Fifteen years ago today, at just seventeen, I was diagnosed with Inflammatory Bowel Disease.
It is hard to believe, at thirty-two now, that I have spent almost half of my life enduring the ups and downs of this horrid illness.  The symptoms I experience now are merely part of my every day life.  I have accepted them into my daily routine.  But I cannot imagine how I coped as a seventeen year old How the hell did I even become a successful adult, I often wonder?  

I have memories of being sick, of course.   They are memories of days when I lived in diapers and survived off steroids.  I can remember these times, but it is the small moments; the in between and random selection of memory that fills me with a paradox of sadness and joy.  The joy surmounts because I’ve come So. Fucking. Far.  No matter how much distance fills the space between me now and me then, I cannot help but feel emotion; an emotion I suppose no one else can relate to who has never been as low as I was during the first year with Crohn’s.

I remember dropping to 95 pounds.  I can still see myself staring at my reflection in my parent’s hallway mirror, wearing a pair of shorts that I would never be able to fit myself into again and a Cliff Lee T Shirt.  I still have that t shirt.   It doesn’t fit in the same way now, but I still wear it.  I went downstairs and cried into my dads shoulders and he told me for the first of many times that Crohn’s would not define my life.

My sister would take me for car rides.  We would go and see my brothers softball team play, and this was the one instance every month where I would socialize.  Unbeknownst to every one of my brother and my friends, my bony body was able to hide that I was wearing a diaper underneath my clothes, and that diaper was the only thing allowing me to leave the house.  In retrospect, maybe they knew but didn’t say anything.  I lived for those spring and summer nights watching my brother play softball.

I remember when Comcast came to install cable because my whole life we didn’t have cable but my mom (hi mom!) decided we could have cable because I was sick and I had nothing else to keep my time occupied.  I remember sitting on the love seat of my parents sofa and watching the techinican install our cable.  I remember my mom went to Dunkin Donuts and got me a bagel.  I ate two bites before I felt sick.

I remember my high school friends coming to visit; not quite understanding why I couldn’t come to school but understanding that I was sick.  Jess brought her dog; Anne brought food.  I was glad they came, and wanted them to leave all at the same time.

I remember going to my high school graduation after my mom fed me 5 MG of percoset, the only time I would ever take a pain pill in the history of my struggle with Crohn’s.  My sister and Ryan gave me a Tiffany bracelet with an American flag.  I remember Mrs. Johnson giving me the tightest hug when she saw me at graduation, and for a moment, this teacher whom I didn’t even realized knew who I was, she understood how much it meant for me to be walking at graduation.  We went out to eat as a family together afterwards and I remember bursting into tears because I was on steroids and quite frankly, out of my damn mind. 

I remember my college roommates, each one of them with the responsibility of driving me to the hospital after a bowel obstruction at some point in our college journey.  Jill went to the cafeteria but was afraid to eat hospital pizza in front of me.  Natalie demanded the nurses give me pain meds, and Claire took me for a walk at the UMMC and we made small talk with the orderlies.  My best friends; famished, delirious and missing valuable studying for finals; all they could think about was me. Until recently I had written the narrative in my head that Natalie had failed her final because of me.  She was sure to correct me.  She didn’t fail her final, but she barely passed. How can I not feel like the luckiest person in the world for having these people in my life?

I remember the posts of this blog I shared with boyfriends who I decided were worthy of knowing  “the truth”.  I still remember the first post I shared with Jamie.  I sent him an email after a date of ours should have turned romantic that included a discription of my ostomy.  He texted me the next day, all day, like nothing was wrong and I feared that he hadn’t yet read his email.  When I asked him if he did he said “of course, it was the first thing I read this morning”.

I’ve been blessed, throughout this curse.  My struggle will never, ever end, no matter how magically I paint my life to be on the canvas that is this blog.

But, I’m just like any other 32 year old with hardships.  My struggles just happen to be in the form of a missing colon and tiny hole at the bottom of my abdomen that has given me life.

Here’s to a happy, healthy, and surgery-free 2017.  Cheers!


One Year Post-Op

Today marks my one year BCIR anniversary.

I am so happy I made the decision to have surgery.  I trusted my instinct.  I researched.  The decision was years in the making, but the timing was finally right one year ago.

I have no regrets.  My quality of life is drastically different and improved.  I don't have to worry about waking up with a leak at 3 in the morning, showering, and stripping my sheets.  I can roll over with a stomach full of gas.  I no longer profusely press on my stomach where my stoma was to make sure my appliance is still intact.  I can manage most days with 2-3 intubations, depending on what I've eaten.  Most days I leave for work at 6:30 am and do not intubate until I get home at 5.  It's incredible.

But, nothing is perfect.  I still suffer from chronic pouchitis, although it is controlled with a maintenance dose of antibiotics.  Pouchitis is a common post-operative "complication" and the more my pouch (the reservoir that stores my waste internally) matures, the more my risk for pouchitis should decrease.  Again, not ideal, but manageable.  It's usually my own fault when I have issues because I've missed a dose of medicine, but within days I am back to normal.  My only other selfish complaint is that my diet is actually more restrictive now.  Imagine everything you eat having to eventually pass out of a catheter.  When they told me in the hospital that my new motto was "chew, chew, chew, drink, drink, drink" they were NOT kidding.  These are surface issues and by no means do I struggle with either, but they are minor annoyances.

I could go on and on...

If you have read or followed my blog, you know that I am fairly resilient.  So while this surgery has been the greatest risk I've ever taken in my life, it also feels like this is how it's been my whole life.  I'd like to think that it's not for a lack of gratitude, but for the knowledge I've always had in myself that I would be okay regardless of having a traditional ostomy or not.

If I have learned anything this last year through my experience with the BCIR, it's that you should trust your instincts.  Once I was approved for this surgery, it became my number one goal.  I researched and prepared myself, and for those reasons I knew everything would turn out okay.

TRUST YOUR GUT.  And surround yourself with people who love you, respect you, and support your decisions.

PRESENT DAY.  You can see the small bandage below my
waist line that covers my new "stoma".  I change the bandage
twice a day.  Because I have an opening in my stomach
I still experience output in the form of mucous.
Despite how horrific this looks, my surgeon actually did an
INCREDIBLE job fixing my midline incision.  Looking at this
photo head on, you can barely see on the left where my ileostomy
was before I had it placed on the right side.  Hopefully over
the next few years that scar will fade as well.  Some of the
other small red marks are just from sitting, but you can see a couple
other small holes where my stomach tube and drains were.
CIRCA 2014?  Ileostomy life.  That's with an empty bag, so you can only imagine how much an ostomy has the capacity to protrude and become annoying.  This picture isn't great but you can also kinda see how my midline incision gave my stomach the look of a butt.  Very thankful Dr. Rehnke was able to tighten up my midline incision as much as possible.  



My 2015 Recap

Okay.  I haven't been posting.  I'd like to say that's because everything has been fabulous health-wise. Although partially true, I've hit some bumps on the road.  It is expected for the first year after BCIR surgery to be a period of adjustment.  After all, my ileum is now serving a completely different purpose than it did its other 30 years of existence in my body.  But the important part is that I do not regret, AT ALL, my decision to have surgery.  It has completely changed my life for the better in ways unimaginable.

The biggest hiccup has been my chronic pouchitis.  I found an awesome GI in my home territory and she's been great about educating herself on my unique anatomy.  I had my first post-op colonoscopy with her (which is actually called an ileoscope when you have no colon) and everything went GREAT.  I am still waiting on the results of my biopsies but she was amazed at my anatomy and how healthy everything looked.  She was also able to look into my small intestine which was always a challenge before because my doctors couldn't navigate the rest of my tract without endangering my intestines.  I woke up after the scope and one of my caretakers who was in the room during my procedure was asking me a million questions.  How do you know when you need to "go"?  What does it feel like?  Etc.  It was a pretty great feeling to know that my insides looked healthy because I think my doctor was expecting to see something crazy in there.  Even for medical professionals, I think it's hard for them to grasp that something atypical can, in fact, be legitimate and a far better option.

Anyway, my pouchitis has been under control with antibiotics but I haven't been able to completely wean off of them since surgery.  Obviously no one wants to be on antibiotics for a long period of time so my new doctor prescribed Entyvio which I started in the beginning of November.  It can take up to 12 weeks to become therapeutic so right now I am in one of those waiting periods.  It really brings me back to the feeling and emotions that these waiting periods used to produce back in the days when I was really sick.  It's a completely different sentiment this time.  There really is no urgency to find out if Entyvio will "work" for me because my pouchitis is under control with the antibiotics.  So the next month or so will definitely be a telling time where we will figure out what the next move is, if I cannot completely wean off of antibiotics.  After seeing how healthy my insides looked, my new GI is definitely more receptive to keeping me on a long-term antibiotic regimen.

For anyone who has been wondering what I've been up to--Rather than spew everything that's happened in the last year, here is my 2015 recap, abbreviated:

I had BCIR surgery.  Game changer.
The bf and I traveled, went to weddings, spent a lot of time with family.
I got a substantial promotion at work, finally feel settled in my career, and I'm lucky to be with a company that is growing.
My sister popped out another boy.  And I'm obsessed, duh.
I discovered that me and my best friend Claire are allergic to snuggle and those nasty rashes I was getting were not, in fact, Crohn's (you may be laughing but it was a pretty serious problem for a few months)

Well, isn't life just thrilling...



Pouchitis, Cipro, and the BCIR

All is going well.  Really.

Considering everything my body has been through, and the fact that my small intestine is now serving a completely different purpose than science designated it to; I am happy.  I can't believe it's only been four months since surgery.  FOUR.  It's incredible.  Life is incredible.  And science and medicine are mind-boggling.

The only hiccup in the road has been the onset of pouchitis, almost immediately after I got home from Palms.  Pouchitis is a common infection that is extremely treatable with antibiotics.  Thank God.  It's actually quiet unusual for someone with Crohn's to feel an immediate, drastic improvement just from popping one of medicines' oldest tricks in the book.  With Crohn's, you're used to feeling months of misery, complete with trial and error.  Mostly error.

Pouchitis, quite simply, is inflammation of the lining of your pouch.  For me, this is the internal reservoir that was created when I had the BCIR.  It's something the nurses and doctors prepared me for.  The first year after surgery it is quite common and I have developed a chronic case of pouchitis that will require me to remain on a therapeutic level of antibiotics for the time being.  I've heard about pouchitis for years and have come to terms with the varying degrees of it.  People with the K Pouch and J Pouch often experience it as well.  For me the pouchitis merely causes more cramping than usual.  I get more prone to dehydration because I am intubating five times a day instead of two. The weirdest part of pouchitis is that (for me) it is NOTHING in comparison to what I thought it would be.  Regardless of my access to a bathroom, I can endure the ebb and flow of the cramps until I am able to get to one.  My tiny, pencil thin stoma, if you can even call it that, remains continent.  I have to change my dressing more frequently but the fluid it excretes is merely fluid.  It is not stool, it is just mucous that develops because my pouch is contracting more than usual.  After a few days on antibiotics, I was completely back to normal.  Since then we tried to wean my dosage but were unsuccessful.  So I had a few days of cramping until the full dosage kicked back in.

And then, several weeks ago at work, I began to have a rapid progression of hives forming on my arms.  I was ignoring tiny red spots that were appearing for the weeks prior because they went away hours after they appeared.  But these ones were getting bigger, redder, itchier, and uglier by the minute.  I admit I freaked out a little bit and I am sure it was not helped by my coworkers freaking out for me.  Anyway, I suspected that my body was rejecting the Cipro, which is common with long-term use and that fact was confirmed once my doctor returned my call.  They switched me to Flagyl which took a bit longer to "work" for me so I had about a week of discomfort before I felt well again.

In the end, I got quite a bit of sympathy at work.  I laid down in an office while I waited for my doctor to return my call.  I have an extremely supportive and laid-back office environment and after taking two benadryl my coworkers let me fall asleep until someone came at 5:30 to wake me up because it was time to go home.  In the end, I was a little bit embarrassed.  But I will take the embarrassment of hives and falling asleep on my bosses couch over shitting myself any day.  A few pictures below will give you an idea of what I was dealing with.

Ignoring these symptoms the week before (Mom, you were right):

 Down for the count:

Later that day: The Swollen Colon rash-covered arm:



BCIR and Swimming and Being Alive

Something amazing happened a couple of weeks ago.

I went swimming.  In the ocean.  For the first time in...I can't remember.  My bff Anne is probably the last person who saw me in a Swimsuit circa 2000.  It's really been that long.

The backstory is that the boyfriend and I traveled to Maine to see one of his best friends get married.  It just happened that my family and his were both staying in the same town at the Jersey shore so once we left Maine we headed to Jersey.  I wasn't too enthusiastic about it but it ended up being a great time.  It was the first time in my life I could take a vacation that was paid for and I didn't have to worry about losing money from not working.

In my adult life I have never been a beach person.  I hate the sun, the sunburn that results from being pale and Irish, and the sand.  But one day on our vacation, I found myself thigh-deep in water with waves crashing on me while I watched my nephews being held by my brother in law.  After a while I said to myself, "fuck it".  Of course I didn't have a bathing suit but I didn't care.  I was already soaked.  I walked back to the beach where my family was stationed, ripped off the bandage covering my new, verrrry small stoma, and talked my brother into joining me in the water.

This is not to say I couldn't go swimming before.  Honestly, I never really attempted it.  I think I just convinced myself I didn't like the beach as a way to cope with my reality.  In the years with my ostomy, I certainly took baths and I knew I could find bathing suits that worked with me, but I just never shopped for them.  If I went to the beach I went in a tank and shorts and read or people-watched.

But that day, several weeks ago now, I swam in the ocean with my brother for an hour.  I watched my nephews as they were crushed with waves.  I watched my mom on the shoreline beaming with a wide smile as she took pictures of me....swimming.  My boyfriend (who spent his day golfing) was dumbfounded when I texted him after hours on the beach telling him that I was still there.  And that I went swimming.

Sometimes I feel guilty with my "new" life, because I would have been fine spending the rest of my life with an ostomy---really.  But there is a sense of freedom I never thought imaginable; one that has made me certain I made the right decision.  I could not imagine life another way.

I suppose I need to find a bathing suit for next season.  Until then...



First Day

I survived.

My first day back to work was a success.  After the anxiousness of the attention I would be getting from my reappearance subsided, I was back into my routine.  My bosses informed me right away they wanted me to take a half day today and tomorrow, which I am grateful for.  Some of my coworkers were quite astounded that I was even at work.  And I guess it is kind of incredible.  Who returns to work one month after being cut open and having their whole digestive system flipped upside-down?  I guess in a way I will never, ever overcome the urgency in my bones to GO the second my body feels normal.  I'll always feel the crunch of time no matter how incredible my life accomplishments are.  It's an issue I am always working on.

But, boy, I was glad I listened to them to take a half day.  After waking up super early, loading my body with more caffeine in one hour than its seen in one month, I worked 6 hours, came home and crashed.  HARD.  Sometimes you just HAVE to listen to your work moms when they tell you to take it easy.

The good news is my intubations are getting easier.  I'm learning which drinks help increase my flow which makes intubation effortless.  I still don't have much pain when it's time to intubate so I have to remind myself that I should only be at 4 hours right now otherwise I forget until I start hearing the gurgling in my stomach and fullness.  It's truly the weirdest feeling, but I am told I will get used to discerning which feelings mean I need to intubate.

Just a short update.  More to come. x


Back to Work and Beginning My New Life with a BCIR

Throughout my hospital stay at the Palms of Pasadena, I had old patients come and visit me.  Many of their parting words, and the parting words of my nurses as I left that last day were, "Enjoy your new life."

Part of enjoying my new life is returning to normalcy.  Tomorrow I go back to work.  I am not scared.  I am excited, anxious, and vainly looking forward to wearing some of my tighter clothes I just couldn't wear at work before.  It still seems surreal to me.  It doesn't feel like a new life yet.

One of the hardest parts about leaving my restaurant world and entering into the nine to five business attire life was learning what clothes I could and could not wear.  It involved a lot of accidents, trial and error.  I had to find leggings or panty-hose that were tight, but not too tight to the point of restricting my stoma from doing it's job.  Needless to say, there were a lot of frustrating leaks over the last year.  I stuck to empire-waisted dresses that allowed me to not use the bathroom constantly throughout the day.  My high waisted pencil skirts similarly followed the same guidelines.  As long as I had my ostomy, I always shopped like my clothes were going to fit with a flat and empty pouch.  Cute, yes; but unrealistic.

Is it wrong that one of the things I am looking forward to tomorrow is wearing this express skirt that I nabbed on clearance for 16 bucks?  I think what I will learn with my new life is that there will be no big moment where I thank goodness for the decision to have this surgery.  I think it's going to be a bunch of these tiny, tight skirt wearing days, that are going to culminate into a much happier ME.  The stress relief of no leakage, no longer waking up in the middle of the night and immediately touching my shirt where my ostomy is to make sure it's okay, not having to think twice about how much I am eating related to the outfit I chose to wear that day.  It's the little, little things.

With that being said, I did have a small set back over the weekend.  My first experience with a common BCIR first year complication called pouchitis.  Pouchitis is essentially inflammation of the lining of your pouch.  It's extremely common but luckily treatable.  Immediately after I started my antibiotics I felt better.  However, before then, it was a few days of misery before I finally called my doctor over the holiday weekend.

It will continue to be a learning process over the next year as my new pouch matures and the rest of my small intestine adjusts to the change in its role.  I sometimes have to stop and remind myself of that.  I just had a huge surgery.  There will be growing pains and nothing is perfect.

For now I am very happy, as I am sleeping through the night and am able to stretch 6-8 hours between intubation.  I might not feel like I have a new life yet, but I think returning to work tomorrow is a huge step in discovering what is ahead.

Hope you are all well and had a fabulous holiday weekend. x.