Sunday, January 27, 2013

Intolerance....The Gastro-Intestinal Story




Soooo... I have discovered that I am intolerant.  I have been having for lack of a more artful term, intestinal issues for the last 5 years.  I blamed the onset of these to a law firm I worked for that was very stressful.  Then I blamed it on the next law firm I worked at that was very stressful.  They were both defense firms.  They are stressful dysfunctional places but...perhaps it was not their fault.  After colonoscopy and endoscopy they diagnosed me with ulcerative colitis.  This is only a slightly more definitive diagnosis than “irritable bowel syndrome”.  After the colonoscopy I was told that there was “minor irritation” in my intestine.

Everyone has advice about this.  Eat this yogurt. Drink this shake.  Eat fiber.  Avoid fiber.  More fruit.  Fruit will kill you.  And all along my doctors telling me that my diet has nothing to do with my stomach problems.  They put me on medication that costs several hundred dollars a month.  4 pills a day.  Along with 6 Juice Plus, Iron and Folic Acid I was taking 10 minutes to gag down a handful of pills every morning.  And I did not get better.  Prior to leaving the other guy I had a pill cam which i got to swallow and they got to watch go through my stomach.  I also had an upper and lower GI and I still don't know what that means.  All of them came back with the Doctor telling me I had “minor irritation”.

I got frustrated and changed doctors.  The new doctor said “I need my own tests” and we did another endoscopy and colonoscopy.  Surprisingly the doctor got the results and told me that they showed I had minor irritation in my lower intestine but now I was prepared.  I had an iPhone and had taken a picture of my “normal” stool and said “Does that look like minor irritation?  It doesn't FEEL like minor irritation”.  He was...troubled.  I was angry.  I explained to him that I needed to fire him because I was not getting better and he was no quarterbacking my treatment but was just doing procedures that were not changing anyone’s thought process.  I suggested that every time I came back from the doc my wife (who is really tired of my shit...literally)and she has all kinds of questions.  Have they tested you for Crones? Have they tested you for ciliac?  Have they tested you for lactose intolerance? have they tested you for syphillis?  LOTS of questions.  And I come back from the doc with no answers.  So we embarked on a series of tests to rule things out.

Oh... somewhere along the line I also got swollen lymph nodes in my stomach meaning I get to have CT scans every 3-4 months to see if they grow.  My internist suggested that it was natural after 5 years of inflammation that I would of course had inflammation.  My gastro-enterologist of course expressed to me that I should be much more concerned about that without being able to advise me on any other course of action I should take other than “monitoring them”.

So now I go in and get three hydrogen breath tests.  One for bacterial overgrowth, one for fructose intolerance and one for lactose intolerance.  Bacterial overgrowth means you have too much bacteria in your small intestine.  Evidently this is bad.  For these tests you eat a little bland food the day before the test and then fast for twelve hours.  I always go in as early as possible but it is a pain and an inconvenience getting ready for these tests and it is more than anything else annoying and time consuming.  You come in and the take you back and you blow into something and they take a baseline reading and then you drink something.  Then they send you back out and you come back every half hour and they take another reading.  For the bacterial over growth test I was there for three hours, blew 6 times and came up with....nothing.  For the fructose test it was the same drill but you drink a super corn syrup fructose powder mixed with water.  I blew the first time and had nothing and blew the second time and was told “we are done, you are highly fructose intolerant and you are going to have a very bad day”.  Fortunately with the nature of my problem it was not even that bad of a day.  I was happy to finally have a diagnosis, that was something I could conceivably figure out how to deal with.  I had the lactose test next week and came back again but I have eaten cheese and butter all my life and I was pretty certain this was not an issue.  

I came in like the other tests.  Took my baseline reading and blew.  I cam back a ½ hour later and blew a .02... then I cam back a half hour later and blew an .06.  Evidently it takes the stomach a while to start processing and creating the chemical reactions and gasses.  I was feeling a lot of things going on in my tummy.  I then came back and blew a .56 and she said “WHOA.  We are done and you know what I said last week about you feeling bad...you are going to feel REAL bad today”.  And you know what, she was right.  I guess when your intolerant it is almost like a full body allergic reaction.  Wow.  She advised that I go home but of course I missed a mornings work and really needed to catch up so I went into work and I sweated, and I ached and I evacuated the poison from my system for about four hours.

Si I am lactose and fructose intolerant.  What do I do?  Well, I don’t know.  Information is all over the board.  Everyone thinks you can just cut things out but both of them are in a lot of things so I have suddenly become a label reader.  I have never read ingredients on anything in my life.  Over the last couple of weeks I have tried to do this on my own and consulted numerous sources on the Internet and am ore confused than ever.  The process of intentional avoidance has offered some immediate benefits regarding general gassiness but my inflammation (diarrhea) is still sporadic.  As a person who formerly enjoyed sitting on the toilet for 20 minutes and getting some reading done, the last few years of 45 second shits has been very odd so transitioning back could be odd as well. One thing I am is very pissed off at a system that misdiagnosed and mis-treated me for 5 years. It is a portrait of our current health care system where docs get paid to perform procedures rather than try and treat the patient and the illness. I do not think they do this because they are stupid or because they with us poorly, I think it is just "the system". It sucks and it makes me think that tearing it down might be the only way to save it.

As I said the information on the Internet is all over the place beer is good, beer is bad, blackberries are good, blackberries are bad.  high fructose corn syrup is definitely the enemy but how this is listed as an ingredient is all over the map.  Almost any lays product has lactose powder in it. Cranberry juice cocktail is bad, or it is OK.  regular cane sugar is fine, or it is poison.  It all appears to be highly specialized to individuals and what their tolerances are.  I am keeping a diary of everything that I eat and what my symptoms are and that seems like a very self involved thing but the internet is universal in telling me that this is a requirement of my...."conditions". So I will see an a dietitian and talk with my doctor next week and try and figure out what this really means.  What it seems to mean is that my intolerance is going to make my life a like more bland.  When I think about what i see politically from our countries intolerance, that sounds about right.

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