Health: My MRI Experience

I had been booked in for an MRI of my small bowel by my gastro consultant. As I've had two Crohn's flare-ups in the last year, they thought it would be wise to do a bit of investigation just to see how things are.

I had booked a taxi which collected me at my house and dropped me off at the Glasgow Royal Infirmary. He thought I was going off to work but I explained briefly that I was going in for a scan. The previous week a colleague overheard I was off for a scan and assumed I was pregnant (which I'm not btw) so I clarified to the driver that in fact it was an MRI scan. He proceeded to tell me that he's had one before and about the nightmares he had before his and that he was claustrophobic etc etc which was far from reassuring. I too am claustrophobic and have been dreading this day. My GP had prescribed me some diazepam so I took these in the taxi en route.

After navigating the hospital corridors I found the MRI unit only to be told I had to find the X-Ray unit to get a nasogastric tube put in. The lifts weren't working (adding to my stress levels!) and so I took the stairs. I was feeling a little out of it, must have been the diazepam starting to work!!

The staff were lovely and made me feel a bit more relaxed. I think they could tell I was anxious and I got asked a few times if I was on my own to which I had to keep explaining yes I was and I intended on getting a taxi home. I got changed into my double gown and went through the questions and consent forms with one of their team. 

The nasogastric tube insertion was not pleasant. The consultant had to get it out of my stomach and into my small intestine and there was a lot of tooing and frowing which was very uncomfortable, particularly in my nose, and a little sore at points. Once it was in place though it was bearable, just. I was sneezing lots during and apparently I'm the only patient who has giggled during a nasogastric tube insertion! I'm so proud of myself for not panicking.

Next up was the cannula. I've had terrible experiences with cannulas before and was not looking forward to this either. However the nurse was fantastic & she got it in first time with zero drama and thankfully no tears from me. Phew!!

I then had to wait for my turn in the MRI machine. From the corridor I could hear how noisy it was but I had been told I'd be going in feet first on my tummy so I wasn't as nervous as having to go in head first. I really would have freaked out if that were the case. Although I had been organised and brought an eye mask with me so that I didn't have to see what was going on. The nurse gave me ear plugs to use, but the best ear plugs I have ever used are these ones from Boots. So I would perhaps consider taking your own, especially if you are going to be in there for a while.

By this point it was midday and I had been fasting since the previous night. I was certainly looking forward to a cup of tea afterwards and some lunch!!

I was going to have my bowel filled with liquid laxative via the NG tube and then a contrast agent put into the cannula to show up my veins. What I didn't realise was how sick I'd feel as they filled my bowels; they didn't manage to get the last two syringes of laxative into me. Add to that the bed of the MRI going in and out of the machine and I really did feel rather sick!! A bit like being on a boat!

I had to breathe in, out and then hold my breath for what seemed like ages. This was repeated a number of times. The consultant had to dash away to another clinic so the NG tube was removed (made me gag somewhat) and then I had a few more images taken. I glad when it was over. However compared to the colonoscopy, this wasn't nearly as painful or traumatic.

I didn't get any feedback; instead I was shown to a cubicle to get changed and then directed to the exit where I could wait for a taxi. I'm guessing if there is anything up with my results then I'd be contacted, otherwise I'm next seeing my consultant in October.

Health - Eating Dairy Free

Given my recent tummy issues I have decided to make more of an effort to look after myself. There is no evidence that diet causes Inflammatory Bowel Disease, but once the condition is established attention to diet can help reduce symptoms and support healing. If there are changes in my diet that I can make that will improve my Crohn's symptoms, then I should be making them.

During a recent flare-up, I've found a low residue diet improved my symptoms.

Now that my symptoms are back under control, I've heard that following a lactose free diet should help longer term. I have to get 3 monthly Vitamin B12 injections; this indicates that my terminal ileum (end of the small intestine) is diseased as this is the only area of the gut that absorbs this vitamin. Lactose is digested in the terminal ileum, which we now know is diseased (this was also found during my most recent colonoscopy), so it follows then that avoiding dairy products should make me feel better. (Just want to stress at this point that I'm not a doctor, so if I'm talking nonsense then please let me know in the comments below).

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However it's easier said than done. There is milk in soooo many food products... there's the obvious ones like yoghurt, cream, butter, milk chocolate, ice cream, custard... but there's also milk in certain crisps, soups, cakes...

There are a variety of alternative milks, like soya, oat, almond, hazelnut, coconut milk. There are also 'lactose-free' brands like Lactofree. Lactofree also have cheese, cream and yoghurts. I've tried almond milk before which was ok, but not great in tea. Today I had my first cuppa with Lactofree milk and it was better than the almond milk. It didn't taste the same as regular milk, but I'm just going to have to get used to it!!

Controlling what I eat in the house is much easier, but it's when I'm at work or eating out that it becomes problematic. I've certainly noticed more gluten-free, dairy-free options whilst out and about and I need to make better choices when it comes to ordering. Where possible I'm going to try and go wheat-free and dairy-free.

Here are my ideas so far... I'd really appreciate your suggestions if you follow a dairy-free diet.

Swap ice cream for sorbet (Ice Delight is dairy-free and gluten-free and tastes amazing!)

Swap milk chocolate digestives for Oreo cookies (Apparently there is cross contact with milk, but I don't think the biscuits themselves contain milk). Oreos aren't gluten-free but I have bought some gluten-free, dairy-free chocolate oatcakes to try as well.

Swap sandwiches for sushi or salad. I need to get organised with this one so that I have lunch options with me at work. Today was my day off and I had a gluten-free Warburtons sandwich thin with a mashed avocado on the top. It was pretty good!

Swap yoghurt for fruit jelly (I'm still not convinced by the dairy free yoghurts - I'll need to give them another try to see if they taste any better from when I last had one. Today I bought a coconut milk yoghurt from Wholefoods and I'll let you know how this is when I try it - it was super expensive so I hope it's good!!)

Swap mayonnaise for avocado or hummous (home made mayonnaise is dairy free)

Snack on almond nuts, dried fruit (I love Nakd cola flavour infused raisins and Bear Nibbles yoyos) instead of chocolate bars. Nakd also have nibbles that are gluten and diary-free - I liked the salted caramel ones... yum! Beyond Dark chocolate drops are also gluten and dairy-free plus delish!

 

Do you have any tips for going dairy-free that you care to share?

Health - Dealing with a Crohn's Flare

Regular followers will know that I have Crohn's Disease, which is one of the Inflammatory Bowel Diseases (the other being Ulcerative Colitis). You'll find a little bit about my diagnosis in this earlier post.

Last year I had my first flare and ended up back on steroids to control the symptoms. Shortly thereafter I had a colonoscopy which confirmed that I still had some active inflammation.

I've never really been back to my usual self since that flare last year, and then last week I had 7 days where everything I ate went through me. It was horrendous and I was absolutely shattered. Hence why I've been pretty quiet on Twitter and here on my blog - apologies!

I restricted my diet and for a couple of days I ate toasted crumpets, white toast and rice pudding to give my gut a bit of a rest. I lost nearly half a stone - which was good because I had put on quite a bit over my Easter holidays - but obviously this was not a good way to lose it!

When I was first diagnosed I had a book called something like The Healthy Gut (it had a bright red cover!) and I thought I'd share some of the advice that I remember; hopefully this might help others out there with IBD.

I've found that when I have a bad day, the BRAT diet helps. It's a bland diet that has foods that are low in fibre. When you're having a flare you want to avoid high fibre foods as they could worsen the bowel upset.

BRAT stands for Bananas (contain pectin which helps regulate the digestive system), Rice (absorbs fluid and adds bulk to your stools), Apples (Peel and grate them then leave to go brown; like bananas, apples are a good source of pectin) and Toast (said to soak up toxins, especially if its burnt).

Apparently Heinz Cream of Tomato Soup is also good as it has the perfect balance of electrolytes for an upset tummy although I'd have thought that tomatoes, which are acidic, aren't a good idea. I saw a nutritionist when I was newly diagnosed and I was told to stop eating tomato-based sauces (I used to eat a lot more pasta and curries than I do now) and not to drink fresh orange juice on an empty stomach.

It's also really important to drink plenty fluids. Victoria (@IckleBear_) on Twitter who also has Crohn's suggested Lucozade Sport to me, so I got myself plenty to keep me going!

Thankfully I seem to be a bit better now and my bowels have settled. I'm still waiting blood results from the hospital and faecal calprotectin measurements which correlates significantly with disease activity in people with confirmed IBD.

At the moment I take azathioprine daily to control my Crohn's, but if I continue to have these episodes or flares then the nurse has suggested that we may look to change my meds. I am also going to investigate different diets more. First up I'm going to switch all my tea to decaffeinated; caffeine makes me run to the loo! I'm also going to consider going wheat-free or maybe even gluten-free.

{Inflammatory Bowel Disease - My Colonoscopy Experience}

This year is my 10 year anniversary of having Inflammatory Bowel Disease. I tend to tell people I have Crohn's Disease, but in reality despite me having had the condition for all these years, the doctors still aren't sure if it's Crohn's or Ulcerative Colitis that I have. The treatment is the same so it hasn't really mattered.

Anyway, last week I had the joys of undergoing a colonoscopy. There's a really good video on the NHS website where Lynn Faulds, a TV presenter, is filmed having a colonoscopy if you want to check it out.

During a colonoscopy, a colonoscope is used to examine your bowel. It's a long bendy tube with a camera and a light on the end and it is inserted into your rectum and moved along the length of your large intestine.

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You need to eat a special low-residue diet for a few days before the examination and then the day before take laxative medication to empty your bowel.

My colonoscopy was arranged for the Friday, so on Tuesday and Wednesday I had to stick to the special diet (which is described in detail in the paperwork I was sent so I knew exactly what I was doing) and then on Thursday and Friday I was allowed fluids only.

The low residue diet is high in fat, and it wasn't hard to stick to. I had cornflakes and milk for breakfast or white toast and jam (with no bits!)... lunches were potato waffles and cheese or chicken mayonnaise sandwiches and crisps... followed by dinner of macaroni cheese! Plus I had delightful plain scones with clotted cream and jam or tea and ginger snap biscuits. 

It was drinking the 2 litres of laxative on Thursday that was tough. I managed all of it, but I threw up half of the last glass!! :-/ My dad's wife Jo had arrived on Thursday morning to help me entertain the kids whilst I did the bowel prep - I doubt I'd have managed it on my own, so thank you very much.

Victoria over on Twitter (@IckleBear_) who also suffers from Crohn's was tweeting me with tips which I found really useful. So I kept the liquid in the fridge to keep it cool and had boiled sweets at the ready to suck after each glass. I also had my book and a blanket in the bathroom for when it started working (which didn't take long after finishing the last glass)! The diarrhoea lasted until about 8am the next morning but thankfully it didn't affect my sleep.

It doesn't taste nice, but I was trying to trick myself into thinking it was a nice cool drink!

I arrived at the hospital at 12.45pm on the Friday and was checked into the Endoscopy unit at Glasgow Royal Infirmary. After changing into my delightful hospital gown I was talked through the consent process by one of the nurses and was asked a few questions about when I had last eaten etc. and was given a wristband to identify me.

Whit-woo!!

A nurse then came along to put a cannula into my hand. This allows the doctors to give me (plenty!) drugs for the procedure. Unfortunately after two attempts I still didn't have a cannula in my arm and I was also in tears (I was really anxious about the whole thing and the cannula issue wasn't helping matters!). A different nurse then came along and in literally a second the needle was in! 

Finally!

Still managing to smile!

Shortly after I was whisked away into the room for the procedure.

Now I'm not going to lie. It was not pleasant and it hurt quite a bit. Apparently it shouldn't be that sore and the worst bit for most people is drinking the laxative fluid the day before. But I have very tight turns in my bowel and 9 years ago when I had my last colonoscopy I was screaming on the table whilst the nurses manipulated my bowel to get the scope along. They gave up and have never got round my large intestine, until now that is.

I was given a sedative and painkiller via a cannula in my hand, and given my previous experience I was given a high dose of both!

It's preferable for you to be awake as it allows you to move around on the bed as the procedure progresses. This time I was on my left side at the start, before moving onto my back, then my right side, and then my tummy before going back onto my side again.

I'm thankful that we managed to get round my large intestine though as we've discovered that most of my bowel is healthy, but at the far end there is active inflammation. So the doctors were able to take biopsies and I'll get the results in a few weeks.

I was then wheeled back to the ward to allow me to rest and I slept for an hour or so as the drugs wore off.

I had been looking forward to my tea and toast, but was extremely disappointed to be given a rather crap looking cheese sandwich. It wasn't very appetising.

By the time my dad & R came to collect me I was feeling ok. A little tender and tired but not as bad as I was after my previous scope (where I nearly fainted in the hospital corridor!).

Now I just need to wait for the biopsy results...

{Crohn's Disease}

For those of you that have seen the move Bridesmaids, you'll remember the hilarious scene where Lillian and the girls get food poisoning and they all literally poop their pants. I too have been there *hangs head in shame* and it really wasn't that funny! The reason was not food poisoning, it was because of the chronic condition that I have, Crohn's Disease...... 

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For those of you that haven't heard of it before, Crohn's Disease and Ulcerative Colitis are inflammatory bowel diseases. They can occur at any age and there is no known cure. I've had a quick look at some statistics on the National Association for Colitis and Crohn's Disease website (NACC) and it turns out that ulcerative colitis affects approximately 1 person in every 500 in the UK and Crohn's Disease is about 1 person in every 1000. The symptoms of the conditions tend to be bloody diarrhoea, pain, tiredness and loss of weight but the severity fluctuates so patients are likely to have periods of remission as well as periods of flare-ups.

It annoys me when someone finds out I have Crohn's Disease or IBD and then they mention that they too have irritable bowels or IBS. It's totally different and not the same at all. IBS isn't a dangerous condition, there's no obvious abnormality and it's really common. IBS can sometimes be relieved with diet and lifestyle changes whereas I'm having to take potent immunosuppressant tablets every day. (Sorry, bit of a rant I know, but it really is rather annoying!).

Anyway, I thought I'd share my story here in the hope that it might help somebody out there...

I was 21 years old when I was diagnosed with IBD. I was working in Edinburgh at the time doing a year's work placement and life was a bit stressful. My mum had recently passed away, I was living away from home for the first time and was struggling financially. For a couple of days I'd had a really dodgy tummy, and I couldn't think of anything that I'd eaten that would have caused it. I put it to the back of my mind and carried on as normal. However, a few months later, I had the same symptoms again. I went to the doctor and he asked me to hand back in a stool sample. It came back negative and I think then the next time I got the symptoms the GP did a blood test to check my thyroid, which also came back normal. By this point I was getting the symptoms frequently. I was exhausted, starting to lose weight, and no joke - I was probably going to the toilet about 40 times a day. I didn't like going to new places as I was always concerned that I wouldn't be able to find the bathroom. I was sent home from work a couple of times, I nearly fainted a few times, and once I was bleeding a lot from my bum which was really scary. The urgency that was associated with going to the toilet was awful... hence the mention of the Bridesmaids scene above. Thankfully, this didn't happen to me when I was out in public... I was in my own home in my pyjamas, but still, not nice!

I was finally referred to the hospital gastroenterology department and after a quick examination it was decided I needed further investigation. I then had a colonoscopy done. I'm not going to lie - it was not pleasant. They didn't manage to get round my colon very far with the tube as I was so badly inflamed at the time. I was informed that I had an inflammatory bowel disease and given a prescription for steroid tablets. At the time, they were unable to distinguish between Crohn's and Colitis and still to this day I don't know which one it is that I have, but the treatment tends to be the same.

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The steroids were horrible, and I was on them for about 11 months. I wasn't sleeping, I was eating loads.... I got the typical steroid 'moon face'... and when I look back at photos I just look horrendous (I tried to find some photos of me to show you, but don't have any digitally and my scanner isn't working - not an excuse, honest!). It was a a difficult time, but eventually the consultants did manage to get my symptoms under control, and touch wood, I've been relatively healthy since with no major flare-ups. I was put onto a few different maintenance tablets (steroids are a quick fix and they aren't for long-term treatment), but was found to be allergic to them.

We finally found a treatment that worked for me and I've now been on azathioprine for what must be nearly 8 years. I continued to take the tablets whilst I was pregnant with both of my children, and I think this may be the cause of the obstetric cholestasis I experienced. To the outside world I look healthy, but I think I'll probably be taking these tablets for the rest of my life in order to manage the symptoms of the disease.

May 2012 is Crohn's and Colitis Month. This year the topic is Sport & Fitness. Thankfully, despite having Crohn's Disease, I've been able to get in shape and will be participating in a half marathon during the month of May (I'm raising money for Macmillan Cancer Support with my sister in memory of our mum). There are a lot of people with Crohn's Disease and Ulcerative Colitis who suffer terribly. I'm one of the lucky ones. The disease hasn't impacted on my life in a dramatic way and it hasn't stopped me from doing anything. I hope I continue to stay healthy...