Wednesday, October 1, 2014

Diary of a Crohn's Flare: Nausea

Throughout most of my life, even after being diagnosed with Crohn's, I have almost never suffered from nausea.  Even when suffering from bowel obstructions and feeling bloated, full, and completely uninterested in food; I still didn't feel nauseated.

This summer with the abdominal abscess, IV antibiotics, constant pain, pain medications, etc.; that all changed.  I've suffered from nausea regularly often multiple times per day.  In most cases, the nausea hasn't been strong enough to make me feel like was imminently about to vomit, but it was strong enough to make me feel miserable and completely disinterest me in food.  I'm told that opiate based pain medicine can cause nausea and constipation.  I've never suffered from constipation from these medications and I don't recall suffering from nausea before this summer.  It's possible the pain medication is contributing to my nausea issues.

Because of these very frequent bouts of nausea I requested and received scripts for anti-nausea medications (both Zofran and Phenergan).  For me, I think the Zofran is slightly less effective but it does not make me drowsy.  However, the Phenergan seems more powerful but it also makes me very drowsy (not as bad as Benadryl but worse than opiate pain meds!).

When I discovered the potential drug interaction between the Diflucan and my anti-nausea medications, I became very worried.  I worried about how I was going to be able to eat with frequent nausea.

After stopping the Zofran and Phenergan I did start the Meclizine.  This helped, some.  I also resumed using peppermint candies.  Eating these provide me with a window of 10-20 minutes nausea free.  So I started eating these peppermint candies before every meal to reduce the nausea.

I also found that my nausea isn't affected by some foods, such as fruit, sherbet, and flavored ices.  So lately I've been eating more sherbet, applesauce, and bananas.  I've also switched up my diet to eat whatever seems appealing at any particular time.  Ironically, one thing that has seemed appealing to me lately is beer-battered fish fillets.  Other than those, I mostly avoid high fat foods.

Today I had a tuna salad sandwich.  After the fact, my GI tract informed me that this was the wrong choice and I've had nausea ever since.  Eating several peppermint candies has provided me with temporary relief but hasn't resolved this bout of nausea.  I might have to limit my diet to sherbet and applesauce tonight.

Although I have not had trouble maintaining a healthy weight over the course of my disease up until this point; this summer's problems (multiple surgeries, bowel obstructions, abscesses, pneumonia, etc.); I have had trouble maintaining my weight this year.  I've lost about 14 pounds from my pre-flare weight.  Although my current weight isn't worrisome, it does not leave me with much cushion should I suffer from additional problems.  So I am working hard to maintain and even gain some weight.

If you have problems with nausea and maintaining your weight, you definitely need to speak to your physician(s).  In my case, the Diflucan takes precedence over the anti-nausea medications so I just have to "suck it up" and make do without them.

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