Update: on my daughter Holly.

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73monte
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   Posted 2/9/2009 2:33 PM (GMT -7)   
Hi All,
 
For those that haven't seen my post regarding my daughter, she had an abdominal abscess with fistula about 7 weeks ago, hospitalized for 10 days. Been on Flagyl and tapering Prednisone since. 
 
Today, we went back fo a SBFT, to see what the state of her Crohn's is, along with the healing of the abscess. We got good and bad news about how she's doing. I'll try not to get too long winded, (as I have a habit of). 
 
As far as the abscess/fistula, it seems to be healed up pretty well, and both our GI and the Radiologist feel that it's a non-issue. The fistula is still present, but they both feel that it will resolve in a few more months. Unfortunately, the Radiologist found a 2cm stricture in her TI. They feel that she may be a candidate for a resection as a result. They want to wait to see if the fistula will resolve first and are running bloodwork for disease activity. They feel that the blood in her stool that she's had a few times is a sign as well, along with her fatigue.
 
Our GI also wants to start the Imuran now as well. She feels that the risk of Chicken Pox is outweighed. She wants to keep the disease under control clinically for as long as possible. 
 
Our GI will be consulting with a surgeon and be going over the SBFT. They will come to a conclusion before the end of the week as to which treatment plan to follow. 
 
It was a pretty big letdown to hear about having to face surgery. I didn't think that would come for a long, long time, so I was taken aback by that. It's been a very long Winter. I hope the road ahead will get better.
 
Thanks for everyones imput over the last couple of months. It's sincerely been quite alot of help. 
 
Tom.
My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Initially, 9 weeks of Prednisone, currently taking 2000mgs of Pentasa.


Zanne
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   Posted 2/9/2009 2:57 PM (GMT -7)   
You sound very discouraged. Please don't be. If you trust your doctors, then you need to believe that they are doing what is in Holly's best interest. There are many people here who have had years, 20+, of remission after surgery. My Mom had almost 30, after her first resection. I have also known people who have had one resection, and as far as I know they have never had another. So it might just be the golden ticket. Plus you may not have to cross that bridge. The doctors are still running tests.

You keep posting that you want Holly to live as normal a life as possible. I know if I hadn't had my resections, I wouldn't be living anything close to a normal life. So please, take this one step at a time.

Take care.
Suzanne

CD 20 years officially, 30 unofficially. 3 resections '93, '95 '97
Managing with strict low residue diet, keeping symptoms to a minimum. All test show small amount of ulceration, still have occasional blockages. But still have a great time with my 2 daughters and husband!


Prednisone, 6MP,Prevacid, B12 shots, Bentyl, Xifaxan.....


gachrons
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   Posted 2/9/2009 3:44 PM (GMT -7)   
Hi Tom I was surprised to see they are thinking possible surgery. Glad to hear though about the fistula and abscess showing some improvement. Keep in touch and let us know how she is doing. Sometimes those strictures can cause alot of problems and hope you have good Dr.'s which I am sure you do.. lol gail
Hallarious woman over 50 ,CD ,IBS 27 years--resection,fistula's,obstructions,hemmies,and still alive.lol gail


73monte
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   Posted 2/9/2009 5:40 PM (GMT -7)   

Hi Suzanne,

I was somewhat discouraged. I went in there feeling really positive. Holly had been feeling pretty well, except for being so darned tired. I understand what you're saying about the surgery, it's just that I figured it wouldn't likely come for several years. Quite frankly, I was shocked that they were suggesting it. I haven't heard of too many her age, (15), already having to have a resection. 

Tomorrow's a new day, and I hope I find a new attitude. I'm pretty tired and drained myself right now. Oh, our GI also told us today, that's she's leaving, and moving to Montreal in June. They haven't decided on a replacement yet.  


My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Initially, 9 weeks of Prednisone, currently taking 2000mgs of Pentasa.


chroniemomx2
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   Posted 2/9/2009 6:03 PM (GMT -7)   
I am surprised also about the surgery suggestion. Personally, I believe that it is a last resort after you have exhausted all of your med options especially when you are only 15. You only have so much intestine. 2 cm is pretty small area also. I understand the discouragement. We all have our days. Hang in there, get some rest, and start tomorrow anew.
 
I asked my surgeon half jokingly to take out my lg. bowel because I was having so many abscess/fistula issues, and he wouldn't.  He said in crohns patients it should be a last resort, and since I wasn't having any disease in there it isn't an option even though I was having rectal abscesses.    

Post Edited (chroniemomx2) : 2/9/2009 6:06:48 PM (GMT-7)


73monte
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   Posted 2/9/2009 6:20 PM (GMT -7)   

chroniemomx2,

I'm reassured to see that there are others that share my surprise at the surgery option. I'm not sure that I understand stricture all that much. As I understand it, if there's stricture, doesn't that indicate narrowing from scarring? Wouldn't her BM's be quite thin and less frequent? She doesn't have any of that. If it wasn't for the fact that she was so tired, which is likely Anemia that she chronically had before, I wouldn't think that there was a thing wrong with her. Then again, being on Prednisone doesn't give a true picture.

Tom.


My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Initially, 9 weeks of Prednisone, currently taking 2000mgs of Pentasa.


73monte
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   Posted 2/9/2009 6:22 PM (GMT -7)   

Hi Gail, (Gachrons)

Thanks for the encouragement. I will keep you posted. Hope you are doing well. 

Tom.


My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Initially, 9 weeks of Prednisone, currently taking 2000mgs of Pentasa.


gachrons
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   Posted 2/9/2009 6:38 PM (GMT -7)   
Hi Tom there is another young person on here called alpha and that person had a ostomy at 14 so you might want to ask some questions about how things went for them, just a thought.I thought perhaps it might give you some perspective about things.. lol gail
Hallarious woman over 50 ,CD ,IBS 27 years--resection,fistula's,obstructions,hemmies,and still alive.lol gail


bektold
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   Posted 2/9/2009 6:50 PM (GMT -7)   

It's shocking the first time surgery is suggested, but there is a good chance that it won't come to that.  Within days of my diagnosis my doctors brought up the possibility of removing my entire colon.  Things turned around, and almost two years later I've still got all my parts.  Sometimes I think they throw out the worst case senario to let you mentally prepare just in case.  Also, it depends on who you're talking to.  The doctor who discussed the colectomy with us was a colo-rectal surgeon.  As he put it, he's a surgeon.  His specialty is cutting things.  If a patient comes to him with a problem he's going to look for a surgical solution.  He leaves the "medical" stuff to the other doctors.  That didn't mean that he thought surgery was necessarily the best option- it was just the best option within his area of expertise.  So if one of the doctors involved in this discussion was a surgeon, then I'm not surprised the topic came up.  I wouldn't read too much into it just yet.

I'm not an expert on strictures, but as I understand it they can be caused by inflammation or scar tissue.  Inflammation can be reversed, scar tissue cannot.  That may be why the doctor is pushing so hard to get her on the Imuran.  If they can get the inflammation down before it creates scar tissue, they may be able to avoid the resection.


inflamed
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   Posted 2/9/2009 7:09 PM (GMT -7)   
Hi there. I have a stricture in the TI. They've talked surgery several times, but I've been able to avoid it with meds for over 5 years. At the TI the stool is actually all liquid, that is why there are no narrow stools. It is also why you can get by for a long time with narrowing there. I've been lucky, I have a great deal of scar tissue there, but so long as there isn't inflammation as well I have no pain and don't need surgery. That's how meds sometimes can help even when there is a stricture. It's the added layer of inflammation that, for some, can throw things off. Don't get discouraged about the mention of surgery. Like Bektold said, sometimes they just throw it out there as a possibility but it isn't always an immediate need.
Hoping to stay in remission after the birth of a healthy baby girl. On Pentasa during my pregnancy, went med-free 2 months to nurse (stupid), but back on Pentasa and still nursing.


Rider Fan
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   Posted 2/9/2009 7:11 PM (GMT -7)   
At the same time, sometimes I think that if you're dealing with a small area of inflammation maybe it's better to just cut it out rather than deal with all kinds of systemic drugs, if the drugs don't seem to be working.

If somewhat in that predicament now, the 6MP didn't get me out of the flare, now I'm on MTX and I have to decide if I want to start Humira (which can open up a whole new can of worms) or talk about surgery.
Dx'ed in 1999. No surgeries.

Current meds: 25mg Methotrexate. 8mg prednisone. Udo's Choice Probiotics (30 billion).

Tried SCD, didn't work, now avoiding gluten and dairy.


chroniemomx2
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   Posted 2/9/2009 7:23 PM (GMT -7)   
A stricture can be either inflammation or scar tissue.

73monte
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   Posted 2/9/2009 7:43 PM (GMT -7)   

Hi bektold and inflamed:

You both give some hope that perhaps surgery can be deferred. You both make good points regarding talking to surgeons and managing with a stricture. As "Rider Fan" indicated maybe getting rid of the small area that's a problem, is the way to go. I think this is my GI's thinking. I think she is suggesting this, then hoping recurrence is a long way off. 

I did ask her about the stricture being inflammation, and she felt that it was more likely scarring, as inflammation is usually much puffier.

The one thing that's always confounded me about this disease is the degree to which my daughter has it. The Doctors have always been vague about that. I'm always tormented about that. Is my daughter a severe case? Having to consider surgery at 15 leads me to believe that she is. Or is she more mild. Our Doctor has used the word moderate, but it seems kind of non-commital. She won't lean one way or the other. 

I just caught myselt getting long again, I'll stop there.

Tom.

 


My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Initially, 9 weeks of Prednisone, currently taking 2000mgs of Pentasa.


inflamed
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   Posted 2/9/2009 7:54 PM (GMT -7)   
I don't think they can classify this DD as mild, moderate, or severe over the long term. I was called severe when I was Dx, but have since had a 4-year full remission (still have the scarring, but no inflammation even on a biopsy). Hopefully they'll get your daughter's disease under control and then call it mild or remission.
Hoping to stay in remission after the birth of a healthy baby girl. On Pentasa during my pregnancy, went med-free 2 months to nurse (stupid), but back on Pentasa and still nursing.


73monte
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   Posted 2/10/2009 4:13 AM (GMT -7)   

After having a nights sleep, (if you can call it that), I woke up with more questions and concerns. I shoud probably post my questions in another thread, maybe I would get some good feedback.

After leaving the Hospital yesterday, I realize now that the biggest concerns are:

1. How much stricture is present, and is it permanent. How much can be managed without surgery?

2. Starting Imuran. What to expect, plus how serious would it be if she contracted Chicken Pox?

3. What's causing her fatigue/tiredness? I thought Prednisone would give her considerable energy as it did previously. The GI doesn't feel it was the Flagyl. If it's disease activity, and she's not in reimission after Prednisone, then what?

4. The presence of blood in her stool. Even though it's only happened 3 times. I'm concerned that it's her intestine seeping.

I could likely come up with about 10 more, but rather than burn holes in the ceiling every night with worry, I'm going to try to be more analytical about it. THese are my main concerns. I want to make the best possible decisions to help my daughter get the best chance at this disease. I don't want to go blindly, just trusting any medical opinion I get. I do have confidence in our GI, but it's an extremely busy place. They are dealing with hundreds of cases.

Thanks, Tom.


My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Initially, 9 weeks of Prednisone, currently taking 2000mgs of Pentasa.


kimberlayn
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Date Joined Jul 2007
Total Posts : 239
   Posted 2/10/2009 6:50 AM (GMT -7)   
Hi Tom,

I really feel for you with this. Medical problems and our kids are the toughest things to take. My oldest son had to have two surgeries in a month last year, due to a dead testicle. He was 15. The surgeries were much simpler than a resection, and no hospital stay. But I wanted to let you know that if it does come down to surgery, your daughter will have the major advantage of youth on her side. I was amazed at how well my son did, and the nurse told me that most teens are like that. There bodies are already growing so fast, they heal right up. My son took over his care in the hospital, answering all the questions before the surgery (the ones he knew) and was so grown up, it was ALMOST like he didn't need me!

My doc is talking surgery again for me. He holds a different view than some have posted here, and I agree, that surgery doesn't always have to be the last option looked at. We agree that having surgery to remove the active disease that isn't being taken care of by meds (i'm on humira and coming off a round of prednisone that didn't help a whole lot) is better done while I am relatively healthy. I would rather take a week in the hospital and 6 weeks off of work to feel good for a year or two, then be miserable all the time. I'm weird, I know, I don't mind surgery, I don't get nervous and I don't worry about what could happen (except when it was my son!). If surgery is recommended, it could be a good thing if it gives your daughter her normal life for a couple of years. I'll be thinking of your family, and praying for the best for you.
diagnosed w/Crohn's 11/06. 35f with 2 boys and a wonderful husband. 150 mg Imuran, bentyl, entocort, vicodin as needed, Humira, metoprolol for orthostatic hypotension and heart palpitations. Bowel resection 9/07. Active disease back, darn it 8/08. 11 year old son with IBS-C, on Bentyl.


Nanners
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   Posted 2/10/2009 8:10 AM (GMT -7)   
Tom have you asked the GI if they could go in with a colonoscopy and stretch open the stricture. Sometimes that can buy time to avoid surgery. Also if it is from scar tissue and not inflammation, no medications will heal that. But.....it doesn't sound as if the stricture is really causing her problems right now, so maybe the Imuran is the way to go for now to quiet her disease down.

Good luck!

Gail*Nanners*
Gail*Nanners* Co-Moderator for Anxiety/Panic Forum
Been living with Crohn's Disease for 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia and Osteoarthritis and Anxiety. Currently my Crohns is in remission.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

Nanners
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Date Joined Apr 2005
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   Posted 2/10/2009 8:13 AM (GMT -7)   
Oh and about the fatigue, I am anemic myself and always have to take a nap, before I go to bed:) My disease is in remission right now, but I am still anemic. Mine is caused by my diet I believe. But in order to stay comfortable Crohnswise, I have to stick with my low residue diet. Have you had her bloods checked lately, she could very well be anemic.
Gail*Nanners* Co-Moderator for Anxiety/Panic Forum
Been living with Crohn's Disease for 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia and Osteoarthritis and Anxiety. Currently my Crohns is in remission.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

bektold
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Date Joined Jul 2007
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   Posted 2/10/2009 8:56 AM (GMT -7)   

Obviously, I can't give you any answers for question number one.  But for the rest:

2. Starting Imuran. What to expect, plus how serious would it be if she contracted Chicken Pox?

I had a little bit of a rash pop up on my arms when I first started Imuran, but that went away quickly.  And I'm not 100% convinced that it was caused by the med.  Other than that, I had no reactions to Imuran.  It didn't control my disease as well as we hoped, but I never once picked up a cold or anything on it, and that was through two airplane trips and a full flu season.  Can't say anything about Chicken Pox.  Until you brought it up I'd never heard that it was an issue.

3. What's causing her fatigue/tiredness? I thought Prednisone would give her considerable energy as it did previously. The GI doesn't feel it was the Flagyl. If it's disease activity, and she's not in reimission after Prednisone, then what?

Are you monitoring her B levels?  The are absorbed in the TI, which with the stricture isn't going to be working properly.  That could cause fatigue.  Also, all that inflammation eats up a lot of energy.  It could just be the disease process.  I believe you said she's anemic.  That will cause fatigue.  Add it all together, and that's a lot of fatigue.  It's unpleasant for her- she'd rather be running around with her friends like any kid.  But it's likely not dangerous or something to worry too much over.  As she recovers from this flare her energy levels should increase.

4. The presence of blood in her stool. Even though it's only happened 3 times. I'm concerned that it's her intestine seeping.

Does she have any ulcers?  What about hemrrhoids or fissures?  If she has any of those, a little blood occasionally is to be expected.  It's not ideal, but as long as it's not large amounts or happening constantly, again it's probably not something to worry about too much.  It's another thing that should clear up as the flare ends and her insides get a chance to heal.


73monte
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   Posted 2/10/2009 12:51 PM (GMT -7)   

Hi Gail, (Nanners),

As far as I knew, the TI couldn't be reached with colonoscopy. I will certainly inquire anyway. As far as the Anemia, we are having blood done again now, so should get the results by next week. I would strongly suspect iron and b12 are low. I'm a bit concerned that she's losing blood, as she has noticed it in her stool a few times. THere may be more that she can't see, it's hard to say. 

Tom.


My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Initially, 9 weeks of Prednisone, currently taking 2000mgs of Pentasa.


73monte
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   Posted 2/10/2009 12:54 PM (GMT -7)   

Bektold,

Thank-you for attempting to answer all my questions, I appreciate that. As I just posted to "Gail", We are getting her blood checked, and will see next week about that. Others have suggested hemmoroids too, but she's pretty young, and hasn't had any discomfort there.

Tom.


My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Initially, 9 weeks of Prednisone, currently taking 2000mgs of Pentasa.


Nanners
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Date Joined Apr 2005
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   Posted 2/10/2009 2:55 PM (GMT -7)   
Tom with all our poop problems I would not be surprised if she didn't have hemmoroids. They can be internal too. If the blood is bright red, I am pretty sure its hemi's. And doesn't she suffer with more constipation than diarrhea? If its more C than D I would feel pretty sure its hemmoroids. I don't have discomfort, but I still have them.
Gail*Nanners* Co-Moderator for Anxiety/Panic Forum
Been living with Crohn's Disease for 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia and Osteoarthritis and Anxiety. Currently my Crohns is in remission.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

Celey
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   Posted 2/10/2009 3:21 PM (GMT -7)   
Just because you're young doesn't mean you can't get hemmorroids (Ugh. IT DRIVES ME NUTS THAT I DON'T KNOW HOW TO SPELL IT!).... I'm 20... I get them all the time... I think I have some right now because I'm starting to see a bit of blood in my stool, and its starting to get very uncomfortable... *Because she is young also... this may be something very embarrassing to talk about...*

Also, I take Imuran... I really haven't noticed any side effects from it... I mean, not saying there won't be any, but... just haven't noticed anything... She will have to get blood drawn every month or so (because serious side effects can RARELY occur... That's why the blood is drawn, so if such side effects start to appear, the GI can stop it in its tracks before it becomes an issue)

As for the extreme tiredness, it could be any number of things..... her body trying to recover from the disease, the anemia, low B12 levels, the prednisone (in some people, prednisone can have the opposite effect. Instead of giving energy, it could sap energy. I've only heard of this from a few people, though)...

I think I may be getting over my tiredness issue... Lately, I'll have a normal amount of energy one day, and then be dead tired the next... so... Dunno.... Think I'll still bring it up with my doctor just in case, though...

Also, my GI doctor thought that I might need surgery on my intestines one time, but when I went to a different hospital to have the surgery done, the doctors there said they didn't want to do surgery and put me on some different medication... so.... Like the others have said, she may not even get surgery...

But if she does, it's not the end of her world.... And most likely, she'll probably feel better after she recovers from the surgery...
I think I am being picked on by life, sometimes. But's that okay. Life and I are good buddies... I know life doesn't mean no harm. It just is the way it is. I can accept that.


njmom
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   Posted 2/10/2009 5:04 PM (GMT -7)   

Hi Tom,

I noticed your daughter is having bloodwork done next week, so I thought I'd throw in a few suggestions. Am assuming she will have a CBC and full CMP done. This posting addresses other tests that can be done. (Hope it's not too long-winded.) 
 
But first, about surgery. It was mentioned early on in my daughter's case, as she has a stricture (much longer than your own daugher's), but we tend to fall into the camp of those who consider it the option of last resort. A permanent solution with the potential for only temporary benefits. Crohn's tends to recur. There can be complications. There might be no remission at all - they might not remove enough TI and/or the Crohn's might not be located only at the TI (the fistulas and abscess could point to this). At least one new medical therapy, still in clinical trials, shows signs of being less effective in patients who have had resections. My own daugher's GI uses the argument "do it now while you are still relatively healthy" to introduce stronger meds like Imuran...specifically, to avoid having to eventually have surgery. A stricture is by no means an immediate ticket to surgery. But for those who cannot get their disease under control even with the strongest meds, it can be a blessing. Now, on to the easier stuff:
 
CRP and sed rate (ESR) can be checked. At the first sign of inflammation, CRP levels tend to react faster than sed rate. BUT 25% or more of Crohn's patients might not have CRP levels that are responsive to inflammation. SO we check both. 
 
Some research indicates low iron might be common in women of mentruating age. Also, meds can cause anemia. The disease itself can cause anemia - the anemia of chronic disease. A viral or bacterial illness can cause temporary anemia - the body sometimes "hides" iron if you have, for instance, a bacterial infection. The bacteria feed off the iron. So iron supplements should not be taken while somebody is suffering from either a viral or bacterial infection. Iron tests include: serum iron, TSAT, ferritin, TBIC. Together, they tell the whole story about iron. Serum iron fluctuates throughout the day, so it is the least useful test. Ferritin is the most useful, but it could be normal while TSAT is abnormal (which could signal a problem).
 
Low Vitamin D is common amongst Crohn's patients. The correct test is 25-hydroxy-vitamin D. If vit D is low, then an endocrinologist is your best bet for advice on supplementation. (Same goes for iron.) 
 
Prednisone and Entocort can interfere with vitamin D and calcium absorption. Pred can cause blood sugar to rise - while on pred, a blood glucose test can be requested.    
 
Optimal B12 is in the 500s and above. The B12 lab test should not go below 400 - if it is below 400, then oral supplementation should be started. If it is below 300, then a B12 deficiency can be presumed and the fastest way to get the B12 is probably through a shot. 
 
Flagyl might have helped your daughter, but it can cause side effects like fatigue (which should be resolved once off the med).
 
In my daughter's case, iron plummeted while she was on 4000 mg Pentasa and resolved after being taken off the med - in all fairness, it should be noted she developed mononucleosis within six weeks of starting the med - mono has such a long incubation period that it could have altered lab results even when there were no mono symptoms present. While the manufacturer of Pentasa admits to field reports of anemia caused by Pentasa, it notes that it has not found anemia as a side effect in clinical trials run on the med.
 
We get a copy of every lab test and with the help of www.labtestsonline.org figure out what it means.


Daughter (21) Dx'd Crohn's 3/06. Misdiagnosed for two years, including by top pediatric Crohn's specialist as stress but landed in hospital on 3/06 with cramps, vomiting, stricture. Now in remission with Entocort 3 mg (one pill) since May 07, SCD multivitamin, homemade yogurt, 2000IU vitamin D3, 900+ mg calcium, 25 mg B complex vitamin, 25 mg iron, daily 1000 mcg B12. B12 shots monthly. SCD diet modified to include potatoes and rice.   

Post Edited (njmom) : 2/10/2009 5:09:42 PM (GMT-7)


73monte
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   Posted 2/10/2009 5:54 PM (GMT -7)   

Hi njmom,

You really took alot of time to provide such a detailed reply and address alot of my concerns. I'm really impressed and appreciative of that. 

I've read you post a few times and am confused about you take on surgery. What kind of treatment did your daughter end up getting for her stricture? Did you opt for surgery?

I'm really wrestling with exactly pros and cons you've indicated. I'm worried particularly about complications and a quick recurrence. The GI did say a 2cm stricture, but I'm not sure how narrow things have become. She seems to have normal BM's and quite large in diameter, not wormy at all. It seems that your take is to exhaust as much clinically first before considering surgery, or surgery as a last resort. 

I believe the bloodwork requisition has most of what you're indicating. She was on an iron supplement for 2 yrs. and likely should have continued it. 

I will check out the link, that sounds like a big help. I didn't know you could get a copy of the lab results.

Thanks again for taking the time.

Tom.


My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Initially, 9 weeks of Prednisone, currently taking 2000mgs of Pentasa.

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