3.24.2009

Health Update

I broke down on Monday and agreed to have the colonoscopy I so vehemently refused a couple weeks ago.  I realized my doctor wasn't going to leave the issue alone nor would he be comfortable making future health decisions without first hand knowledge of what exactly was going on inside.

For those of you who have never had the priveledge of having a colonoscopy, you are really missing out.  If you are getting complete anesthesia, the preperation beforehand really is the worst part of the whole deal.  Because doctors need your whole digestive system to be cleaned out, you have to drink massive amounts of fluids mixed with different laxatives the night before.  In the past I've had to mix mine with Sprite and Capri Sun.  Needless to say, I can drink neither to this day.  And although this prep wasn't that bad this time around, I won't be touching a bottle of blue gatorade for a while.

So I arrived for my appointment at 7 am after getting a total of 45 minutes sleep the night before.  Around 8 am they started me going with fluids and medicine to relax me.  I was visibly anxious and slightly emotional the whole time.  In case you didn't know, I had my bowel perforated during a colonoscopy before and laid there for four complaining of pain before anyone recognized something was wrong.  I've had colonoscopies since then but it's always something I think about especially when I'm flaring and my bowel is prone to perforation.

I had the procedure done at Penn Presbyterian hospital where I see my doctor.  I must say, it was the most comfortable colonoscopy I have ever had done and the staff was beyond accomodating.  Thankfully at Penn Presby, they completely sedate you.  I woke up from the procedure about 30 minutes later.  The last thing I remember was them telling me to lay on my left side and get comfortable like I would at home.  And I was out.

Now before the procedure the doctor asked me if I would like my bowel dialiated if they came across a serious narrowing.  Dialation would allow them to pass the scope around the narrowing to figure out what was beyond.  I told them No, basically, because that's exactly how my bowel perforated before.  I didn't wanna go down that road again.

So after being in recovery and getting to see my momma, the doctor came in with the results.  I was still pretty woozy as he explained the severe inflammation I have in my bum and lower colon.  Thankfully there's some healthy large bowel beyond that but they were concerned about a narrowing and abandoned the procedure when they reached the point where my small and large bowel met.

This meant that I needed to have another procedure, called a barium enema, to determine the extent of the narrowing.  Oh...My...God.  I have never had this done before and had I known how horrible it was, I would have agreed to dialation during the colonoscopy.  After my doctor lying and telling me it would "only take 10 minutes", I went to another department to have that done.  Basically, without going into too much detail, they stick a tube in you and shoot barium up there all while having you move in ridiculous poses while they take xrays.  Keep in mind the tube is still up there while you are being told to lie on your stomach, side, standing up, on your back, etc.  It was a very uncomfortable exam.

So the good news; the barium enema showed no stricture like they thought during the colonoscopy.  Apparently it was just my appendix.  Whatever that means.  The bad news; the severe inflamation at the lower end and the discovery of a fistula and possibly an abcess.  I already had an inclination that I had a fistula for a while now but didn't really say anything about those symptoms.  I don't know how to explain it so I'll just give you the dictionary definition. A fistula is, "an abnormal passage leading from an abcess or hallow organ to another organ permitting passage of fluids or secretion."  It's a lot more complicated then that but I will spare you the details.  Basically, the fisutla is like a crack in my intestine from all the damage inside whereby bodily fluids flow to places they aren't supposed to be.  Therefore, you develop a pocket of infection (abscess) somewhere in the body.  I have to get an MRI in a couple of weeks to determine if in fact I do have an abscess.  From what I've read and heard from people, an abscess can be quite serious and almost always needs surgical intervention.

While my doctor waits for the results of my biopsies, I need to consider the next move.  We briefly discussed several options as far as medicine.  Some of them have serious side effects regarding fertility and paralysis.  Scary stuff.  He also mentioned surgery to give me a permanent colostomy.  This would most likely give me my life back but at the risk of a whole host of new issues.  Not ready to even think about that yet. 

I just had the procedure yesterday (Tuesday) and I've already been contacted by my doctor and various hospital peoples about 5 or 6 times.  It's kind of scary and the fact that my doctor himself has called 3 times has me worried that he really doesn't know what the hell is going on.

Lots to think about.  In the meantime I'll keep taking Humira.  My hope for it hasn't died quite yet.

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