Category Archives: disease

Ulcerative Colitis: An (Often Misunderstood) Autoimmune Disease

I was inspired to write this piece since my husband suffers from the disease himself and has additional disorders because of it. This is not a Christian article particularly (though it’s obvious from internet comments that Christians can be just as unsympathetic in their ignorance of the disease as anyone else), but one that many found useful at the now defunct Yahoo! Voices, where it had been published.  It was my most viewed and used article, by far, there.  So, instead of trying to republish it elsewhere, I’m posting it here.  I hope you find it informative and of value to pass on!  We hope that a cure may be found some day.

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UC is not a disease with localized symptoms only, as many believe

Ulcerative Colitis is not just ulcers in the colon due to stress or eating habits, as many people mistakenly believe. It is an autoimmune disease that is controlled through medication, if possible, and the removal of the colon if medications fail.

My husband has moderately severe ulcerative colitis (UC) and, despite being on medication, has frequent symptoms. Difficult for him, then, is his encounters with people who think this disease is no big deal or it can be self-cured. While some people with UC respond so favorably to medication that they remain in remission for very extended periods, for many this is not the case, and, there is no such thing as curing yourself of UC.

It seems hard to lead people to understand that UC is an autoimmune disease that has very little to do with controllable factors in a person’s life. About 500,000 people in the U.S. have UC, and about 50% of these have milder cases that respond well to medicines. The other 50% have more symptoms, have to go through difficult treatments, and may even have to have their colon removed.

The white areas are ulcers (image is from author's husband's colonoscopy).
The white areas are ulcers (image is from author’s husband’s colonoscopy).

What is Ulcerative Colitis?

Ulcerative colitis is a single disease, but it does vary significantly in its manifestation. It can be quite mild if found and treated early, or it can be deadly if not treated. The colon is an upside-down U-shaped organ, and UC can affect just the lower part of it (“proctitus”), the left side of it (“distal colitis”), or all of it (“pancolitis”). My husband has pancolitis, and no doubt this is partly due to a late diagnosis.

What happens with UC is that, for reasons currently unknown, the body attacks things in a person’s colon–and the colon itself–because it mistakenly views these things as infections. The colon becomes chronically inflamed, and this in turn further damages the colon. Left untreated the colon can become completely nonfunctional (called “toxic megacolon”), swell significantly, perforate, and cause death.

Ulcerative Colitis Symptoms

All of the symptoms listed below can range from mild to severe, and keep in mind that not everyone experiences all of these symptoms.

  • In children, a slowed growth rate
  • Abdominal pain and cramping; diarrhea
  • Blood and pus in stool
  • Weight loss; loss of appetite
  • Fever
  • Fatigue
  • Swelling and pain in joints
  • Nausea and vomiting
  • Lumps in skin that become ulcerated and then spread; mouth sores
  • Swelling of the iris of the eye

Complications from Ulcerative Colitis

  • Malnutrition, caused by malabsorption and/or medications
  • Bone loss and low bone density, caused by medications. (My husband had a foot break from only exerting normal pressure on it, and at a later point was found to have basically no vitamin D in his system.)
  • Anemia, and in some cases, massive internal bleeding
  • Colorectal cancer; cancer risk significantly increases each decade
  • Blood clots (especially in the legs, and clots formed there may travel to the lungs)
  • Kidney stones and liver abnormalities
  • Weight gain from certain medications, and emotional distress
  • Toxic megacolon, which leads to death if the colon is not removed

How is Ulcerative Colitis treated?

There are varying treatments, depending on the severity of the disease. They include proper nutrition relative to UC, prescribing “aminosalicylates” for mild to moderate UC, “immunosuppresents” for more severe levels of UC, and more difficult to handle drugs for emergencies or very nonresponsive cases. Please see Ulcerative Colitis: Medications for a detailed overview.

The ultimate treatment is the removal of the colon, or proctocolectomy. There are two different surgeries relating to proctocolectomy: the outcome of one is having an exterior bag that collect stool; the outcome of the more difficult procedure is that stool is expelled through the anus, made possible by a surgeon forming an interior “bag” from the small intestine. To read more about these procedures, see Removing the Colon: Surgical Options and Opportunities.

The CCFA: An Advocacy and Support Group

The CCFA, or Crohn’s and Colitis Foundation of America, is a nonprofit organization that funds research into inflammatory bowel diseases (IBDs) and publishes the scientific journal “Inflammatory Bowel Diseases.” The group not only has local chapters, but all kinds of information for coping with UC and other IBDs, research information (including clinical trials needing participants), leads to support groups and doctors, and an online community. If you want to find out more about UC and IBDs, or if you want to help find a cure through giving, the CCFA would be a great place to start.

 

Additional Sources

Ulcerative Colitis – PubMed Health/A.D.A.M. Encyclopedia

Survival and cause-specific mortality in ulcerative colitis: follow-up of a population-based cohort in Copenhagen County – NCBI/PubMed.gov

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Varied and Odd Happenings; brains, kidneys, and the kitchen sink

Hi wonderful readers.  I’ve been neglecting my Christian posts of late but I’ll tell you of the odd happenings and other reasons why (besides my previous post regarding CafePress).

First, let me mention what has been unfortunately happening with my husband.  My hubby has been ill all his life, and was finally diagnosed a while back with moderately-severe ulcerative colitis, an auto-immune disease.  They try to keep it under control with a drug that is for milder cases, and it doesn’t really make him disease-free.  So he has had those issues, but, something new came up.  He passed out just before work one day – prior to that he was very fatigued and had other symptoms for some time, too, but he kept working (it’s hard to tell if some symptoms are from UC or from something else).

That was about four weeks ago and the doctors still don’t know what is wrong with him.

Though not too clear, this was the view of Catalina Island from my husbands first hospital room. Amazing.
Though not too clear, this was the view of Catalina Island from my husband’s first hospital room. Amazing.

They had done an MRI of his head and found that he has a large group of brain cysts that are very odd.  They said at Kaiser that they had never seen anything like it (perhaps that’s because they don’t do as many tests on people as they should – seriously), but that those cysts would not be causing his symptoms.  So they apparently will be testing him more to try and figure out what is going on (this had been a slow and agonizing process with Kaiser – another healthcare provider is recommended).

In the meantime, if you can believe this, he developed extreme pain where a kidney is and he went to the ER.  They assumed the basic and normal thing – first time kidney stone victim.  But, as he needed more pain medication than normal and his heart rate was elevated for a very long time, he was admitted to the hospital.  I could write a whole long essay about his incident relative to our insurance, but right now I’ll ignore that.  In the end, what they found was that he had a large “kidney stone” that isn’t a “stone” blocking the tube from kidney to bladder.  He has stabilized but we’re waiting for the thing to come out to determine what it is, since it’s not made of calcium.

English: A kidney stone with associated hydron...
A kidney stone with associated hydronephrosis mid ureter (Photo credit: Wikipedia).

Otherwise, as we simply need more income, I’ve been trying to garner more freelance work and have been checking out the possibility of  another part-time job (haven’t looked into temp agencies yet, but if you have opinions of any agencies I’d be interested to hear of your experiences).  I’ve had two* assignments published at Yahoo! and am waiting–for what seems like an eternity, they are so slow–for other submissions to be accepted or rejected.  So, the time I used to spend writing posts here, I’ve been investigating where I might publish, obtaining writing gigs, and writing articles/essays.  One of my poems, one that is posted at this blog, is to be included in a Korean anthology of Christian poems.

I haven’t forgotten about this blog, however–no way.  I had studied much for writing a nice post on the book of Jonah and how it relates to Christ and God’s plan for mankind, but got distracted and overly annoyed about an explanation I saw by Calvin regarding why/why not God “changed his mind” about destroying Nineveh.  I thought it so absurd that I was preparing to write an essay about that only, but, I stopped myself (rage posts aren’t a good idea).  I then lost interest in writing up the Jonah piece, but I do plan on getting that done sometime soon.  It is one of my favorite prophetic sections in the Bible.

* I posted about my first one involving appendicitis, and if anyone is interested in my second one on preventing strokes, well, I’d be happy to know that you enjoyed it!

Update (May 18, 2014):  My husband became extremely pained again and we went to urgent care.  While kidney stones indeed cause a level of pain that is compared the child-birth, we just weren’t sure what to do.  What is “normal” when dealing with kidney stones?  Should you have to miss one to six weeks of work because of constant excruciating pain and/or nausea?  We now know that a big part of my husbands health problems are related to becoming dehydrated, which is being caused by his ulcerative colitis.  This was causing more problems with his kidney/kidney stones.

But to get to the point, he had surgery to remove the stone, which was found to be lodged in his ureter somehow.  I wish I knew more – I was at the pharmacy when my husband woke up and the nurses told him about the unwelcome lodger.  Regarding the weird non-calcification issue, the surgeon did speak to me briefly and said that the stone WAS calcified, so it is currently a mystery to us why were told differently earlier.  Thanks for reading and any prayers; if you have questions, feel free to ask!  We don’t mind, and maybe we’ll learn more from the question and in the effort to answer.

 

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Appendicitis Symptoms are not always “Typical”

Appendicitis isn’t a big killer in the US, but knowing more about it could save your life.  Having an unusual case of appendicitis myself, I wrote about it at Yahoo! Voices:  Appendicitis Symptoms Are Not Always “Typical.”  Since Yahoo! Voice shut down, I’m posting the full (but short) piece below.  Under it is a bit of additional appendicitis-related information that I find interesting and helpful.  I  hope this post helps with whatever you came here for.  Since my word-count for Yahoo!’s post short by requirement, not everything that I would have liked to have written is included; feel free to comment with questions if you have any.

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Appendicitis Symptoms are not always “Typical”

I have irritable bowel syndrome (IBS) so when I noticed a small but different feeling in my abdomen, I wasn’t sure if it was anything to worry about. The next day it was still there, but I didn’t know what “it” was. On the third day, I knew that what I was feeling couldn’t be OK; appendicitis came to mind, but I wasn’t experiencing the typical symptoms.

My symptoms were not average

I did not experience the pain—which is often severe–near the belly-button that then travels down to the lower right abdomen.   I didn’t have nausea, nor did I ever vomit. One common symptom is a change in digestive behavior, having either diarrhea or constipation, but these are normal with IBS. I did have a low fever, however.

Having symptoms of something, I went to an urgent care center. The blood tests ordered by the doctor revealed that my white blood cell count was elevated, but not as much as is “normal” with appendicitis. My fever was also lower than it should’ve been. Nevertheless, thinking I might have appendicitis, the doctor told me to get to the emergency room (ER) while he called ahead so I’d be examined quickly. His call seemed to be ignored by the ER intake nurse, however, and I stressfully waited minute by ticking minute to be seen. Because I wasn’t writhing in pain, vomiting, or running a high fever, I felt a bit invisible to the staff–but significantly, my abdomen became more and more tender.

The long awaited diagnosis and surgery

Hours later, after being granted entrance to the bowels of the ER, my symptoms confused the staff. (This is not necessarily surprising since every year up to a third of child-bearing age women are misdiagnosed; AHRQ 2013.) The area affected was not the right place, they told me. Then there were delays: a gunshot victim was admitted and drew the doctors away, and, though a CT scan was ordered the scanner needed repair (!). So I waited, again.

Once the CT scanner became available appendicitis was solidly confirmed, and not something like an ectopic pregnancy. The lead doctor was very kind and acknowledged to me that a high degree of tenderness in that area can be just as indicative of appendicitis as much pain. I never did have much pain.

I was immediately attached to an IV with antibiotics and admitted to the hospital. Though my appendix had already perforated and I had a very long wait for the typical laparoscopic surgery, it went well. Due to modern medicine, I feel very fortunate to be alive. By sharing my experience, I hope that readers won’t ignore this potentially life-threatening condition simply because they don’t have typical symptoms. To learn more, go to the NDDIC’s Appendicitis page or the pediatric Appendicitis/Appendectomy page of CHOPS.

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Age-standardised disability-adjusted life year...
Age-standardised disability-adjusted life year (DALY) rates from Appendicitis by country (per 100,000 inhabitants). (Photo credit: Wikipedia)

Deaths from appendicitis in the USA are at about 400 per year.  This hard-to-get figure is from the latest WHO statistics, which aren’t all that recent (2008 data published in 2011).  I assume that this statistic includes deaths from people who didn’t go to the doctor in time, as well as deaths from post-operation complications.  There are over 250,000 appendectomies done in the US each year (about 8% – 10% of all people will develop appendicitis in their life times).

Besides my story of not being sure when and if I should see a doctor about the abdominal pain I was having, here is another story about a father-to-be who wasn’t so fortunate.  I am glad to be able to share this article about (partially) Paul Hannum, who lost his life due to appendicitis and lack of insurance.  He deserves to be remembered, and I wish his daughter had been able to know him.  In case you’re interested, here is a wiki list that might lead you to more anecdotal information:  Deaths from Appendicitis (list).