Friday, March 21, 2014

Diary of a Crohn's Flare: Post ER doctor's visit.

First a quick update:

I've been in constant pain since last Wednesday (that's 9 days).  The pain varies from merely annoying to all-encompassing.  Eating aggravates it in multiple ways.  Merely taking a single bite of food and swallowing triggers a digestive-wide cascade of cramping that hurts pretty badly.  It also also leads to painful bloating of my abdomen.

Since the ER visit on Saturday, I've now had 4 night sweats.  One on Sunday night (before resuming Imuran), one Monday night (the night after resuming Imuran), Wednesday night, and Thursday night.  Although the first two were moderate night sweats, Wednesday's was bad.  I thoroughly soaked my clothes, bottom sheet, top sheet, and blanket - I did not have to towel off though.

So I put a towel on the bed and changed clothes and went back to sleep.  It was not a restful sleep.

At my Doctor's visit we discussed a lot of topics.  The most important of these was my treatment options.

As I've mentioned previously, Crohn's has 5 main treatment options:

  1. ASA (Asulfadine, Pentasa, Dipentum, et al)
  2. Steroids (suppress immune system, reduce inflammation)
  3. Azathioprine (and 6 MP)
  4. Biologicals (Remicade & Humira)
  5. Surgery
I'm now using 1, 2 & 3 of these and the doctor suggested that #4 may be needed.  Some other factors include the fact that it takes 8 weeks or more for the azathioprine to build up effectiveness but that my flare symptoms seem moderately bad right now.  The steroids might help bridge that time period.


Since I've only had one surgery, the immediate flare symptoms may be receding, and I'm otherwise in good health, the doctor said I can take my time and decide for myself.


I really want to just feel normal again and am beginning to think that the biological might not be a bad choice.  Can I stick it out for another 7 weeks?

3 comments:

  1. The pain you’re going through is quite hard to imagine, Jim. It seems to just get aggravated as it progresses. So, how are you now? I hope you didn’t get further complications after this medication period. Take care!

    Maribeth Almanza @ Primary Care Associates

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    Replies
    1. Maribeth,

      A lot lot lot has happened since last March. More ER visits, minor surgeries, major surgery, hospitalizations, and developing fungal pneumonia preventing me from getting any additional treatment for my bowel issues.

      For the details, read my blog. For a summary, read below :)

      However, since October I've generally improved. if you walked by me in the street you wouldn't know I was sick now. Today, my infectious diseases doc approved me to resume treatment for my Crohn's Disease.

      Pain is absent, tolerable, or manageable. The doc has Rx some pain medicine and anti-cramping meds which I use sparingly.

      I was running from October through December, developed the flu, had to stop, and haven't gotten back into running since. I plan to resume my running any day now.

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    2. In 2014 I used every treatment mentioned except the biologicals. It looks like I start those for 2015 in a few weeks.

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