Here’s my latest health update! A lot of you seem to be very interested in my latest misfortunes and I’m tired of explaining my situation, so here it is.
Emergency Room Trip #1
In early June 2017, two few weeks after competing in Men’s Physique at the BC Provincial Championships, I headed to emergency after suffering from severe but all too familiar abdominal pain and cramping. Severe bloating, nausea and unbearable pain that felt like I had been stabbed and someone was twisting the knife; I knew as soon as it started that I was having another bowel obstruction.
I have been suffering from bowel obstructions since being diagnosed with Crohn’s Disease in 2009. The bowel obstructions are caused by a buildup of scar tissue in my small intestine called a stricture. Strictures are areas of scar tissue caused by inflammation within my intestine that does not expand elastically when food tries to pass through the narrowed section causing bowel obstructions.
Fortunately, I was not admitted and sent home because the partial obstruction passed. I took it easy for the next few days but I was still having daily, severe abdominal pain. I flew the Calgary the following week for my commencement ceremony for completing my Bachelor’s of Science degree, majoring in Geology from the University of Calgary! I met with my GI that I had been with for the past 4 years since I relocated to Calgary for my undergraduate degree and he wanted to keep me off steroids at all cost due to previous issues with Prednisone in the past. He told me to come to his office to pick up an extra two Humira syringes to double up on my already doubled dose of Humira (I am on weekly Humira injections) to see if that would calm things down.
$1200 of medication on the floor of a Starbucks bathroom
Long story short, I didn’t have a car on my trip because I flew, so I made the trek across Calgary to the far end of the city to pick up my Humira. It was over 30°C degrees and I didn’t have an ice pack to keep the medication cold. I felt absolutely terrible so I walked to the nearest bathroom to inject in hope of getting some relief. Feeling like a junkie, I found a Starbucks and went into the bathroom to inject. I didn’t realize they gave me the Humira auto-inject pens this time that I had not used before, I usually get the pre-filled syringes. In a lot of pain, I just wanted to inject the medication in hope that I would feel better and it looked pretty straightforward but there was not any instructions in the box. I took the cap off, held the syringe to my stomach and pressed the button. It clicked but nothing happened. I looked at the auto-injector again, and it looked like I had to twist the pen to expose the needle. As I start to twist, $1200 of medication squirts all over the floor of the Starbucks bathroom. I sat on the floor of the bathroom, had a bit of a meltdown and tried to figure out what to do next.
Rattled and in severe pain, I travel all the way back across Calgary to visit my pharmacist to see if I can get another syringe. He shows me how to properly inject the Humira pen and tells me to contact Humira to get a replacement. I injected two doses of Humira later that day, and luckily got another replacement mailed to me to inject two doses the following week after I flew back home to Vancouver Island.
With no improvement in symptoms or pain, my Calgary GI referred me to the nearest local GI in Victoria, BC, 2 hours away. Due to a very limited number of gastroenterologists on Vancouver Island for over 750,000 people, I could not get in to see him for a month. Thankfully, he did a thorough overview of my previous history and we spoke over the phone. He suggested the next step was to go on a short but high dose of prednisone.
Prednisone – The Devil’s Tic-Tacs & ER Trip #2
Prednisone is a corticosteroid. Differing from anabolic steroids, corticosteroids are catabolic and act quickly to reduce inflammation by dampening the immune system responsible for creating inflammation.
I have been on Prednisone many times in the past and have had great success in reducing Crohn’s symptoms but not without a plethora of side effects. Side effects I have faced include rapid weight gain, increased appetite, muscle loss, acne, difficulties sleeping and immunosuppressant complications just to name a few. Prednisone is a horrible yet amazing drug and is sometimes a necessary evil.
I was on Prednisone for a week with no improvement in symptoms or pain. My series of misfortunes continue, as I ended up in the ER again after being on prednisone for a week. I woke up one morning, unable to move my arm with a seized and extremely swollen elbow. It felt like I had a broken arm again. The ER doctor took a look and said I had a severe infection in my elbow. Being on high doses of biologics and prednisone which are both immunosuppressant medications, it wrecked havoc on my immune system and my body could not fight off an infection caused by a ruptured bursa sac in my elbow. Treating one problem and creating another, I was on antibiotics for a week and that cleared things up.
Following the infection, I got an MRI done to confirm our suspicion that the pain was likely not inflammation related. The double dose of Humira and the cycle of Prednisone should have mopped up any inflammation present. The severe pain I have been having daily for two months is the result of a build-up of scar tissue called an intestinal stricture.
A new Gastroenterologist, Colorectal Surgeon and “the most well-nourished Crohn’s patient”
In mid July 2017, I got in to see my new GI to discuss surgical options. Upon first impression, he took one look at me and said that I was “the most well-nourished Crohn’s patient” he’s ever seen, so I must be doing something right. I was very impressed, he was very thorough and seemed to genuinely care about my well-being.
I was referred by my new GI to a Colorectal Surgeon in Victoria, BC as well. I met with the surgeon and the consensus was to go ahead with my second surgery. The plan is to remove the scarred section in my ileum and install stricturoplasties in other scarred sections. The problem is that there are at least three other diseased sections that may also have intestinal strictures present. Due to the location in my small bowel, a scope is unable to get that far into the small intestine and that area is difficult to see on an MRI without inflammation present. There is a bit of a gamble with the surgery as it could be a much more complex than a typical small bowel resection.
The pain I have been experiencing is technically not an emergency situation unless I get hospitalized again, I am currently on the waitlist for surgery but it is not looking like I will be able to get in until October at the earliest. Unable to work, I am still experiencing a lot of pain but doing my best to still enjoy the summer and workout when I can. I have been having a hard time maintaining a consistent diet lately. I have restricted my already very restricted diet again, in an attempt to reduce the chronic pain I have been facing and I go into further detail in THE BOWEL OBSTRUCTION DIET – Restricting my already restricted diet.
Check back for another update soon!