Monday, March 17, 2014

Diary of a Crohn's Flare: Partial Bowel Obstruction, Imuran, or just plain Crohn's

My abdominal pain which began Wednesday continued through Saturday.  Although I'd been eating lighter foods, I hadn't adopted a low-residue diet completely.

By Saturday the pain had gotten bad enough that it woke me from my sleep and I had to take a Norco (5 mg hydrocodone + 325 mg acetaminophen).  I assumed I was experience a partial small bowel obstruction - which I can normally deal with from home by restricting myself to a fluid diet and treating myself with pain medication.

Through the morning of Saturday, I ended up taking another 3 full pills (in 1/2 pill doses).  By 2 pm, my pain medication was not controlling the pain and I decided that I needed to get to the hospital for evaluation and pain management.

The hospital performed a number of blood tests.  I believe they checked CBC, renal (kidney), hepatic (liver), and pancreatic enzymes (imuran).  Pretty much everything came back clear.  They performed a CT scan and found no blockage but did say that the Crohn's was more involved.  I didn't get clarification about what exactly this meant - more tissue involvement, larger affected area, both, something else?

They did treat me with pain medication.  Dilaudid did an excellent job in knocking the pain back and actually kept me at minimal pain levels for more than 12 hours.

  • They elected to put me on a heavy dose of prednisone.
  • My GI doctor instructed me to resume the azathioprine.
  • I have an appointment to see my GI doctor on Thursday.
  • I found that my genealogical tests show that I do have the enzyme for metabolizing imuran.
  • I canceled my travel reservations for work this week and am not only working from home, I'm working from bed :)

I'm sad to say that this is putting my running on hold for the near future though.  I'm still in nearly constant pain from the Crohn's.  I can do things to tamp down the pain (peppermint candies, norco, etc.) but at this point I think I need to allow pain to be my guide on what to do and not do.  If it's too painful to run without something to reduce the pain, then I'm not going to run.

My current medications for Crohn's Disease:

  • 60 mg Prednisone per day
  • 150 mg Azathioprine per day
  • 1000 mg sulfasalazine twice a day
  • 10 mg Bentyl as needed for cramping
  • 0.375 mg Levsin as needed for cramping
  • 0.5 mg Hydrocodone + 325 mg Acetaminophen as needed for pain (I take these as 1/2 pills)
  • 1 ml of injected B12 per month

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