pain management/emotional health

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Cookie's Wife
Regular Member

Date Joined Aug 2005
Total Posts : 299
   Posted 4/21/2008 8:07 PM (GMT -7)   
I searched and couldn't find anything so I apologize if this is a repeat question(s). 
I've had Crohn's for nine years and I'm having a hard dealing with it emotionally now.  I had my worst flare yet in January.  I was hospitalized for 7 days with the my "typical" Crohn's symptoms.... bloody stools, vomiting, pain, high fever, dehydration, did I mention pain... :-)
Since then I've been having panic attacks when the thought of traveling ANYWHERE. (just a side note... I work in the social services field and my job requires me to be in client's homes once a week.  Right now I have a caseload of 10) so I'm having the attacks quite often.  It's the fear of having an accident while in a client's home or while I'm traveling with them.  I know what your thinking... just use their restroom if it's an emergency but trust me some of these homes you do not want to go there plus that's a big no, no.  I've talked to my primary doc and he's put me on some meds to help this but it's only been a week so no results yet.  I guess my question is have any of you went to counseling to deal with the emotional aspect of this DD? And if yes, what type of doc/counselor did/do you see?
I also could use some pain management tips.  My GI isn't fond of pain meds because "we need to know if your feeling pain to see if the meds are working"  yet when I tell her I'm in pain, I need to give the meds time to work...ugh!  FRUSTRATING! confused  
I'm currently on;
Humira, bi-weekly, since October
Asacol, 400 mg tabs, 6x daily, since January
Prednisone, tapering, 5mg
Thanks! tongue
If God brings you to it, He will bring you through it

Veteran Member

Date Joined Mar 2003
Total Posts : 607
   Posted 4/21/2008 8:34 PM (GMT -7)   
I know it's easy to say find a new doctor, but I know that's not always possible, so I won't tell you to do that. Maybe if you are very specific with your doctor about your pain he or she will give you something to help. By specific, I mean keep a journal keeping track off all episodes of pain. Use the 1-10 number system to let them know how you are doing. I know that when I start to hurt, I tense up which makes me hurt more which makes me tense up more, etc, etc, so getting something to at least take the edge off is important for me. I also have Xanax for anxiety which helps me too. Maybe if you explain this to your doctor it might help.
I have a heating pad next to my bed and next to my chair. I use it all the time and it seems to help me to relax which helps my pain. I've never tried ice, but I have thought about it. It might work, but it might make you tense up a little too.
I hope this helps at least a little. I know waiting for the meds to work while you are in pain is hard both physically and emotionally. I wish you good luck and relief.
Dx in 1984 with Crohn's Disease.  In 1988 my terminal Ileum was removed due to inflamation that caused it to rupture.  I had surgery in February 2007 to remove more of my intestines due to scar tissue.  I then developed a very bad abdominal infection and was on IV antibiotics until June 2007.  I had chronic URQ pain which has gotten better.  I'm now in the process of getting off of the pain patch.   

Veteran Member

Date Joined May 2005
Total Posts : 4219
   Posted 4/21/2008 8:48 PM (GMT -7)   
Hi! I worked in social services and corrections and probation so I know exactly where you are coming from. I did see a therapist because my anxiety was making my symptoms worse. I was always worried about getting sick on the job. I worked in a pretty big city when I was doing home visits so I was never more than 10 minutes from a bathroom. I would just have to wrap the visit up quickly and make a speedy exit. Once or twice I made an excuse and said I would have to return later to finish the visit. I also had a partner and had to explain everything to her so she would understand the flying trip to McDonalds that would soon follow. I highly reccomend speaking with a therapist and making whatever accomodations you need at your job to feel comfortable. Try to always give yourself an "out" at least in your mind. Like I knew I really couldn't use a client's bathroom but just knowing it was there would make me feel a little more relaxed. When you are feeling well map out some different routes to and from their houses. Note all the coffee shops, fast food places, libraries, town halls, fire stations, ANYTHING with a toilet, even if you would have to ask to use it. That is your back up emergency plan. I have to admit though. I also took a lot of Immodium and did all my home visits in the afternoon when I felt better. As far as pain meds, they might not be ideal since you have to drive for your job. I hope you find something that works for you and just know that I understand your situation.
26 Year old married female law student.  Diagnosed w/ CD 3 years ago, IBS for over 10 years before that, which was probably the CD.  I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid.  For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn.  I also have bad acid reflux and have been on PPI's since age 13.  I have been through prilosec, prevacid, and nexium.  Currently I am on Protonix in the morning and Zantac at night.  I alos take a birth control pill to allow some fun in my life.

Regular Member

Date Joined Feb 2005
Total Posts : 200
   Posted 4/22/2008 3:52 AM (GMT -7)   
I'll admit off the bat, I've never had a job that I had to visit clients houses or go multiple places at once for work related things. But from the time of my first flare to the two years it took to (thankfully) get me into some kind of remission, I did become afraid to leave my house. Really afraid. I stopped driving, stopped visiting anyone, stayed at home and just, literally, stared at the walls. My old GI never recommended any sort of pain meds, he never recommended any sort of therapy, he never recommended anything but different medications to try and surgery. It did take me going to another doctor to finally feel better. I do realize how hard looking for one can be, but sometimes you have to do it. My new GI got all my old tests results and scans into his office, sat me down and asked me.. why haven't you been on anything for pain?? I simply answered him that my old GI was against it. His jaw dropped.

I know it would be impossible to take most pain meds while driving around and about, and Fitzy's idea about mapping out different "potty stop" locations is a great one. It's a great thing to do whether you're going to a clients, or going to the grocery store.. or anything. Just good to know where you can rest your behind :)!! Also, maybe talking to a therapist would help! Stress can mess with your body anyways, CD related or not, it can do things to you, hurt you and just make you feel blah. You put that ontop of CD and yeah, even if your meds start to work you may not realize it due to the pains and effects of stress.

Sorry for the bunches of words :D. It's just I hate seeing someone go through that stress :). I hope you feel better!

Cookie's Wife
Regular Member

Date Joined Aug 2005
Total Posts : 299
   Posted 4/22/2008 4:46 AM (GMT -7)   

Thanks evryone for all your great responses.  It's nice to know that I'm not alone.  My family laughs at me cause I have stops mapped out all around town.  I know the which bathrooms are good, bad and ugly...:0)

I have even told the families I work with about my disease in case I have to cancel a visit or have to leave in a hurry.

Thanks again!

If God brings you to it, He will bring you through it

Veteran Member

Date Joined Feb 2007
Total Posts : 1010
   Posted 4/22/2008 7:07 AM (GMT -7)   
As to the emotional issues that sometimes complicate our relationship to this disease, yes absolutely I would recommend counselling if you are struggling. You need to seek out a health psychologist, preferably someone who is associated with a GI clinic and has lots of experience dealing with patients with crohn's.

I was first introduced to the health psychologist working in collaboration with the GI unit in a large teaching hospital in 1993 when I was dealing with a severe health crisis. This centre was 4 hours drive from my home and I didn't think I needed counselling at the time, but I never forgot his standing offer. "I'm here if you need me."

At the time I just wanted to get out of hospital and back to my workoholic lifestyle. Three years ago I realized I was in big trouble. I knew intellectually that I was really sick, but I had coped through denial for so long I couldn't acknowledge it emotionally. Despite suffering ever increasinglyl violent obstructive episodes, there was a part of me that believed I was to blame for them and that I really wasn't that sick.

Getting through surgery was one thing, but I knew that I needed to make changes in how I related to this disease. I really was afraid that, without change I was at risk of dying. Luckily, I had always remembered this guy's name and got my family physician to refer.

Best decision I have ever made. Gave me back my perspective and provided the guidance to work through some really tough decisions. I worked with him for 36 months. And even though it meant an overnight stay in the city and an eight hour round trip trek, I never considered finding a counsellor closer to home. This guy knew enough about the disease, to be on top of everything I was experiencing. I shudder to think what might have happened to me if I had been in the care of someone who doesn't understand what this disease can do to your psyche. Probably would have been pumped full of mood elevators and labeled a looney.

30+ years living with Crohn's.

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