MR Enterography
I had my first MRE in fall 2012. My doctor at the time was concerned with the state of my Crohn's disease, and wanted me to get a second opinion at Cedars Sinai. The doctors there knew that the main location of my disease (a couple inches into the terminal ileum) was tough to get to via colonoscopy (see below!), so they wanted to try a different way to see my disease, and the extent of the swelling. Amazingly, you can see everything with an MRE (a special type of MRI using barium and contrast dye for a clearer image. Barium is administered by drinking some thick, milky, salty substance, contrast by IV). It was there that they saw fistulas forming, and how inflamed my gut was.
Since then, I've had an MRE almost every year, typically around mid-July. In fact, I am due for my next one tomorrow! It is a great way to visualize what is going on, and my doctor is now able to make decisions based on what she sees in those images.
Blood Work / Lab Tests
Every 3-4 months, I have the privileged of getting poked in the arm and have a couple vials of blood stolen from me to check for important things like CBC (Am I anemic? Do I have increased/decreased red and white blood cells?), Liver Panel (Is my medication ruining my liver?), and vitamin levels (Is my body absorbing nutrition?). Once a year, I also have to have a TB test to make sure I don't have tuberculosis, since I am more at-risk of contracting it while on my immuno-suppressing medications. When things are going really bad, my doctor may also order a stool sample to see how things are going at the other end. <sarcasm> What Fun! </sarcasm>
CT Scan
A CT Scan is a quick and easy(ier) way to see my disease with imaging. This typically involves drinking barium (or getting a barium enema - which I do not recommend) as well to help the radiologist see the inside of my intestines better in the images. CT scan was the test used to first diagnose my Crohn's, and is the test they used both times I went to the ER to get a quick view of the disease.
Endoscopy
This test is the easiest of them all. I've only had one, and it was only to check out as much of my GI system as possible to ensure there weren't any additional issues as a result of the Crohn's. Essentially, the doctor knocks you out with some good meds, then sticks a camera down your throat to see the inside of the esophagus, stomach, and first part of the small intestine. As a result of the procedure, I was diagnosed with a hiatial hernia (where the valve between the esophagus and stomach does some funny things), likely the cause of some of my crazy hiccup attacks, as well as some minor stomach ulcers.
It's the one we've all been waiting for... the COLONOSCOPY!
As a young old person, I had my first colonoscopy at age 20, a procedure most people have around age 50 (if you're 50 or over and haven't had one yet, go see your GI!), then every 10 years after that for colon cancer screening. Including that one when I was 20, I have only had 4 colonoscopies (about 1 every 2-3 years). This is mostly due to the location of my Crohn's - it is higher up than a typical colonoscopy can reach, so it is a less useful procedure for me.
I'll spare all of the gory details, but I will tell this one story:
Colonoscopy prep involves drinking 64 ounces of laxatives, and you aren't allowed to eat solid foods (clear liquids only!), and no colored food that might discolor your insides (e.g., reds, blues). Essentially, for 24 hours before the procedure, you are stuck drinking lots of water, apple juice, chicken broth, and lemon-lime flavored beverages / jello / popsicles. I was so sick of lemon-lime (mind you, the prep is usually a salty lemon-lime flavor too) that I sent Kevin out to find anything non-colored and non-lemon-lime flavored. he came back later with BANANA flavored popsicles! It was probably the best thing that has happened to me while prepping for a colonoscopy!
Also, I'll share a few colonoscopy prep tips:
- The day before, eat a very light meal (I recommend things like clear liquid soups, bananas, rice, applesauce, toast, etc.) - do not eat a Quiznos turkey and cheese sandwich, you will be in for a long night
- Make some Jello in advance (non-lemon or lime flavors)
- Prepare some chicken broth (if you're not at home, just heat up water in a coffee pot & mix it up!)
- Buy some good air freshener (I recommend Lysol Neutra Air spray)
- Buy some good wet wipes (or if you have a really sensitive bum, preparation H wipes)
- Plan to spend a lot of time on the toilet
This year, I am once again taking part in Team Challenge, participating in the Lake Tahoe Triathlon at the end of August for my 10 year anniversary of being diagnosed. You can support my fundraising efforts here. All funds go to the Crohn's & Colitis Foundation, dedicated to finding a cure!
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Stay tuned for Part 5: Coming to Terms
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Stay tuned for Part 5: Coming to Terms
