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Tuesday, April 13, 2010

Again!?

April 8, 2010

Ok. So time for a refresh. Everybody remembers Dr. Rider. He is my per-rectal doctor and he is also my surgeon when it comes to those issues. Well ever since December I have told you good and bad days. Well one thing that I have continuously had problems with is still my anus.

I knew the fistula was healed. I knew that the knot was gone, but every time I have a bowel movement it still hurt -feels like razor blades- and I bleed with my bowel movements. After my bowel movements I'm in terrible pain so I will have to take some Darvocets or sit in a hot bath. Well finally when I went for that Remicade treatment I had asked Dr. Rodriguez to look at it, but I was exhausted and we all forgot to remind him.

Well I thought about it and I knew that the best and smartest thing to do would be to make an appointment with Dr. Rider since he specializes in that specific area. Well we made the appointment and on the 8th Mom, Andrew, and I went to see him. Well when he walked through the door you could tell he was like Oh no. Now let me back track for a second. Back in December I had begged Dr. Rider to be my doctor for my Crohns...well he got a shocked looked then laughed and said "he** no". Now don't think he is mean...it was actually really funny. Also in December he had told me that on a scale from 0-10 I was a 3 on the scale as far as treatability. So he was saying I could be pretty much treated pretty easy...so now back to the day...when he walked in he gave me the face and I said well on a scale of 0-10 I'm a 10...and I laughed. He sat in his chair and just did his little face and said "Well...I'm sorry...I got to give it to you...you have a really bad case". So I told him everything that was going...caught him up about the port...my first Remicade. He was happy to know I was finally on the Remicade. So next...he needed to examine.

Well let me just tell y'all. I'm now finally comfortable with laying on a table and getting examined, but that is now. It is very demeaning when you have to lay up on a table and people have to look at and up your booty. It's just an embarrassing situation. However, Dr. Rider has such a nice bed side manner and is so respectful. Well he spreads my cheeks and he said "Huh?" Well I'm turned the other way and I said "Uh Oh...what?!" He was like well..."It's funny...you are saying you are having problems, but your external fissures are completely gone...and also where your fistula was, the skin looks so healthy." This brought more concerns. I asked him "Well why am I hurting and bleeding" (I had just had a bowel movement before he came and I had bled and hurt with it) He told the nurse to grab a pediatric scope.

"Well...that's what we are about to find out." He got the scope and I started getting nervous. I have never had a scope stuck up me while I was awake...only during the surgeries while I was completely out...before the fissures you could see with your eyes by spreading my cheeks apart. Well he put the gel on it and inserted it...I'm talking about PAIN! I started breathing hard and humming with my breath trying to ease the pain. I finally felt something warm and I knew he had it up there and the light was on. He examined and finally said "huh"...again I'm like "What?" He said "Well...you do have a fissure...but like I suspected it's internal." He pulled the scope out and told me to get dressed and he would be back to talk to me.

So we go back to another room. He walked in. He told me that 1-good news because the external fissures were gone which meant something had worked at one time or another 2-now that I had an internal fissure we were going to have to deal with it. He told me there was 2 nonsurgical ways and 2 surgical ways. With my case of Crohns there would be only 1 nonsurgical and 2 surgical. So only one way to try to treat it first. It was the Cardizem cream. It is a blood pressure pill that is crushed and made into a cream. Problem with me is that my blood pressure runs low and I can only use a thin coat and sometimes it gives me that blood pressure bottom which makes me feel terrible. I have to apply 4 times a day.

Next...he told me that he would see me in 3 weeks. If it wasn't cleared by then then we would set up for surgery. The first surgical try would be putting a scope in and give botox shots around the fissure and in it... this would then relax the area and muscles around, which would hopefully help give it time to heal. We didn't discuss the second surgical procedure if that didn't work.

He then asked about pain medicine. He showed me that my fissure was about 2 inches long. He said its not terribly long, but long enough to cause terrible pain, so he refilled my darvocet and gave another refill. He also talked to me to try to encourage me. He talked to me about my Remicade and I told him I was just trying to stay level headed about everything. He asked me what I meant. I told him I didn't want to be super excited because I had with everything and they didn't work. Second, I didn't want to think they weren't going to work because I wanted them and thought they really might. He said he understood because none of the treatments before had worked.

He also had told me that he had wanted me on the Remicade in the beginning and that people were going to have to get over the fear of giving it to young people with the risk of lymphoma. He said that they haven't had one yet, but it eventually would happen. He said if I was the one...that I was the one...it was inevitable, but to hold back the treatment because of the risk was depriving someone of treatment that may put them in remission.

I understood where he was coming from, but it's not like I waited that long...I got diagnosed in December and ended up getting Remicade in April because nothing worked. 4 months...no big deal. Now for someone else that waited years...I might can see that.

So we left and stopped by waffle house got us some food!

Now before you continue to scroll down I told you to be aware. That this was my story and I was going to tell and show all...so I got a picture from Adams...which is a medical website. It just an image created on computer to show what a fissure is. It is much worse in reality.






This is a picture of both internal and external.
With external you can see them on the outside, but they also
run into the inside of your anus. With the internal you can't
see as easily in this picture but it looks just like the external
just further up and harder to treat. Just as painful. With Crohns
fissures are located in places opposite from normal people with fissures.
If you have excruciating pain and bleeding with bowel movements
you may have a fissure. You can get them from many things including
constipation however I just get them and in harder places to treat.




This is a picture of ulcers which line and are all
in my intestines and also a picture of a fistula. Fistulas
can tunnel any which way they desire and can't get as large
as they want if untreated. Mine was very long and tunneled from
my rectum all the way out into my cheek and up towards my female parts.




Another picture of a fissure and fistula. Now
a fistula is a fissure that has gone untreated (possibly
not known about) and gets infected and starts infecting more
and tunneling. Now in this picture that fissure is very short...
like I said mine is about two inches and up further into my rectum.
So every time bowel passes it just rubs it and it hurts terribly




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