Monday, February 4, 2008

One Day away from Humira and article on Pregnant Woman that Died from Crohn's

I need a Humira shot. I can feel it. Ate too much crap during the Super Bowl and am spending my energy fighting off the cold that is going around as well as a Crohn's Flare up. The Pats lost in a great game. They played poorly and got beaten by the better team on that night. Good for the Giants...heartbreaking to lose the Super Bowl while on the verge of the greatest season in history, but it happens. I am happy my kids actually saw a New England team fail....I think they think championships are a given. Certainly not the way I grew up!

People ask me pretty often if people die from Crohn's. Unfortunately they do. Sad Story below.

(article is here)A PREGNANT woman who died with her unborn son after emergency surgery for a chronic bowel condition was sent home two weeks earlier because doctors thought she only had morning sickness, an inquest heard.

Former University of Worcester student and newly-qualified teacher Melanie Gough, aged 24, who was six months' pregnant with Luie, died after surgery for Crohn's disease, which doctors failed to diagnose, despite four earlier visits to hospital. Richard Gough claimed in court that his daughter, who was due to marry partner Phil Adams before her illness, would not have died had Gloucestershire Royal Hospital staff acted sooner. Mrs Gough, who fell pregnant in October the previous year, was treated throughout January 2007 for severe vomiting, dehydration and weight loss.

But she was discharged at the end of the month, after doctors wrongly diagnosed an unusually severe form of morning sickness, or hyperemesis gravidarum.
When she was readmitted at the end of February, after her symptoms worsened, an expert consultant immediately diagnosed her with Crohn's disease and ordered an operation to remove part of the colon.

She died on March 6 last year after she was found to be suffering from a septic infection.
Mr Gough told Gloucester Shire Hall that his daughter was one of five children and active in her local community in Longhope, in the Forest of Dean, Gloucestershire.
He said: "She was a real home-body, and very close to her mother. They did everything together. When it was time for her to go to university we found her a place close to home where she could travel back and forth every day. pregnacy and crohn's

"She went to Worcester university, stuck it out and got a good degree. She didn't get a teaching job straight away, and worked in various pubs to support herself. She also got supply teaching work.

"She had been with her fiancee Phil for four years, and they were due to get married in April. She lived a very happy life and was very involved with her local community. She kept two horses in fields were she lived."
She fell pregnant on October 1 2006, and had the couple had named their son Luie.
Mr Gough said she had enjoyed good health, apart from being diagnosed with irritable bowel syndrome at university.

But after Christmas she began to suffer with projectile vomiting, constipation and diarrhoea, he told the hearing. Despite several trips to the maternity unit with ongoing sickness and rapid weight loss, Mr Gough said that nurses urged her to put up with the pain.
He told the court: "They said, 'Pull yourself together. This is part of pregnancy. You'll get used to it'."

It was not until February 15 that she was diagnosed with Crohn's disease when Professor Hugh Barr, a consultant gastroenteritic surgeon, became involved in her care.
Mr Gough said: "They realised there was something seriously wrong. There was 100 per cent obstruction in her bowel and it was so advanced that the intestine had become stuck to the abdominal wall.

They said, 'Pull yourself together. This is part of pregnancy. You'll get used to it.'
Richard Gough, father But after the procedure she again became seriously ill and was treated in hospital again on March 6 where it was clear that she was terminally ill.
Mr Gough said: "After they injected her through a tap her eyes closed and her chest started heaving. The doctor asked her to open her eyes and wake up. We were in shock.
"Phil and me were asked if we would prefer to save Melanie or the baby. We both agreed that Melanie should be our priority.

"Shortly afterwards, the doctor said she had suffered a second cardiac arrest and that the best doctors in the country were working on her. They said she was critical and didn't hold out much hope. "After she died she was put into an office full of papers.
"Our family are absolutely devastated by the loss of our daughter and her unborn child. We feel her death was unnecessary and completely avoidable.
"We feel that had her illness been treated earlier she could have been saved. There was at least half hour delay before they made any sort of attempt to do anything. We are not happy about her treatment before and after the operation."

Consultant obstetrician and gynaecologist, Mark Whittaker, who looked after Ms Gough throughout her pregnancy said that her symptoms bore all the hallmarks of morning sickness and that she had begun to improve. He said: "I thought she had emesis gravidarum (morning sickness). We see patients on a daily basis with pain and vomiting - it is very common in the first 16 to 20 weeks of pregnancy. But we thought there might be some other course, that's why a follow up was arranged. "We felt she had hyperemesis gravidarum and we treated the condition we felt was affecting Ms Gough.

County coroner Alan Crickmore asked: "With the benefit of hindsight could anything have been done differently? Crohn's disease during pregnancy is rare isn't it?"
Mr Whittaker said: "I think that it was extremely difficult to identify the cause of her symptoms. I think she was seen by four experienced obstetricians and four experienced consultant surgeons, proving how difficult it is to diagnose this condition."
The coroner said: "I understand that it is difficult to diagnose because a woman's body produces various hormones that act as immuno-suppressants."
Matthew Barnes, the family's barrister said: "She had had four admissions for symptoms that were getting worse and worse..."

Mr Whittaker said: "We were uncertain as to diagnosis so a surgical opinion was sought. I was uncertain about the symptoms but she seemed better - her pain was less and her abdomen was soft. "We felt that hyperemesis gravidarum was the most likely cause. I spoke to her and her partner and explained that because we were really uncertain as to cause and she was welcome back at any time."

Mr Barnes said: "The family want to know why more wasn't done to find out what was going on."
The court has yet to hear what part, if any, the delayed diagnosis played in Ms Gough's death.


Anonymous said...

I think it is true that a flare of Crohn's during pregnancy can be very dangerous indeed. Although had they knowen that is was Crohn's earlier she would almost certainly be alive today.
After I had surgery for my Crohn's in Jan 2006 I asked about pregnancy with Crohn's and was told that provided I was in remission when I fell pregnant that it was more likely that I would experience better health during the pregnancy and I did, no diarrhea until the las month (which I hear can happen with a "normal" pregnancy).
I was however strongly advised against trying to become pregnant whilst flaring, I figure that one of the issues being that if constant diarrhea is preventing me from getting good nutrition then there is huge risk of this to the unborn child.
Thankyou for posting this.

casey said...

I live in Austalia and the story is exactly the same for me...right up to the part were my body became septic...but i recovered from that. It has just made me realise how lucky we were!

Anonymous said...

I think that doctors should investigate every possible illness that goes with the symptoms.The sad fact is they don't and expect patients to accept whatever diagnosis they may give.
I too lost my sister feb.07,2008
due to her crohns diease not being diagnosed soon enough.She suffered 10 months,five of the months in the hospital,along with four fistulas on her,before the doctor sent her for crohns test.It was 5 weeks after diagnosis that she passed away.She was to weak from the constant drainage from the fistulas and vomiting for any surgery.I wish the family of Melanie Gough all the luck and may God be with you...

Crohn's Disease Blog