#colonoscopy

Family doc and GI down, Gyno to go tomorrow.

I’m not anticipating any more follow up at the gyno, so I figured I’d post about updates now.

My GI appointment was actually pretty interesting. I mentioned the weird issues I’ve been having with perianal symptoms (itching, discomfort, pain while pooping, some really minor bleeding, and being awoken at night due to itching), and she did an exam to check for fistulae. She didn’t see anything, but did say that they can be pinhole-sized, so she ordered an MRI to check and make sure there’s nothing there.

Due to my increased frequency, the fatigue, and general malaise I’ve been experiencing lately, I’m also getting scoped at the beginning of August. She palpated my belly, and asked a few times if it hurt on my lower right (not more than usual), so she may be feeling something there that I’ve just not noticed, or have gotten used to. I mentioned that we will be trying to get pregnant within the next few months, so she said that any investigation should be done now. We can make sure everything looks good to give me peace of mind before trying, and if there are issues, we’ll deal with them. Increasing Humira, or switching to Entyvio or Stelara were mentioned.

I’ve done a round of normal bloods, but she also ordered the antibody test for Humira - Anti Adalimumab. Apparently a nurse will come to my home to do this. Hopefully, I can get it arranged for this week, before I inject on Sunday. Otherwise, I think I’ll have to wait until a few days before the injection following this next one.

Just waiting on results and test dates now. Anxious to see how everything looks.

I’m already researching prenatal vitamins to start taking asap.

So excited!

Prep is going as well as can be, and it looks like it’s almost at the optimal level of effectiveness already.

One more sachet of pico salax tomorrow morning at 5:30, and then I’m off to the hospital at 10:15.

Please wish me luck. I’m actually quite nervous about this one because if the scope doesn’t look great, I will likely have to delay trying for a baby even more. I’m not sure how it will look in there, given the symptoms I’m having.

Interesting. Having some fairly significant lower-right quadrant pain today. Usually mine comes and goes but this has been at about a constant 4ish and approaching 5 at times.

Scope can’t come soon enough.

lifewithchronicpain-original:

I’ve been to the hospital many times, and I’ve had bad nurses and doctors and good nurses and doctors. My recent overnight stint had pretty decent doctors and nurses. As patients we will certainly remember the more unpleasant experiences and be rightly angry about them.

However it’s important to remember that not all nurses are the bully from school. Many are genuinely nice and caring people, like my aunt who was a maternity ward nurse for many years. Many of these people are put under pressure of a for-profit medical system that forces more patients on less nurses. We should be outraged at genuinely cruel medical professionals, but if we want to be acknowledged as human too, we should do the same for them and advocate for better working conditions for nurses.

Yeah they’re supposed to be professional and not be rude but is anyone truly perfect at the end of a double shift with double the work? And some nurses are disabled too. I’m not against venting against terrible nurses but when we act like the problem is just the wrong people going into nursing we ignore a large problem about the state of nursing jobs and overworked underpaid caregivers that ultimately hurts and potentially kills us. I personally don’t want to do that.

I had some GREAT nurses when I was in for my colonoscopy. After, in recovery, my nurse went so far as to spend 10 minutes using alcohol wipes to gently remove my IV bandage, because I told her it rips my skin because of my fragile EDS skin. Did she have to do that? No. Did she have other stuff to do? Yes. Did I really appreciate it? SO MUCH YES

So I was kinda whiny and full of feels yesterday.  I was also prepping for a colonoscopy that is happening in a few hours. (Hurray for chronic illnesses!) This meant I had to drink massive amounts of nasty stuff. And I couldn’t eat anything that isn’t essentially a clear liquid. Neither of these improved my mood, especially being unable to eat comforting things. 

Today I will be better.  I will come home afterwards, eat Chipotle, smoke some dope, eat some more Chipotle and some Mega Stuf Oreos (not just Double Stuf), and then talk to my friends and finish something long and more interesting for this tumbla. 

Symptoms of irritable bowel syndrome include stomach cramps, bloating, diarrhoea and constipation. These may come and go over time.

IBS is characterized by abdominal pain and altered bowel habit in the absence of a specific and unique organic pathology. This means that there are symptoms of colon irritation/damage, but no specific disease can be identified and there is vast variation between patients.

Pathology

Causes for IBS have not yet been identified, but current research suggests:

Altered GI motility

• Themyoelectric activity (electric potential of muscles - how muscles contract and relax, in this case to push food along) of the colon is composed of background slow waves with spike potentials.
• Colonic dysmotility in irritable bowel syndrome manifests as variations in slow-wave frequency and a blunted, late-peaking, postprandial response of spike potentials. 
• This causes delayed meal transit (slow digestion) in patients prone to constipation, and in accelerated transit in patients prone to diarrhoea. 
• Current theories suggest generalized smooth muscle hyperresponsiveness - the muscle cells overreact to the electric currents. 

Visceral hyperalgesia

• IBS symptoms may be a result of an increased pain response to colon activity
• Rectosigmoid and small bowel balloon inflation produces pain at lower volumes in patients than in controls. 
• Notably, hypersensitivity appears with rapid but not with gradual distention.
• Patients who are affected describe widened dermatomal distributions of referred pain. Sensitization of the intestinal afferent nociceptive pathways that synapse in the dorsal horn of the spinal cord provides a unifying mechanism.

Psychopathology

• IBS is both more common and more debilitating in patients with panic disorder, major depression, anxiety disorder, and hypochondriasis.
• The psychopathology and stress caused by these disorders may contribute to IBS.
• This is particularly concerning as IBS symptoms will worsen these conditions, which may in turn worsen the IBS.

Microscopic inflammation

• Both colonic inflammation and small bowel inflammation have been discovered in a subset of patients. These studies are still in early stages.

Alterations in the intestinal biome

• Small bowel bacterial overgrowth has been heralded as a unifying mechanism for the symptoms of bloating and distention.
• The faecal microflora (bacteria in poo) also differs among patients with irritable bowel syndrome compared to those without.