Sunday, May 31, 2009
BACKGROUND: Crohn's disease is a chronic, long-term illness in which the intestine, or bowel, becomes inflamed. It is part of a group of diseases known as inflammatory bowel disease, or IBD. Crohn's disease can affect any area of the GI tract, but it most commonly affects the lower part of the small intestine, called the ileum. The swelling extends deep into the lining of the affected organ and can cause pain, fever and diarrhea. The disease can surface at any age, but it is most common between the ages of 15 and 30. People with Crohn's disease experience periods of severe symptoms, followed by weeks or years of remission. Treatment may include drugs, nutrition supplements, surgery or a combination of these options. The goal is to control inflammation and relieve the symptoms. Treatment can help control the disease by lowering the number of times a person experiences a recurrence, but there is no cure.
CROHN'S AND PREGNANCY: In the past, women with Crohn's were counseled against pregnancy. However, current medical management strategies have made childbearing safer for both mother and baby. Some medications are best avoided during pregnancy, but others are considered safe because of their long history of safe use by patients. Research studies have shown that some drugs commonly used for both maintenance therapy and acute flare-ups of Crohn's are safe for pregnant women to use. They include sulfasalazine (Azulfidine), forms of mesalamine (Asacol, Pentasa, Rowasa) and corticosteroids (Prednisone). Other drugs like azathioprine (Imuran, Azasan), adalimumab (Humira), certolizumab (Cimzia) and infliximab (Remicade) appear to be safe to take during pregnancy.
Methotrexate and thalidomide are two immunosuppressive drugs that should not be used during pregnancy as they have an effect on an unborn child. Methotrexate can cause abortion and skeletal abnormalities, and it should be discontinued at least three months before conception. Thalidomide is well known for causing limb defects as well as other major organ complications in a fetus.
The severity of Crohn's symptoms that are present at conception often continue throughout pregnancy. Women are encouraged to get their disease under control and in remission before conception. They can also get their bodies prepared for a pregnancy by increasing intake of folic acid, quitting smoking, getting more exercise and eating healthier.
For women with Crohn's, the biggest factor influencing a healthy pregnancy is the state of disease activity. A planned pregnancy when Crohn's is in remission has the greatest chance for a favorable outcome. To best manage all aspects of your care during and after pregnancy, work carefully with the doctor you're seeing for Crohn's disease as well as your obstetrician and your baby's pediatrician.
Tuesday, May 26, 2009
Drew is afflicted with Crohn's disease and has spoken in many interviews about his struggle with the disorder. It has not stopped him from competing in mixed martial arts, but he does believe it has a large effect on his athletic ability. McFedries won his match last Friday (Drew McFedries threw 14 punches in his middleweight bout at UFC 98 against Xavier Foupa-Pokam.
His second punch -- a massive right hook -- was the only one McFedries needed. It took all of 37 seconds for McFedries to secure the TKO over Foupa-Pokam, who threw all of zero punches, kicks, knees, etc "I come in ready to throw down," McFedries said. )
McFedries’ influence extends far beyond fight fans and kids looking for inspiration though, and what he takes pride in is showing people with Crohn’s disease (a painful disease which attacks the intestinal tract) that you can live a normal life.
“I’ve come to the realization that pain is just part of your day,” he says simply. “Sometimes there are some embarrassing moments, but you learn to deal with it and you move on. You wake up some days and you have no energy and you definitely don’t want to move around. You don’t want to do anything, and you’re forced to train three or four more hours. Some days can be brutal for me, but other days, I’m on all cylinders man; I’m more than electric, that’s for sure.”
You sort of wonder where McFedries would be in his career right now if not for the disease, which sidelined him for over three years from 2003 to 2006. In some bizarre way, he believes it has mellowed him out and made him a more responsible and professional athlete.
“My chron's disease was a crutch because I was forced to take three years off,” he said. “I did train in that time, but I couldn’t really do much of anything because of my energy level. I’d get into the gym once a week or maybe three times a week, but that was about it. But when I got through the barrier of that, and getting the right medications and things, it changed my perspective on the fight game. I used to be a guy who could go out party until three, four in the morning, pass out, get up at eight, be at the gym at nine, train from nine to noon, take a nap, go party again, and I could do that day in and day out. We used to have so much fun, but that came to a screeching halt with the Crohn’s disease, and I think it put things in perspective. Back when I was a younger guy, I really didn’t respect or value my life. I took my body for a roller coaster ride, and what happened to me has really calmed me.”
So at 30, with the past experience that could fill volumes, Drew McFedries may be right on time to become MMA’s unlikeliest hero as he starts making some noise in the middleweight division. At the very least, he certainly has some tricks up his sleeve for the new generation of mixed martial artists.
Thursday, May 21, 2009
Sit down and relax, because this is the story of how I shit my pants on a date and successfully cut my underwear off while walking down Broadway in New York City.
Away we go. Let me transport you too a chilly winter night in the early winter. Must have been about 1998. I am living in Connecticut and decide to take a girl I was dating into the city for a night on the town. We enjoy a nice dinner at Gramercy Tavern (strange how many details I remember from this night). We are walking to a play (Rent..UGH) and I innocently try to slip a fart past a turd. Well, I failed miserably and propelled a liquidy stream down my right leg. (too much detail?) Thank the good lord for my 3/4 length suede jacket, which mostly hides the damage. While it isn't too obvious to others, I still have issues to deal with.
Great, now what? Not very romantic. As panic start to step in, I coolly collect myself and begin to formulate a plan. I will use my Swiss Army Knife to cut my underwear off! BRILLIANT! But wait, the keys jingling are going to give me away. So before I set about this operation, I remove the knife from the key chain. I open it up, slide my hand down the side of Gap Khakis.
Over the course of several blocks and 15 minutes, all while maintaining a conversation on how great the meal was, how awesome Savage Garden and BackStreet Boys are (hey its 1998) I proceed to cut my ALL-TIME FAVORITE BOXERS off. And no..despite discussing Backstreet and going to see Rent...I am not gay.
So anyhow, I am making progress. It takes another block while I shake, wiggle and shimmy until I smoothly expel the soiled underpants out my pants let and onto the sidewalk in front of a Chinese takeout restaurant (great marketing tool)! I look back longingly at my trusty (and slightly dirty) friends, and briefly wonder if I should fess up just so I can rescue them from the feet that will surely trample them (Honey, did you step in dog poo?).
Begrudgingly I forge ahead, all the while wondering if I will ever be able to replace them. Never once did my date figure it out. Believe it or not, I went on to marry this woman. In hindsight (poor word choice), I shoulda just told her I taken a dump on the sidewalk...would have saved me alot of money and trouble, since we were divorced after a coupla years.
An city councilman in Everly, Iowa who was arrested on marijuana charges has resigned.
47 year old Stephen Rank submitted his resigation from the council on Monday. In a letter to city officials, Rank says the May 11 search of his home and his arrest have brought an inordinate amount of attention to the council.
Rank was charged with possession of marijuana and possession of drug paraphernalia after investigators with the Clay County sheriff's office found what they described as a significant amount of marijuana in Rank's home in the small northwest Iowa town.
Rank was in the middle of his second term on the council when he was arrested.
He claims he has Crohn's disease and uses marijuana to treat the condition.
In Other Crohn's and Marijuana News: Judging by the picture Grandma SEVERE flare up of Crohn's Disease.
Sunday, May 17, 2009
Julie Katrichis lay on the bathroom floor in her parents' West Allis house and screamed in pain.
It was December 2004. She was a junior at the University of Wisconsin-Milwaukee, about to start finals week. Her Crohn's disease had been causing her immense pain for two months, but she'd tried to stick it out at school.
Katrichis went to the emergency room. She wouldn't return to UWM for two years - after months-long stays in the hospital, multiple surgeries and various complications.
When she graduates Sunday with a bachelor's degree in nursing, her diploma will represent just one piece of her wrenching and enlightening education in health care.
Her story is one of many that will play out Sunday and this week, as many area colleges and universities host commencement exercises.
Katrichis, now 24, was in her late teens when she was diagnosed with Crohn's disease - a type of bowel disease that inflames the digestive tract, causing severe diarrhea and abdominal pain.
"It's like you're being ripped apart from the inside," she said. "You feel embarrassed, you feel weak, and you hope it goes away."
When it came time for Katrichis to attend college, UWM made the most sense - she could live at home and manage her health with the support of family. At first, she wasn't sure what she wanted to study.
Life would intervene to help her decide.
After her December 2004 visit to the emergency room, Katrichis needed a colectomy - surgery to remove her colon. Complications in the surgery led her to contract pancreatitis. Her life for the next two years was a chaotic and painful series of procedures. Each step seemed to lead to another problem requiring another procedure, another specialist or unit.
"It was so chaotic, and I was still pretty shy about advocating for myself," she said.
The people who provided most of Katrichis' care and spent the most time with her were nurses. Her best nurses at Froedtert Hospital were "saints" who became part of a second family. They were genuine. They let her make decisions about her care.
Katrichis said good nurses are "ones who are willing to listen. You think that's a given, but it wasn't."
The bad nurses - and she had some of them - are task-oriented, just trying to get things done without speaking to the patient.
"It's really scary when a nurse comes into a room and rushes and does not clue you in to what's going on," Katrichis said.
By fall 2006, Katrichis was ready to go back to school, but she faced challenges. She was still physically weak. Just taking a shower exhausted her. Hospital bills had left her family with a heavy financial burden, particularly because her father had been laid off not long before she had her first major surgery. The application process for the nursing program was intimidating and complex.
With the help of her mentor, Nigel Rothfels of the office of undergraduate research, Katrichis navigated the system. She got into the program and won a $10,000 scholarship for students with Crohn's from biopharmaceutical company UCB.
As she embarked on her clinical placement, Katrichis found herself sharing her experience with her cohort of classmates in the program. She has already started exercising her power as a patient advocate before she officially becomes a nurse.
"She just really treated all the patients individually," said Theresa Grotkiewicz, a clinical instructor at UWM. "She never made assumptions and really listened to what they were saying."
Katrichis is graduating with a bachelor's degree in nursing. She'll soon start a job as a cardiac care nurse at Wheaton Franciscan Healthcare-Elmbrook Memorial.
In the run-up to the big day, her father left her a voice mail message every day with a commencement countdown.
"It's definitely this huge accomplishment - it's not just 'I'm graduating.' This was my goal," she said. "To make it just feels incredible."
Wednesday, May 13, 2009
"As a parent I broke down, it was hard," Lee Pinder said. "He'll have it for the rest of his life and the doctors said he may not able to play sports. I am a single dad and it's tough because I love my son. Still, it was amazing that six days later he was begging to play sports. It was amazing that he got sick and he never gave up."
Six days after being diagnosed Pinder played in H-F's final football game of the season.
In the nineteen months since being diagnosed, Pinder lettered in baseball, basketball, football and track and did not miss a single game during his senior season. And if you think this story can't get any better, it does.
That's because Pinder signed a National Letter of Intent to play baseball at Southland Conference school Texas A&M-Corpus Christi.
"Hard work gets you to where you to where you want to be," Pinder said. "It's pretty much what I've done. I've made sure everything was still OK. I don't know how to put it other than to say that it just takes hard work and dedication."
One of 140,000
Nearly 1.4 million Americans are affected by inflammatory bowel diseases and 140,000 of them are children under the age of 18, according to the Crohn's and Colitis Foundation of America.
Pinder became one of those 140,000 just hours after he was taken to the hospital.
During football season, Pinder started getting sick and his stomach started giving him problems.
He sat out a week and started playing again.
"The day before we played Silsbee I went to the doctor and I was supposed to have some tests for that Friday," Pinder said. "I told him that I have a football game and that I couldn't let down my team."
Twenty-four hours later, he knew something was up. After all, this was a guy who was flying around a football field making catches and blocking cornerbacks.
Now, he could barely walk around his home because the stomach pain was so great.
"The day I went to the doctor's office before I found out I had it, I weighed around 175 pounds," he said. "And that Sunday, when they told me I had Crohn's, they told me that I had lost 12 to 15 pounds. That came as a shock to me because I didn't realize that it had happened."
Road to Recovery
It's a simple routine for Pinder these days.
Wake up. Go to school. Take eight pills a day for the rest of his life. Go to practice. Go home and eat a dinner that's a far cry from what he was eating two or three years ago.
"He's probably more selective in what he eats," said Dr. Joseph Holland, of the Southeast Texas Gastroenology Associates in Beaumont. "With most people it affects primarily their small intestine and that is important for absorption especially when it comes to food and so forth."
While getting adjusted to that routine, Pinder found time to travel south to a baseball showcase at Texas A&M-Corpus Christi.
It was at the showcase where he impressed the team's coaching staff.
"Those coaches said he ran fastest time in 60-yard dash they ever saw. They were really interested," Lee Pinder recalled. "Lamar called him right after they saw him talking to Texas A&M-Corpus Christi after a game at Vincent-Beck Stadium and offered him a red shirt season next year."
Pinder said he chose A&M-Corpus Christi because he liked the coaching staff and its laid back way of life reminded him of home. Pinder said he told the coaches about his condition and they respected him for his honesty. But before he goes south, he wants to help H-F, which placed second in District 21-3A, go far in the playoffs.
"You can't let things get you down and stay positive at all times. At first, I was scared because I thought I wouldn't be able to play any more sports," Pinder said. "But I have been keeping my body healthy and have stayed positive about everything. You can't let your dream's go to waste."
Hamshire-Fannett senior Jeremy Pinder has excelled at baseball well enough to earn a scholarship to play next season at Texas A&M-Corpus Christi despite the rigors of living with Crohn's Disease, a life-altering stomach illness with no cure that destroys the small intestine.
A list of professional athletes with Crohn's and other inflammatory bowel diseases:
u David Garrard, quarterback, Jacksonville Jaguars
u Theoren Fleury, retired hockey player who played with the Calgary Flames
u Kevin Dineen, retired hockey player who played 18 years in the National Hockey League
u Shayne Corson, retired hockey player who played 15 years in the NHL
u Al Geiberger, professional golfer who won the 1966 PGA Championship
u Chris Gedney, retired tight end who played with the Arizona Cardinals and Chicago Bears
u Steve Redgrave, won five consecutive Olympic gold medals for rowing
u Rolf Benirschke, retired kicker who played for the San Diego Chargers
u George Steele, retired wrestler
Friday, May 1, 2009
Living with the chronic, painful and unpredictable condition of the digestive system is even tougher.
Kitchener's Liz Elliott suffered with the illness for decades before she had drastic surgery to remove the diseased part of her large bowel.
"Half of my life I spent trying to struggle with inflammatory bowel disease," said the 56-year-old. "After surgery it was like I had to learn how to be healthy again."
Elliott was finishing her first year of university when she first started having trouble.
She was overwhelmed with flu-like symptoms -- vomiting, nausea, abdominal cramping and diarrhea -- but she chalked it up to exam stress.
But the symptoms lingered for weeks, then began worsening and Elliott's weight dropped.
She was admitted to hospital with a high fever and a gastrointestinal specialist diagnosed her with inflammatory bowel disease -- a condition Elliott and her family had never heard of before.
"Once the diagnosis was made, that kind of scared me," Elliott said.
She heard only two things the doctor told her: there is no known cause and no cure.
"I was terrified that I was going to die."
There are two types of inflammatory bowel disease: Crohn's disease which can affect any part of the gastrointestinal tract, and ulcerative colitis which is in the large bowel.
Elliott was diagnosed with Crohn's colitis, which is Crohn's disease in her large bowel.
Immediately she was put on heavy doses of steroids and anti-inflammatories.
"I had been really healthy up until then," Elliott said.
That changed with Elliott's diagnosis. Suddenly socializing was tough for the teenager, and she felt different from everyone else her age.
"You can't eat the same things as your peers and I was always looking for washrooms," said Elliott, who later trained as a nurse and now works as a clinical manager.
For many years, Elliott did her best to cope with the disease. Medication helped, along with a careful diet to avoid foods that aggravated the condition.
She was careful about doing too much because that could cause symptoms to flare up.
And people weren't always understanding or sympathetic. Some thought the problem was in her head, and Elliott had to explain the disease wasn't imagined.
"On the outside the person looks normal, but on the inside the pain is real," Elliott said.
Tired of the chronic illness, Elliott decided to have surgery about 14 years ago to take out her entire large colon.
Such an extensive surgery is uncommon for the condition, but only removing a bit may have worsened things for her.
"They removed it all, so the symptoms are gone," she said.
Elliott does have to always wear an ileostomy bag, which collects waste material from the small intestine.
But she has gained so much -- both health and freedom.
Suddenly she was able to eat what she liked, go out without worrying about accidents, travel and enjoy being active. Even something as simple as taking her two dogs for a long walk was no longer impossible.
And now she has the energy to volunteer with the Crohn's and Colitis Foundation of Canada, helping to raise money for research to find a cure for the debilitating disease.