|Photo credit: Winnipeg Sun|
"Then I vomited again, the clear fluid with green flecks splashing onto the floor before me. A few people in front of my wheelchair darted away from me to avoid the projectile stream of puke."
Crohn's Disease wasn't entirely foreign to me at the time of my diagnosis. My mother's sister, Penny, was diagnosed with the disease a few years before. Her battle with it included daily consumption of "maintenance" drugs, a drastic change in her diet and, at times, unbearable pain that made her immobile for days.
According to the results of a test on tissue taken from my bowel during my appendectomy, I was suffering from Crohn's Disease affecting about 18 centimetres of my ileum - a portion of the bowel where the small intestine meets the ascending colon, or large intestine. The pain associated with the diseased ileum and it's location adjacent to the appendix led the walk-in doctor to her diagnosis of appendicitis.
Besides the biopsy of a portion of my small bowel, my diagnosis was also the result of a barium test, where I had to drink a thick, disgusting, metallic paste, sit for up to two hours while it moved through my digestive tract, then obtain x-rays to determine the efficiency of its passage.
Crohn's Disease is a chronic condition that causes inflammation in the lining of the digestive tract anywhere along the digestive system. This inflammation causes abdominal pain, severe diarrhoea, malnutrition, fatigue and weight loss.
The disease can cause numerous complications, some of them life-threatening. Inflammation can cause an obstruction in the either the small or large intestines. Ulcers, or open sores in the wall of the digestive tract, may also develop with chronic inflammation. When the ulcers extend completely through the bowel, they may develop into fistulas, which is the abnormal connection of tissue between different parts of the intestine, between the intestine and the skin, or between the intestine and other internal organs. Fistulas become especially dangerous when they allow fecal matter to leave the intestine and enter other parts of the body, like the skin, other organs or the abdomen.
Crohn's Disease may also cause anal fissures, cracks or clefts in the anus or in the skin around the anus. This condition causes painful bowel movements and infections. The disease is also known to cause malnutrition in its patients. Diarrhoea, abdominal pain and cramping make it difficult to consume food and maintain appropriate nutrient levels, while inflamed bowel will lose its ability to effectively absorb required nutrients. Crohn's patients are also at a higher risk of contracting colon cancer.
But this isn't the end of the list of side-effects Crohn's Disease patients need be concerned about. The ailment can also cause arthritis, inflammation of the eyes or skin, clubbing of the fingernails, kidney or gallstones, inflammation of the bile ducts and, in some cases, osteoporosis.
The cause of Crohn's Disease has not yet been found. The current thought is that the disease is caused by a combination of factors between heredity and a malfunctioning immune system. The idea is that a virus or bacterium is triggering the disease by forcing the immune system to work against the invader. Should the immune system be working abnormally, it will not only attack the invading virus or bacteria, but the healthy cells of the digestive tract, causing the inflammation.
At one time, diet and stress were thought to be a substantial cause of the disease, but not anymore. They are, however, considered instrumental in triggering relapses of the disease in patients with the disease in remission.
There is currently no known cure for inflammatory bowel diseases, which also includes ulcerative colitis.
In a report dated May 15, 1997, Dr. G. explained that the Pentasa was having little affect on improving my condition. However, the Crohn's didn't seem to be spreading further up or down the intestinal tract, meaning there was no need to prescribe further medications for the time being.
I weighed about 165 pounds at the time. I continued to suffer from severe abdominal cramping and a total loss of appetite. I tried to return to work, but my condition was growing worse by the day.
After explaining the situation to Dr. G. a week later, he replaced by Pentasa prescription with Prednisone, a corticosteroid that suppresses the immune system for the treatment of severe inflammation. On our first visit with him, he had mentioned the potential for its need, but hoped we wouldn't require the powerful medication. After assessing my condition a second time and seeing the continued downward spiral in my weight and general health, he decided it was a necessity.
While Prednisone has been shown to be effective in everything from arthritis to cancer, consuming the synthetic chemical is a terrible option in any case and, in my opinion, should be used only as a last resort. Many of the drug's side-effects relate to the patient's mental and emotional well-being. I've come to learn that a positive mind-set is integral to overcoming not only the ailment affecting you, but the stress associated with the entire situation surrounding it. Prednisone seems to do everything it can to mentally defeat you while "helping" ward off whatever is causing the inflammation.
The list of potential side-effects caused by Prednisone includes aggression; agitation; anxiety; blurred vision; dizziness; irregular heartbeat; headaches; irritability; depression; mood swings; nervousness; troubled breathing; numbness or tingling in the arms and legs; pounding ears; swelling in the extremities and other areas of the body; trouble thinking, speaking and walking; and weight gain.
There are dozens more side-effects on top of these, both physical and neurological.
In my condition at the time, I was willing to try anything. The pain was so severe, it felt like someone was churning a jagged knife around my abdomen from the inside. There was little I could do to fight it. It hit me most frequently at night, when I would just get up and pace the apartment, holding a heating bottle to my stomach or just rubbing my abdomen to try and trick my brain into feeling some other sensation than the unbearable pain.
My "tricks" rarely worked and by late May, I was a physical, spiritual and mental skeleton from the chronic torture, lack of food and inability to hold anything in my stomach.
I had another barium test ordered by Dr. G. After drinking what seemed like a combination of liquid steel and sewage, I remember laying in a dark ante-room in the x-ray ward of the hospital. I shivered in the soulless concrete surroundings. I tried to sleep, but the gurney they supplied me was hard and cold. I just laid there on my left side; which I was told would hasten the barium's passage through my system; trying to sweep away the depression that weighed heavy on my heart and mind.
An hour and a half later, I vomited the barium into a trash can near the exit to the room. I would need to choke down more of the sludge in order to get an accurate reading of the full-length of my digestive system. I cried when the nurse brought me another half portion of barium smoothie. She rubbed my shoulder in sympathy as she left the room.
I saw Dr. G. again on May 27. This time with my mother, who had come to care for me while Coral began taking on more work to fulfill our financial obligations. Dr. G. went through his general assessment and suggested we continue in the direction we were moving. My increased speed at which my condition was deteriorating, however, had both Coral and my mother questioning this assessment and treatment plan.
On May 28, 1997, I woke from a fitful sleep after suffering from another disrupted night of unbearable pain. My mother did her best to nurse me, but, really, there was little she could do but watch her son dissolve before her eyes. It must have been as painful for her as it was for me physically.
That morning, I woke unable to relax any part of my body. I writhed on my bed, only getting up to vomit more clear fluids from by bowels. I hadn't eaten anything solid or moved my bowels in more than a week. A simple glass of water wouldn't even remain in my system.
With tears flowing down my face from the pain and the frustration with the situation I found myself in, I asked Coral and Mom to take me to the emergency ward.
I was in a haze and barely coherent enough to walk down the stairs towards the foyer and out into the parking lot. Coral and my mother each took an arm and guided me to our vehicle - now a Suzuki Sidekick - and rushed me back to the Victoria General Hospital.
I spilled out of the Sidekick at the emergency entrance and stumbled into the building. Someone brought us a wheelchair, where I sat barely noticing the chaos of the conventional city emergency ward around me. Then I vomited again, the clear fluid with green flecks splashing onto the floor before me. A few people in front of my wheelchair darted away from me to avoid the projectile stream of puke.
I was handed a shallow bowl, but it was filled with even more of my stomachs contents - which, despite not being full for days, seemed to have a bottomless supply of bile and stringy, clear, acidic liquids.
Due to my condition, I was placed in a triage line for "urgent" cases, then rushed to the head of the queue as I continued to vomit. Once past the triage desk, I let my mind relax and fell into a cloud, only noticing the nurses buzz around my gurney and the touch of Coral's hand in my own.
A nurse taking my blood pressure winced and sighed when she saw the results. Coral caught a glimpse of the screen despite the nurses efforts to turn it away from her. My heart rate was dangerously low. The nurse rushed away, returning not long after to hook up an IV line to start feeding my emaciated and dehydrated body with nutrients and fluids.
The same internal surgeon who performed my appendectomy arrived to assess my condition and explained that he may need to do extensive surgery to determine what exactly was happening inside of me.
Despite feeling a peace and relaxation I hadn't experienced in weeks, I didn't realize how close to the precipice I was. At that moment, with consciousness dimming and my senses deceiving me, my body was giving up the fight.
In my stupor, I didn't realize how close I was to dying.