Category Archives: Health

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Turmeric as an anti-inflammatory

Yesterday I had my follow-up appointment with Erin. As I’ve said before, Erin is a Nurse Practitioner. She can do pretty much anything an MD can do, but is nicer. So anyway, I’m just going to refer to her as my doctor.

I expected that this post would be about the questions and answers around going on Humira and that was mostly what my appointment was about. Erin was great at explaining how Humira works on Crohn’s and answering my questions about side effects, costs and alternative treatment approaches. But there was one small detail that stood out for me. When I asked her about diet she mentioned that turmeric had been shown to be an effective anti-inflammatory agent.

“What?!?” This took me aback because she has been very much toeing the party line of western medicine. She’s given me straight answers about the body of research around Crohn’s and the treatments for it. So if she would even mention something that you can buy in the health supplement section of HyVee, there must be something to it.

I did some research and it turns out that this little rhizome has some pretty impressive health benefits.

What is turmeric?

Turmeric, the spice, is made from the rhizomes and roots and bulbs of the turmeric plant. turmeric is a relative of ginger and the rhizomes look very similar to ginger rhizomes, but when cut open they are bright warm yellow on the inside. It is a main ingredient of curry and is used in many asian cuisines. It’s what gives the yellow color to curry dishes. It has long been known for it’s medicinal qualities and is a major part of Siddha medicine of Southern India.  Incidentally, my daughter Quinn was WWOOFing at Hale Akua farm on Maui, where the main crop is turmeric. The Hawaiian word for turmeric is ‘olena, which is also the word for yellow.

Curcumin is the compound in turmeric that gives it it’s health benefits. This article from the University of Maryland Medical center is a good list of curcumin’s benefits, from indigestion to heart disease, and the state of research into each.

Needless to say, as soon as I got home from the doctor, I headed over the HyVee and got a bottle of turmeric capsules.

 

Colonoscopy

golytlelyColonoscopy day, everyone’s favorite day. Mine was last week. I’m lucky I get to have one every five years instead of the recommended 10 for those of us over 50. Thanks again, Crohn’s disease. There are few things easier to put off than having a camera up your ass. In fact I was about 3 years behind (no pun intended) schedule, so of course I was sure that there was some nasty malignancy brewing in there, undetected because of my procrastination.

For those of you who haven’t yet had the pleasure, this might be hard to imagine, but the procedure itself isn’t bad at all. The start out by shooting you up with Versed and Fentanyl. Which is to say they send you to Happyland. Besides you get to watch the live video of the journey up the poop chute, it’s almost like science fiction.

No it’s not the rubber tube being threaded up my ass that I dread. It’s the prep. They want your colon to be squeaky clean when they make their entry. If you’re going to go diving for treasure you want it to be in a clear spring fed river, not a murky Minnesota mud lake. So the day before you get to fast and flush. And by flush I mean drink a gallon of a foul-tasting liquid that has the most ironic product name in the universe, Golytly. There is nothing lyte about it’s effects. As the instructions say, “Expect to experience diarrhea, stay near a toilet.” Even a person like me, with forty plus years of Crohn’s, will be shocked by the purgative effects of this intestinal rocket fuel.

After the fun part was over and it was time to move on to the procedure itself, I got an extra bonus dose of discomfort. It’s become aware that I’m a difficult subject for I.V. poking. It’s hard to find a usable vein in my skinny arms. It took three tries to get me hooked up. The first two nurses failed so they had to call in the top gun to do the job. Maybe they could have had the expert go first. Just sayin’.

This time around the captain of the anal explorer wasn’t my usual G. I. doc, because we wanted to get in as soon as possible. Since my usual butt surfer is a guy not much younger than me, I was expecting a younger person, but when he showed up he looked like a clean-shaven Santa Claus. Maybe young people just aren’t taking up anal exploration as a specialty anymore.

So the spelunking began, the camera went into the cavern, some polyps were found and clipped off and everything seemed to go just fine. I got the report the next day that the polyps were just from inflammation, they weren’t malignant and would not become malignant. So good news. The bad news is that because there was active inflammation, they were unable to take biopsies for an assessment of the Crohn’s disease progress. It’s kind of funny how the report stated it. It said a follow-up would be required, but a couple of paragraphs down it said “This is an optional procedure.” OK, I pick the “not doing it” option.

Tomorrow I have a follow-up appointment with Erin, the NP that I saw a month or so ago. She’s going to give me the Humira pitch. I’m going to be a tough sell.

I’d love to hear suggestions for questions to ask about treatment options.

 

Hypochondriac Humor

If someone asked me to name the scene a movie that most resonated with me, this would be it. My name is Bob and I am a hypochondriac. My gravestone will read, “I told you I was sick.”

So of course the fact that I was suffering from pain and bloating over the weekend, and that the NP thought I needed a CT scan to check for an obstruction sent me on a wild spiral of anxiety.  Nevermind that I’ve had all the symptoms before and it proved to be nothing more than constipation, I convinced myself that I had a huge tumor lurking in my intestines and that I should stop buying green bananas.

At one time in my life hypochondria almost took over my life. Every little lump or sore was a death sentence that I would obsess over relentlessly. I obsessed over the possibility that I was insane because I was obsessing so much. Finally I went to a shrink and he put me on Celexa, an anti-anxiety and anti-depression medication. I got almost instant relief. I probably started dangerously ignoring symptoms. But alas the drug had some unpleasant side effects. Imagine that. So a few months ago I decided to wean myself off of it, which I did over a period of a couple of months. Until now the I’ve not been obsessing about my health. But Crohn’s and gut problems always get me worked up so I was spinning down the rabbit hole of paranoia for a few days.

The scan came back clean. You might have seen me skipping down 4th Avenue yesterday afternoon.

I’m not whining. Am I?

doubtIt dawns on me these recent posts on Crohn’s might come off as whining. Poor me, I have a chronic condition and it’s going to cost me a lot of money to treat it. If that’s the impression I’ve given, I apologize.

I don’t have anything to whine about really. My Crohn’s is about as mild a case as you can get. I’ve never had surgery or even been hospitalized for it. Sure I’ve crapped in my pants a few times and have gone through some miserable periods, but all you  need to do is follow the Crohn’s hashtag on Twitter and you will realize I’m lucky. You can die from this. Young people are hospitalized and having colostomies and finding themselves unable to work. Not eating for days because it causes too much pain. So really I don’t have much to complain about. I should be thankful.

I have a couple of reasons to write about my Crohn’s disease adventures. One is that I need something meaningful to write here, and although talking about one’s shit is pretty personal, it gives me the opportunity to talk about things beyond what I had for dinner and what TV I’m watching. The other is that I hope I can help others with Crohn’s by providing information and telling my story.

I won’t be writing exclusively about Crohn’s here. I’ll probably still write about TV and what I had for dinner, review a book or movie, post some artwork and keep you posted about my battle with the bunnies who use my garden as a smogasbord.

Stethoscope and money in soft light for Medical cost saving or in business marketing concept

Can I even afford to go on Humira for Crohn’s?

First, I’ve created an aggregated feed of Crohn’s disease on social media. Check it out!

My last post I talked about the resurgence of my Crohn’s disease. After three years of remission it’s suddenly returned and I’ve been dealing with the symptoms a couple of months now. After the usual period in which I just hope that it will go away, I finally made an appointment with the doc. My usual GI guy wasn’t available so I saw a nurse practitioner. In forty-five years I don’t think I’ve ever had someone sit down and talk to me about my Crohn’s as long and thoroughly as she did. I recommend going to nurse practitioners, because they will take the time to listen to you. My GI doc is a really nice guy, but he always seems like he’s in a rush to get out of the room.

Last night I was calculating how much Humira would cost. I came up with $8000 a year. But that’s not right. The direction of this post has changed since I started writing it. I emailed James Romeo, the agent that handles my supplemental Medicare insurance. He got back to me within the hour and walked me through the coverage and the dreaded “donut hole” in Medicare prescription coverage. I’ll try to explain that in a future post. I already had a pretty good handle on that, but our conversation revealed that I’d made a mistake when I was calculating the cost in my head. Hell, it would only cost around $4000 a year. Whoopee! James says it’s the most expensive medication he’s run across. Do I get a prize?

I suppose you could make the argument that the folks at AbbVie spent a lot of money on R&D to develop Humira and they need to get that back and make a profit. I’m not too worried about them, Humira sales grossed $14 billion last year. That’s with a ‘b’.

We have saved for retirement and I thought we were going to be in great shape financially, but that number could mean we wouldn’t be able to do all the things we’ve been looking forward to.

One of the things the NP said was  that continuing without more aggressive treatment might result in requiring surgery. When I think about it, from my standpoint surgery would be more cost effective than the drug. With the Medicare coverage that I have I could get to the deductible pretty fast. I could just roll the dice and hope that I didn’t have to have surgery too often. After all it hasn’t happened yet. Another argument was that I wouldn’t want to go on prednisone four or five times a year. Well I’ve needed prednisone only a handful of times in 45 years, maybe twice in the same year one time. Another temptation to just roll the dice.

Currently there is a class of drugs coming on the market called biosimilars which work like Humira and the other biologicals, but presumably would be less costly. But the bigger question is whether they work and what are the side effects.

Update on my condition

I reported in with an update for the doc, mentioning that I had pain and bloating, so now she want me to come in for a CT scan next week. Bah.

 

The straight poop

Some time ago I wrote about what I would and would not write about here. I stated that I my intention was to avoid politics and not talk about my health, specifically Crohn’s disease. I really don’t think anyone wants to read about me obsessing about my bowel movements. There’s that apocryphal story of Eskimos having a hundred words for snow. Well I could have the same diversity of vocabulary for my stools. No one wants to read about that.

But events have taken a turn lately and I’ve decided to change direction with them. My reason is that I’ve reached a crossroads where I need to make some decisions about how I treat this annoying companion I’ve had since I was 23. But first a little background.

As I said, I was first diagnosed when I was 23. I had just gotten back to Minneapolis from Northern Idaho, where I’d spent the summer working for the U.S. Forest Service. That fall I suddenly started having nasty diarrhea, that lasted longer than what could be explained by a bad taco. After about six months of tests and doctor bouncing, I finally got a diagnosis. I’ll talk more about that later. Crohn’s is an inflammatory disease of the intestinal tract. It’s an autoimmune condition; in other words you immune system attacks your own body. They don’t know what causes it and there’s no cure. It can manifest itself in various ugly ways, the most common is a really nasty case of the shits, accompanied by painful cramps in the gut. It can also cause inflammation in other parts of your body, including joints and other internal organs, as well as skin rashes. It can even do a symptomatic flip-flop and cause constipation when your inflamed poop chute contracts to the point of obstruction.

I’ve been lucky, I have a pretty mild case. I’ve gone all these years without being needing surgery, being hospitalized or worse. It can kill you. It comes and goes, a few months of remission, a few months of hell. It seems to really like to flare up in the fall. Stress seems to be a factor. Although there are some foods I’ve learned to avoid, diet doesn’t seem to be that much of a factor, but I intend to look into that aspect more thoroughly in the near future.

Three years ago I went into a remission that lasted until a couple of months ago, when it came back with a vengeance. I took my usual “ignore it and it might go away” approach until a couple of weeks ago when I decided I needed to come in from the cold and see my gut doctor. We did the usual drill of making sure it wasn’t some kind of bug and I started a course of prednisone to knock down the inflammation. I’m just starting week three of treatment.

Here’s the kicker. The doc wants me to start taking a more aggressive kind of medication. A new form of treatment referred to as a biologic, specifically in my case Humira. It works by dumbing down the immune system, which somehow just doesn’t sound like such a great idea to me. It has some nasty side effects, not the least of which is poverty. That’s right, poverty; because of something called the donut hole in my Medicare Part D coverage, I figure it’s going to cost me $8000 a year to use the drug. I can put up with a lot of shit for that kind of money.

This is getting a little long so I’m going to continue later. In my next post, I’m going to explore the conundrum presented by the next stage of treatment and my changing views of western medicine, the cost of health care and how I think about my health.

Meanwhile back at the ranch.

IMG_1466To say there’s been a lot going on in my life since my last post is like saying the Titanic sustained some minor damage from an iceberg hit. I got a new job. I broke my hip, my daughter got married, I learned to surf. Ok that last one is a lie.

In August I was contacted by on of my web clients, The Minnesota Spokesman-Recorder,  asking for me to recommend a print designer. The Spokesman-Recorder is a weekly newspaper for the African-American community, it’s the oldest Black owned business in Minnesota. Their designer had left for another job and they were looking for someone who could take over and help them with laying out the paper and handle collateral design projects.

I’ve been tossing around the possibility of getting a part-time job, a few hours a week to supplement my retirement income. But given the fact that I can’t really bend my knees or be on my feet for long periods of time, I’m kind of limited to what I can do. I already failed as a barista. But doing some design work in-house a few days a week would be perfect. So I recommended myself. I’ve been working there for a couple of months now and I really enjoy it, great people to work with, perfect hours and a regular paycheck. Between Social Security, my freelance income and this, I’m almost as much as I did when I retired.

Actually I didn’t break my hip. I broke my greater trochanter. Which is the little nub on the outside of the top of the femur where the glutes connect to your leg to articulate your hip. If you’re walking through a house that has a sunken dining room, looking back over your shoulder talking, it’s the part that hits the floor first when you miss the step. Yup, that’s what I did. In Chicago at the rental house we were staying at, two days before the wedding. I had the pleasure of escorting my daughter down the aisle on crutches.

The fracture wasn’t displaced and didn’t require surgery. They didn’t see the crack on the X-rays in Chicago, they diagnosed it as a bone bruise. It wasn’t until the pain wasn’t getting any better and I went to a local bone doc who discovered the break. I didn’t have much pain in resting position, but there were certain movements that gave me a breathtaking shot of pain. I was told to use crutches until the pain went away and start physical therapy. It’s been about five weeks now and the pain has pretty much gone away, it seems to be getting better by the day. I’m down to one crutch now, and sometimes I find myself walking around without it. I’m hoping to be crutchless next week for the Gopher Women’s Basketball opener.

Yes, Lucia and David got married. I’m going to save this story for another post.

Pills

skeleton

I have Crohn’s disease. I take pills. Twelve a day. Really expensive pills. Thank God for insurance. Specifically, I take Asacol, which is Mesalamine wrapped up in a plastic tablet that’s designed to keep it from releasing the good stuff before it gets to the target area in my poop pipe. It works, kind of. I have long periods of remission punctuated by some very long periods of, let’s just say, discomfort. When that happens I get to take a course of Prednisone , which is similar to making a pact with the devil. Fortunately I’ve been in a fairly long period of remission (knock wood) I think partially due to some diet changes and some supplements that my doctor probably would view as the product of witchcraft, but that’s another story.

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