or something) seemed more than competent. I was really happy that they listened to my current case, said “you shouldn’t be living like that” and decided to shoot for symptom free. My old doctor never seemed to see symptom free as a goal. He wanted to make it better, but he was happy to settle for just a little better. The new guy wants it to be totally better.

But with that came the realization that my case is worse than I thought. I have an average of 7 bowel movements per day, at least one of which almost always wakes me up in the middle of the night. My appetite is patchy, and I never feel like I’ve gotten the proper nutrition out of the food I eat. I feel tired all the time. I have flares every couple of months but even in between I never feel really good. My old doctor never seemed too concerned, and since Crohn’s isn’t life-threatening, I just resigned myself to having to deal with this. I thought of it as being mild, compared to people with “real diseases”, and I really thought this was what well controlled Crohn’s was supposed to be like. I have problems, but everybody poops. I just do it more and it sucks harder. The new doctor told me he’d consider my case moderate to severe and doesn’t think it’s well controlled at all. He doesn’t accept that I should “just deal with this” like I’ve been doing.

And, higher expectations for where I can get to means more aggressive treatment, which scares me a lot. There’s a lot that I didn’t know (possibly because they don’t talk as much about the scary stuff in pediatrics?) about other risks as the disease goes on (I’m coming up on the 12 year mark now). Fistulas, cysts, colon cancer, all that stuff. I knew I needed a colonoscopy soon, but apparently now I’ll need one every 1-2 years instead of every 5. And they have to biopsy to check for early stage colon cancer.

And apparently, I’ve basically taken everything you can take before it becomes time to move on to Remicade or Humira. I have been so against these ever since I heard about them a few years back because that’s serious business, and my Crohn’s is really not that huge a deal. I don’t have the kind of disease where you have to go in to the hospital just to get your routine medications (or yes, I know you can inject Remicade at home, but I don’t like that either). Apparently though, I do have that kind of disease (unless bumping up my 6-MP dose is enough on its own, which the doctors don’t seem super hopeful for) so now I have to start seriously considering the possibility of going on the serious business drugs.

But first is the colonoscopy, so they can see exactly what’s going on, what the level of inflammation is, etc. October 11, 1pm. My dear mother is coming down to the city to make sure I’m okay afterwards (last time my legs cramped up for the whole evening, apparently a reaction to the anesthesia), and I’ve been forbidden by my roommate to go to class the next day.

All this has been really hard for me to hear, and consequently I spent the entire weekend, as I said, in one big pity party. I’ve been sewing like a madwoman to take the edge off, but it’s been really rough. As soon as the doctor told me I’m not doing as well as I thought I started feeling like a sick person. Nothing has changed other than my perception of my disease, but I feel physically much worse. This must be what they mean when they talk about the placebo effect. Your body physically manifests what your brain thinks is going on. So now I feel awful. Working is a huge burden, and I’m more tired than ever. I’ve been trying to take some time to myself to adjust and heal, or whatever, but it’s hard when I have so many things I’m supposed to be doing, including social interactions, which are just stressing me out at this point. I just wish I could take a week off and get it together.

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Super long winded post today, but there was a lot to say. A couple questions before I leave you.

Has anybody taken Remicade or Humira, or know about them, who can tell me about it? Should I be worried? Are there side effects, a rough adjustment period, etc.? Does it really work as well as the doctor says it will? Should I get a second opinion before starting this?

Anybody have great ideas for “low residue” meals I can make for the week before my colonoscopy? Or good clear liquids for the day before (I know it’s impossible to make a meal out of this)?

I hope all of you are doing well.