Much has transpired since my last post made on 9/8. The reason for my long absence is that I've felt like crap and hadn't had the energy or motivation to compose any posts.
My hospital stay which started on 9/7 continued through 9/11. The first couple of days of my stay focused upon the bowel obstruction. First with diagnosing it and then treating it (which mostly consisted of pain management and limiting my diet).
My doctors who reviewed the CT scan indicated that the bowel obstruction occurred upstream of the location of my surgery. This meant that I suffered an obstruction in a location not compromised by intestine severely affected by Crohn's or surgical scarring.
One of the diagnostics was a CT scan of my abdomen (taken on 9/7). Here's the summary of the CT scan results:
IMPRESSION:
1. Findings suggest partial small bowel obstruction.
2. There is induration/inflammation around the ileocolonic anastomosis in the right abdomen but there is no discrete abscess in this area.
3. Small fluid collection in the anterior abdomen deep to the midline wound. This contains no gas bubbles. It could be sterile or infected.
4. Potentially significant abnormality in both lung bases where there are new nodular infiltrates. These are only partially included on the study. A CT scan of the chest with intravenous contrast is suggested for further evaluation.
Item #2 indicates that they see something going on near my bowel resection but that it doesn't look like an abscess.
Item #3 indicates that I *could* have an infection under the incision wound.
Item #4 indicates big problems.
The radiologists report ended with a recommendation for a CT scan of my chest.
The radiologists report on the chest CT scan (taken on 9/7 too) looked like this:
IMPRESSION:
Multifocal pulmonary consolidation, consistent with pneumonia. A subcentimeter cavitary nodule is present in the right middle lobe. If the patient is immunosuppressed, one should consider opportunistic infection.
It was explained to me as "atypical pneumonia". Ironically, I was displaying no overt symptoms of this pneumonia - no fever, no coughing, no wheezing, and no crackling in my lungs. In fact, I was told repeatedly by the doctors they could not believe that I was sick.
At this point I had several doctors looking in on me on a daily basis. This included my surgeon, pulmonologist, infectious disease doctor, and an internal medicine doctor. They concluded that my prednisone use with Imuran suppressed my immune system enough that an opportunistic infection had set up in my lungs.
The second part of my hospital stay was a series of diagnostics intent on figuring out what was infecting my lungs. This included 40 blood tests and a broncoscopy with biopsy. The initial diagnosis based upon the results of a blood titer test (a test which indicates my body had developed antibodies to an organism) revealed that I likely had Cryptococcus Neoformans.
This organism is a fungus and is consider an environmental pathogen - meaning its spores are commonly found in the environment around my home. People without compromised immune systems rarely suffer from infections by this organism.
Because this is a fungal bug, they immediately started me on anti-fungal medications. The dose they put me on, 400 mg of Diflucan per day, is much higher than I've ever been on before. Because of this, they are monitoring my kidney and liver function using blood tests every 2 weeks or so.
The doctors held onto me for several days to ensure that the bowel obstruction cleared and they had gotten enough blood tests started. I was told that it would take 2-8 weeks to get the results from all of the tests.
My hospital stay which started on 9/7 continued through 9/11. The first couple of days of my stay focused upon the bowel obstruction. First with diagnosing it and then treating it (which mostly consisted of pain management and limiting my diet).
My doctors who reviewed the CT scan indicated that the bowel obstruction occurred upstream of the location of my surgery. This meant that I suffered an obstruction in a location not compromised by intestine severely affected by Crohn's or surgical scarring.
One of the diagnostics was a CT scan of my abdomen (taken on 9/7). Here's the summary of the CT scan results:
IMPRESSION:
1. Findings suggest partial small bowel obstruction.
2. There is induration/inflammation around the ileocolonic anastomosis in the right abdomen but there is no discrete abscess in this area.
3. Small fluid collection in the anterior abdomen deep to the midline wound. This contains no gas bubbles. It could be sterile or infected.
4. Potentially significant abnormality in both lung bases where there are new nodular infiltrates. These are only partially included on the study. A CT scan of the chest with intravenous contrast is suggested for further evaluation.
Item #2 indicates that they see something going on near my bowel resection but that it doesn't look like an abscess.
Item #3 indicates that I *could* have an infection under the incision wound.
Item #4 indicates big problems.
The radiologists report ended with a recommendation for a CT scan of my chest.
The radiologists report on the chest CT scan (taken on 9/7 too) looked like this:
IMPRESSION:
Multifocal pulmonary consolidation, consistent with pneumonia. A subcentimeter cavitary nodule is present in the right middle lobe. If the patient is immunosuppressed, one should consider opportunistic infection.
It was explained to me as "atypical pneumonia". Ironically, I was displaying no overt symptoms of this pneumonia - no fever, no coughing, no wheezing, and no crackling in my lungs. In fact, I was told repeatedly by the doctors they could not believe that I was sick.
At this point I had several doctors looking in on me on a daily basis. This included my surgeon, pulmonologist, infectious disease doctor, and an internal medicine doctor. They concluded that my prednisone use with Imuran suppressed my immune system enough that an opportunistic infection had set up in my lungs.
The second part of my hospital stay was a series of diagnostics intent on figuring out what was infecting my lungs. This included 40 blood tests and a broncoscopy with biopsy. The initial diagnosis based upon the results of a blood titer test (a test which indicates my body had developed antibodies to an organism) revealed that I likely had Cryptococcus Neoformans.
This organism is a fungus and is consider an environmental pathogen - meaning its spores are commonly found in the environment around my home. People without compromised immune systems rarely suffer from infections by this organism.
Because this is a fungal bug, they immediately started me on anti-fungal medications. The dose they put me on, 400 mg of Diflucan per day, is much higher than I've ever been on before. Because of this, they are monitoring my kidney and liver function using blood tests every 2 weeks or so.
The doctors held onto me for several days to ensure that the bowel obstruction cleared and they had gotten enough blood tests started. I was told that it would take 2-8 weeks to get the results from all of the tests.
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