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Crohn's Colitis -- Abscess and Fistula -- HARD TIME!

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nfburton
New Member
Joined : Sep 2011
Posts : 10
Posted 9/7/2011 6:44 AM (GMT -7)

Hi everyone.  I have never posted here before and don’t know if anyone can offer any advice or help but I am feeling pretty down and very frustrated.  If you aren’t in the situation or have not been before, try as you may, you really can’t truly appreciate the number active crohn’s does on your body and your mind.  My husband tries but how can he really understand.  He sees me hurting and doesn’t know how to help me or what to do.

 

Anyway, in March of 2009, out of the blue I ended up with hemorrhoids….worse than I’d ever had.  I went to my regular doc who referred me to a Colon and Rectal specialist because of how severe they were and the amount of pain I was in.  I had never had an issue with them before except for when I was pregnant with my daughter in 2001/2002.  Anyway, he said they were bad and would operate the following day.  He operated and removed them and explained that it’s a painful recovery but to follow his directions and I should heal in several weeks.  During this time, he saw me regularly to check my progress.  He was pleased with the way I was caring for the wound and said it was clean, etc. but was still concerned at my serious pain level, the swelling back there and the lack of healing evidence.  Well, about 3 weeks passed and I still was in lots of pain and not healing but had begun having severe pain and swelling on the right side of my bottom and was running a fever of close to 104 off and on.  I went back in and they did a CT to see if I had an abscess and nothing showed up but the same surgeon suspected I did have one they just couldn’t see.  So, he scheduled me for exploratory surgery the following day and stated he would drain it if he found one.  They did surgery and did find a large abscess.  Well, the healing this time was no better.  It drained and such and I kept it wonderfully clean but it didn’t heal.  After a few return post-op visits, the surgeon asked if I had ever been diagnosed with Crohn’s or if it runs in my family.  I explained no on both counts.  He said that if we could get my bottom to heal up enough, he would like to do a colonoscopy because he suspected I might have Crohn’s evidenced by the fact I was struggling so badly to heal.  In addition, I had evidence of Erythema Nodosum on my legs horribly and was beginning to get stiff in my knee and ankle joints and the joints in my hands….to the point I was struggling to walk.  (Mind you, I was only 34 at the time!!!)  Well, in June of the ’09, he did a Colonoscopy and found evidence of Crohn’s in my ascending Colon, diagnosing me with Crohn’s Colitis.  They did an upper GI and Endoscopy as well and found nothing.  I have inflammation in the rectum as well.  He referred me a GI doc and I began a high dosage of Prednisone, 6 MP, Flagyl, Colazal, and Calcium supplements, and Probiotics.  After about 3-4 months, the abscess wound did finally heal up and I slowly got better but the meds EXHAUSTED me and made me sick to my stomach.  I did wean off the prednisone and was only taking the 6MP and Colazal.  Well, due to differences with the GI doc, I shopped for a new doctor and found a good one.  He switched me over to Lialda and advised since I was in remission that I could come off the 6MP since it made me so sick but that I may end up back on it in time or another form of treatment.  So, I had no trouble other than the occasional belly ache or run of diarrhea every once in a while until…….

 

July 2011 – I began getting the worst mouth ulcers I’ve ever had.  …to the point I could barely eat.  They continued to get worse and my belly was “iffy” at best.  So, I made a GI doc appointment.  My regular doc could not see me but I saw his partner who put me back on Prednisone at a lower dosage and did a stool test and blood work.  My CRP and Sed rate were slightly elevated but he didn’t seem too concerned.  Well, the mouth ulcers came and went and then about 2 weeks later, I began having a pain in my bottom similar to the abscess I had before and in a matter of a day and a half it had come back in the same spot and was more painful than ever and I called the nurse back.  They prescribed Flagyl and Cipro and made me an appointment again with the surgeon.  So, I went to see him and he scheduled me again for an abscess drainage.  Well, by the time surgery rolled around the following day, I could not sit at all and was in the worst pain I’ve ever known.  After the surgery, the surgeon spoke with my husband and told him not only did I have the abscess he knew about but he found another large one behind the muscle wall in the rectum that he did not cut into for fear I would lose bowel function.  Instead, he put a drain in to try and save my bowel functionality (THANK GOD!) and also put a seton in place as he found a fistula had formed.  He said the seton and drain could be in indefinitely.  Well, I have now had 2 post op visits and during the first week could not hold my bowels at all and that made for a really bad mindset on my part.  I took lots of hot baths and have kept it very clean.  Spoke with my GI doctor who is now working with my surgeon to determine when the wound is healed enough to begin Remicade or Humira to try and put me in remission and deal with the fistula and recurring abscesses.  I’m not in the amount of pain I was, but it has been 21 days since my drainage surgery.  When I have a bowel movement, I am doing better holding it to make it to a bathroom but it sets me back quite a bit pain-wise.  I’m still exhausted and not wanting to eat much at all.  I went back for my 2nd follow up with the surgeon yesterday and he said it looks extremely clean and is still draining which is what he wants to see but he said I was not healing well and he expected that due to the Crohn’s.  Anyway, he said he wants to see me back in another 2 weeks and will determine if he can give me the go ahead or not for the Remicade or Humira.  When I asked him about when he gives the go ahead would I have to be concerned about the meds blowing up the infection and he said “All I can tell you in 100% certainty is I hope not, I really do, but we can’t guarantee it.”

 

I’m frustrated at what lies ahead.  I’m young….36 years old with a new husband, a nine year old daughter and 2 step sons.  I want to be healthy and still be my active self and enjoy life, which I have not been able to throughout this.  I’m frustrated.  He did put me back on Flagyl just as a precaution until he sees me again in 2 weeks.  Anyway, I know that my husband must be growing weary of listening to my concerns and hearing me cry at times when I am in the bathroom.  My daughter tries so hard to understand but she doesn’t really grasp it.  I don’t want to stay like this.  Is there any hope for healing?  Any advice on what I can do differently?  I want my life back!

 

Thanks.

Nicole

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Nanners
Elite Member
Joined : Apr 2005
Posts : 14996
Posted 9/7/2011 7:42 AM (GMT -7)
Hi Nicole and welcome to Healingwell. I was diagnosed at 18 years old and am now 53 years old. I know you are suffering right now, but rest assured that better days will be ahead. Its just going to take sometime unfortunately. I think you will find some success with either Remicade or Humira. These are good meds to heal fistulas, abcesses etc. I hope you are able to start one of them soon, and can get onto the business of healing. Gentle hugs!
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nfburton
New Member
Joined : Sep 2011
Posts : 10
Posted 9/7/2011 7:55 AM (GMT -7)
Thanks so much, Gail. I am hoping that the treatment can begin soon and really does help. I don't want to continuously have to go through this. I think the damage it does mentally is almost as bad as the physical issues.

Thanks for the hope, though. It is really very appreciated!
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Nanners
Elite Member
Joined : Apr 2005
Posts : 14996
Posted 9/7/2011 8:05 AM (GMT -7)
Oh yeah, the mental issues are just as bad. I had been in remission for about 6 years and then in July my first flare in a longtime hit me out of the blue. I got so depressed for a little while, as I hadn't felt that bad in a long time. Spent 2 1/2 weeks in the hospital. I think I had deceived myself into thinking that the Crohns had burnt out in me (something my realistic brain knows really is a lie). Once you get feeling better you also tend to forget how bad you really felt before when you flared. I have been out of work since July 1st and hopefully will be better enough to go back to work on the 19th of this month.

Alot of folks have to add in either a anxiety med (me) or an antidepressant. This disease can literally cause some to have post traumatic stress too. So if that is an issue with you, either depression or anxiety, be sure to bring it up to your doc. You are not alone with those feelings. Hugs!
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andorable
Veteran Member
Joined : Jun 2005
Posts : 981
Posted 9/7/2011 8:10 AM (GMT -7)
I feel your pain Nicole! But it will get better in time as Nanners said. I do hope you can get onto some remicade or humira soon as they have both been quite successful in gaining remission in quite a few people. Remicade worked well for me for about 18 months but then unfortunately I developed antibodies against it and they tried me on the humira and for me it didn't work either so I had ileostomy surgery, but thats extreme and I'm not trying to frighten you but it has given me back my life and I am now pain free and have a better life than I ever thought was possible. It did take me a while to get my head around my new life but now I am in a happy place with it and know I am not restricted to anything anymore. I truely hope you get some relief soon and if I were you I would get back to the doc asap and push for some heavy duty meds to get you through this. I also used to lose control of my bowels on a regular basis and mentally almost destroyed me. Keep us posted on your progress and know you are not alone, we are all here to help so any questions you have ask away we are only too happy to help. Glad you found us but sorry you have to be here and dealing with this. Take care
Doreen
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nfburton
New Member
Joined : Sep 2011
Posts : 10
Posted 9/7/2011 8:34 AM (GMT -7)
Gail -- I hope you get better enough to go back to work. I know having something to occupy my mind even when I don't feel 100% helps. I hope you continue to heal!

Andorable --Thanks for the encouragement. I truly appreciate it. I think finding folks who deal with the same issues may be a blessing for me and a relief for my poor husband.
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this-to-shall-pass
Regular Member
Joined : Jul 2011
Posts : 241
Posted 9/7/2011 8:43 AM (GMT -7)
Hi Nicole

Welcome to this forum. Here you´ll find very active, supportive people wich absolutly know what your talking about. I recognise your feelings, been there. Have also got crohns colitis and it took a really long time before I could "accept" it (If i´ve ever fully will). After a while thou you´ll learn how to live with it untill something new turns up.
There are many people here who have responded well on Remicade or Humira. Unfortunally I haven´t but I´m getting another treatment there not giving in the US- apheresis and it´s working fine fore me so fore the moment I´m symtomaticly in remission ( doing a colonoskopy and taking bloodtests the first weak in october).

Hope you´ll find the treatment that works the best for you.

It´s never as dark as before the sun raises again.

Post Edited (this-to-shall-pass) : 9/8/2011 2:58:11 AM (GMT-6)

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Julia Hill
Veteran Member
Joined : Mar 2008
Posts : 565
Posted 9/7/2011 7:55 PM (GMT -7)
Nicole,

I to think that Remicade would help you. It is the best med out there for fistulas, abscesses and perianal crohns. I know the pain you are in and how frustrating it can be, but it will get better. Your surgeon is keeping a very close eye on you which is a good thing, and when you start the remicade you wil feel better sooner than later. I did the flagyl and cipro thing for years when ever I had an abscess and it upset my stomach and bowels big time to. Now that your surgeon has found and drained your abscesses and inserted a seton, you should be on the road to recovery - lets hope.

Take care and keep smiling - it will get better.

Julia
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TakillRa
Regular Member
Joined : Nov 2010
Posts : 489
Posted 9/7/2011 9:21 PM (GMT -7)
Oh mama i went through almost the same thing..minus the absesses... I hope they get you healed up enough to start the remicade.. It has helped me alot.. have had a couple of minor reactions to it..but the pain in the butt is gone , i can go to the washroom without crying. Hugs to you!!! Keep us updated
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triathlon
New Member
Joined : Sep 2011
Posts : 3
Posted 9/8/2011 1:50 AM (GMT -7)
As far a mouth ulcers-- it can be directly related to the inflamation of crohns-- ask the Dr about using Nystatin the oral solution which you use like a mouth wash, do not swallow

I have been on 6mp for 20 years- the Doctors I see in Boston at MGH tell me we with Crohns really need to stay on it and not come off or the symptoms you talk about can come back.

I had fistula, had them excised, the surgeons avoided the spincter muscles, they can used a fistula plug http://www.goremedical.com/fistulaplug/

and increase the 6mp way up in dose for a short time to try and heal the fistula, then reduce the 6mp. Given we had fistulas, we need to stay on 6mp or similar to get the inflamation under control. If the DRs will not listen-- search out new DR. Mass General in Boston has some great DR!
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nfburton
New Member
Joined : Sep 2011
Posts : 10
Posted 9/8/2011 3:56 AM (GMT -7)
Thank you all for the uplifting words and advice. I really appreciate it. As for the Remicade, it's looking like my insurance may not cover it so that will be a whole new set of issues. Is Humira just as effective with the fistula/abscess healing as Remicade if that were to be the covered option? Does anyone know?
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Jonny Five
Regular Member
Joined : Sep 2009
Posts : 107
Posted 9/8/2011 6:57 AM (GMT -7)
Humira and Remicade have the same method of action (inhibit TNF-alpha), so they should have the same effects on fistula. My previous doctor told me they both had the same chance to heal up the fistula, but unfortunately I don't know if there are actually confirmed studies on this or if it is just assumed because they act in the same way.

Edit: Remicade was studied in 1999 and shown to help heal fistula in somewhere around 60% of patients - with complete fistula closure after 6 weeks in 40%-50% of patients. I did a quick google and it looks like the CHARM study looked at Humira's ability to treat fistula. They found 58% of patients experienced healing after 1 year (68% after 3 years). So it sounds like they are about the same.

Post Edited (Jonny Five) : 9/8/2011 8:04:53 AM (GMT-6)

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nfburton
New Member
Joined : Sep 2011
Posts : 10
Posted 9/8/2011 6:59 AM (GMT -7)
Thanks for the clarification, Jonny Five! :)
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Jonny Five
Regular Member
Joined : Sep 2009
Posts : 107
Posted 9/8/2011 7:04 AM (GMT -7)
Added an edit for you after a bit of googling :)
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nfburton
New Member
Joined : Sep 2011
Posts : 10
Posted 9/8/2011 7:07 AM (GMT -7)
Thank you so much! :)
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Ferguie73
New Member
Joined : Sep 2011
Posts : 3
Posted 9/8/2011 7:12 AM (GMT -7)
Hi Nicole,

I have read through your story. I am so sorry to hear of your recent Crohn's struggles and suffering. Crohn"s can be an awful disease to have to cope with. I am sorry you have to deal with this too.

I wanted to share with you, that I too have Crohn's disease now for almost 20 years. I was diagnosed as a teenager in High School and now married. No children. I also have suffered from what is called perianal Crohn's disease. I have had 2 bowel resections and abdominal surgery with over a foot of bowel removed. four years ago, I had suffered from 3 fistulas and reaccuring abcesses. I had five anal surgeries within two years in order to drain the abscesses, ultimately inserting setons and drains into my rectum. These were left in for up to a year. I was also taking flagyl, Cipro, and tried on Remicade for a period of six months. The Remicade seemed to work for my symptoms for the first few months and then not at all. However, the people I met along the way, some of them have other more positive outcomes. Everyone is an individual when it comes to Remicade and Humira.

I would suggest like the others that you read up on Remicade and Humira. It seems to work for a lot of people. That would seem the next likely step to take. I was lucky enough to get the treatment in Canada where it was covered by health insurance. I understand your situation might be different in the U.S.A. Not sure how to address that issue.

In my opinion, the only thing you can do for yourself is do a lot of reading and learning about the treatments and options. If you are proactive in your treatment and question the doctors fully, you will be more informed and in control of the decisions you choose to make. So you are making the right move by asking around in these forums.

AND while your family may never fully understand what you go through, it sounds like they love you and want to support you all the same.

Big hugs and hang in there!!!!
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nfburton
New Member
Joined : Sep 2011
Posts : 10
Posted 9/8/2011 7:19 AM (GMT -7)
Wow, Ferguie...you have been through a lot. I am so sorry. You seem so cheery, though, and I respect that very much.

I tell ya, the perianal stuff is pain like I have never known. I believe I'd take childbirth over it in a heartbeat!!!

Anyway, thanks for the encouragement and great info. Just being able to talk a little here yesterday and today and helped so much. I don't feel like I'm going home and dumping it all on my husband. It's so hard for him to see me hurt and frustrated and he really is so supportive, but doesn't know how to help me. His support is help enough, though. That and the fact that we haven't even been married a year and he's helped with my 9 year old daughter and house work, etc. I'm lucky to have him.

I think my biggest fear with the biologic drugs is praying that the healing from the fistula/abscess is enough to not blow back up once I have the opportunity to start one. I will have faith, though, if the docs feel I'm ready.
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Ferguie73
New Member
Joined : Sep 2011
Posts : 3
Posted 9/9/2011 5:26 AM (GMT -7)
Thanks for your kind words Nicole - I am a fighter and believe all Crohns patients are incredibly strong people. I have a huge amount of respect for everyone faced with this disease.

Reaching out to others and talking is a great way to know you are not alone.

Good luck with your treatment - let us know how it goes!
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BMW3series
New Member
Joined : Sep 2011
Posts : 1
Posted 9/10/2011 2:54 PM (GMT -7)
Wow- you have almost the exact same story as me. I used to just look around on this site and never yet joined but hearing your story made me join. Last November, I too thought I had hemorrhoids and went to my family doctor and just told me to bulk up the fiber. It obviously didn't work and I went to a GI doctor who told me that I had Crohn's. At this point I had constant drainage but he did not diagnose an abcess or fistula, instead puting me on Prednisone. I still had pain but was doing a little better. I then switched GI's and went to my Cousin who put me on Remicade from the start knowing that I strictly had Perianal Crohn's. about 2 weeks after the first infusion he sent me to a GREAT colo-rectal doctor who immeaditly saw a horseshoe abcess. I waited about 3 months for surgery and then had an incision and drainage with 8 setons inserted. I was fine with slight pain for around 1 month. This summer was the WORST. In the beginning of July, I was having very high fevers and unbearable rectal pain. My doctor wasn't in so his partner did the same surgery and put in new setons. That surgery didn't work at all. 3 weeks later my regular doctor did another Incision and Drainage surgery and took out the setons. I was still in an EXTREME amount of pain!! I couldn't get out of bed- and lost 25 pounds. This was only 1 month after one of my Remicade treatments. My Rectum was on fire. My cousin (GI Doctor) advised me to go to Mt. Sinai in NYC, just 20 minutes from me. I saw a leading GI in the country and a Cheif Rectal surgeon. I was there for 3 days and had yet another I and D surgery with more setons inserted. While there I had a DOUBLE dose of Remicade. The Friday I got out- I was still raw from surgery, but felt like a new man. Finally, I had something that worked. Its been around 2 months from the surgery and havent had barely any rectal pain since. Whatever the surgeon from Mt. Sinai in NYC did was amazing and it proves to show that Remicade is a miracle drug. I know that it is probably going to come back but now I think I know how to handle it.

Hopefully everything goes well for you and I wish you the best of luck!
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sudsmom
Regular Member
Joined : Nov 2010
Posts : 167
Posted 9/12/2011 1:41 PM (GMT -7)
nfburton -

I recently went thru having an abdominal fistula. Was on Humira for 18 mos, but since it didn't work for me (this was the second time I had abdominal fistula), I ended up with surgery to get rid of it. Turns out I had alot more wrong than just the fistula - 2 feet of diseased small bowel, narrowed down to .5 cm, knotted up bowel and adhesions. So I really needed the surgery!

The good news is that Humira has a drug assistance plan. I paid $5 for each delivery of 2 pens, which lasted 1 month. I was doing the normal dose of every 2 weeks. That's pretty cheap. Don't know if Remicade is similar or not. I was offered either one by my doctor and I chose the Humira because I didn't feel like going to the hospital for infusions. I live in the U.S.

Hope that helps!
Sudsmom
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nfburton
New Member
Joined : Sep 2011
Posts : 10
Posted 9/13/2011 3:01 PM (GMT -7)
BMW3SERIES: WOW! You have been through a lot. I hope your treatment continues to work for you. I wish you all the best. Thanks for the post!

Pumpkingirl2000: Keep fighting the good fight. I think this forum has helped calm the overwhelmingly alone feeling I have been feeling. Just tot know there are others out there with the same concerns and issues is very comforting.

SUDSMOM: I find out next Tuesday (9/20) if I am cleared by my surgeon due to the residual infection from the abscess and fistula. If he clears me, my GI will pursue the biologics but he's waiting on the surgeon's OK. Thank you for the information. I am trying not to panic about costs and insurance too badly yet! :)
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