My story, oh my story...

Hi. I am new to the forum and have been actively following many of the threads. They have been an amazing coping mechanism and I feel it is about time I became more active as a member of the forum.

I am a doctor and just started my surgical residency training. I was diagnosed with crohn's colitis my 4th year of medical school. One day (after a night of hard drinking), i began to experience bloody diarrhea, urgency, gas, etc. Had a colonoscopy done and they found the colitis to be in my descending colon (left side). I have been managed on prednisone and asacol but I have now got to a point where everytime I come off the prednisone, i begin to experience symptoms again. I had a repeat scope just a week ago and the colitis is more patchy and throughout the colon. There is no involvement of the small bowel. I have no doubt that the stresses of intern year have made this worse. It sucks because I do not want to give up on my dream that I have worked so many years for, but I do want to move towards better control of my situation. I believe immunomodulators are next on the list for me, 6-MP which I will most likely start sometime this week after seeing my GI doctor.

I am sure at this point that stress will be my biggest kryptonite. I am attempting to find any and all means to alleviate this. The ability to sleep while I am on call is also another challenge. Some days when I am on call I am here 24 plus hours and get maybe 2 to 3 hours of sleep if I'm lucky. I try to make it up when i get home and sleep extra early at night. I used to drink but have completely cut that out as it has contributed majorly to my flare ups as well. Diet modification has also been something that I have begun to tackle, but this will most likely come with time and experience. Many posts on this forum have definitely begun to guide me.

Welcome Doctor and we are so glad you found us and decided to join
our group here on the web.

Please feel free to browse the forums and it's good to hear you
have found some degree of coping through reading various
posts from our members.

If you have any questions please do not hesitate to ask.

Once again, welcome!
Nancy~

Hi MD
and welcome

I'm glad you've decided to join us, and that we've already guided and reassured you!
Fatigue is a killer alright, especially on your shifts! I'm in awe of you!
Hope the new meds work for you, either aza or 6mp, and we'll see you around the boards!
lotsa luv
Joan xxx

Welcome to the forum, CrohnMD.

It's reassuring to have an MD on the forum, and just to reiterate what Astra said, I too, am totally in awe of you for not letting IBD get in your way. My Crohn's got in the way of my work and job prospects, but this year I'm determined to try and get back to work and support myself.

I wish you all the best for the future MD and look forward to chatting to you on the forum.


Liam

Dont give up on your dream... my dream is that we have better..more knowledgeable doctors that sincerely want to help...sounds like you are well on your way....

Hi MD and welcome!

I'm sure you have zero spare time at this point in your life, but here is a must read for you:

http://www.amazon.com/Kitchen-Table-Wisdom-10th-Anniversary/dp/1594482098

Kitchen Table Wisdom by Rachel Naomi Remen. She is a doctor who has battles Crohns/Colitis since she was in med school. She is an inspiration!

Good luck with school and keeping stress under control. Where are you located? Where are you doing your residency?

- Amy

Hey thanks for encouraging words. I've been doing much better. I'm a surgical resident at Yale

Yes, welcome, and all the best.

welcome to the forum, i saw your post you left me before but havent had time to go back and answer it.. i wanted to thank you for the information and 6mp is a scary thing to be on.. i decided to find a holistic doctor and try going throught that way, rather than staying on 6mp for a long period of time.. i cant do the cancer thing its way to scary for me.. i have a son to live for and to be honest i have to sit and weigh my options..

so my family found a doctor that people they know deals with , so waiting to see if he will send me the herbs or what ever it is he gives.. im praying he can get this under control that way so i can be completely off these meds this year

Hi - I'm also a physician with Crohn's. (I did Peds, at a well-known place northeast of you.) I hope your new rx is helping. Residency sucks, regardless, but hopefully a good combination of meds, sleep (*fingers crossed*), and a minimally stressful life outside of the hospital will keep you feeling ok.

Also, it's not fun to think about, but if you really start to get into trouble, there are alternative training routes (e.g., take a research year after your 2nd or 3rd year) that might make it easier to finish in the long run. Are you thinking of specializing in anything in particular?

Also, a colleague recommended Pedialyte, particularly for sick days - the orange flavor tastes okay, and is actually better for you than Gatorade... for what it's worth.

Cheers, and hang in there.

Another doctor here.... my spouse has Crohn's. I also had someone a couple of years ahead of me in my Internal Medicine program in the Southwest who had Crohn's and did well.

Stress is going to be a major factor for you....as is diet...since hospital food gives even the best GI tracts problems. You will need a good support system, a regimented diet, and a cool residency director. I am not sure what your residency program is like...but the surgeons where I trained are put through the ringer during intern year. Luckily...if you are in the US...the new hour restrictions are kicking into place...and will save you some grief.

Do not give up your dream. If you have to take off a month here or a month there...no worries...you can finish your program off-cycle. That should not be a problem. My spouse would have killed for a general surgeon with your background. Instead, she had a second-year surgerical resident who walked into her room after an ex-lap and said, "You have Crohns in your ileum. You have 10 years to live." WTF? She was wrong, of course, but hey....docs who have been patients make better docs, hands down. It will improve your bedside manner and inspire trust.

Dr. S

******
Spouse's regimen

Asacol
6-MP
Humira
Steroids
Gingerforce
Probiotics
Aloe vera
Senna
Miralax

crohnMD,
Something else to consider adding to your regime is a liquid elemental diet. For the days when you aren't able to eat enough, properly, or are ill, an elemental diet as a supplement can help maintain your weight, improve your energy and sometimes even help you to attain remission or remain in remission if you've achieved it. I use VivonexPlus. I still had bloating, diarrhea and nausea on Ensure and Boost. Pedialyte helps if you are dehydrated, but it does not have any protein in it, so it sure won't help you get through a night of call. The proper elemental drinks have the protein as amino acids so it is easily absorbed.

Good luck!

Hi CrohnsMD..welcome to the forum. We know your pain and I do know being a doctor is a high stressed occupation. Stress and lack of sleep will throw your body off and cause you pain. I am sure you are aware that being steroid dependent is not good especially long term. Taking calcium and Vitamin D3 is so essential to all of us.

I was thinking that maybe Remicade would be of a great help? So many people do wonderful on it or Humira. Having this disease makes you a more compassionate person and therefore your bedside manner will be the best! My daughter who is in Univiersity Kenisiology and Phsychology, also is taking nutrition because she knows most docs lack that knowledge. She is also a very compassionate person because she has seen me at my worst at 4 years old and thought I was dying. So even family members are great support.

Glad you are here, hope you get total relief, let us know how you make out.

Hi crohnMD -

Your Crohn's sounds quite similar to mine. My colonoscopy revealed patchy inflammation throughout the ascending and descending colon, though the transverse seemed pretty clear. My ileum was also clear.

I was started on 30mg of prednisone, plus dicyclomine and asacol HD and immediately started to feel much better. As I tapered down on the prednisode things went OK at first, but when I hit 10mg/day, my symptoms came roaring back. Ultimately it was decided that I am steroid dependent, so now we're on to Plan B.

For me, Plan B is Humira, which I just started one week ago. I administered four injections with the starter kit, and I'm compelled to reiterate that doing so was easy and did not hurt. Within 48 hours, all the symptoms I had been experiencing vanished. Night sweats, which I had almost every night, are gone. Cramping pains in my abdomen - gone. Whereas I had previously had 4 -5 bowel movements per day accompanied by mild to moderate amounts of blood, I now have one perfectly "normal" such experience per day, no bleeding.

It's early and I'm trying to manage my own expectations, but if the early results are a reasonable predictor of future success, Humira may be the thing that works for me. I feel better now than I have in six months, before I was diagnosed.

Hope it all works out for you. I'll always be interested in reading your perspective on matters.