As far as the gallbladder goes -- there's a certain type of medication (I can't remember the type other than that Questran is one brand) that works specifically on gallbladder diarrhea, so I'd say at least ask for a sample of it and give it a try. If it doesn't help, then you can rule one thing out. (I know what you mean about Imodium! It used to be my lifesaver but I've been having D problems again over the last month and it doesn't help at all. It'll stop me up, but it's just a temporary abatement and when I do start to have D again I cramp twice as hard.) I've also heard that some people can continue to get gallstones even after gallbladder removal, but that they end up forming in their own little pouch?? I don't remember much, just something I saw in my reading, and I don't know what the symptoms are.
I guess if the treatments are the same then it doesn't really matter if it's Crohn's or RA -- but maybe you should ask the GI or Crohn's guy, "OK, if I really do have Crohn's, what about my treatment would be different?" I know Humira is a Crohn's drug too but what about the other Crohn's drugs out there that aren't used for RA? I can't remember names off the top of my head except Asacol (sp?). Can you link the switch to D to starting any particular medication, like maybe starting the steroids full-time? Steroids is a Crohn's treatment as well so you'd think that the longer you were on them the better you'd feel if you did have Crohn's, right?
A laparoscopy wouldn't rule out Crohn's, but they can get a good look at the outside of your bowels to see if there's anything there that could be causing bowel problems. They can also check out your organs for anything abnormal and biopsy everything to make sure it's healthy. I had really really really awful D from endometriosis -- it was mainly because my appendix was covered in it (which would've ruptured sooner than later if I hadn't had the surgery). I took tons of Levsin and Imodium every day to try and stay stopped up but I still had BMs every day and I usually had at least a couple really nasty D attack every week. I kept trying to go off the meds but every time I did within a day or two I started having horrible D -- where after awhile there's NOTHING in your system so the stuff that comes out is whatever fluid your system can scrounge up in order to expel!! It was so awful, but no one would help me because they kept saying I just had IBS. Arrghh.
Although going to Mayo was ultimately a bust, I do think part of it was the way I handled it. And I don't know if it's even possible, but I'd try to avoid actually going to a department -- I'd call them and see if I could just have a basic initial workup, where you get a complete physical and tell someone nice and sympathetic your history and get bloodwork and urine/stool samples and basically get tested for everything known to man and *then* have them send you to a department. Because the thinking of what department you end up in is going to influence your diagnosis. If you go to gastroenterology, they're going to try and diagnose you with Crohn's or UC or whatever, and if you really have an autoimmune disease or something else, they're probably going to miss it.
Yes, it'd be expensive to go -- but if you're not getting anywhere local, it might be worth a shot. I didn't get much out of it, but at the same time, I don't regret going because I think it was something I had to do. It made me realize I had to get more aggressive for myself if I was going to get anywhere.
We've spent enough on medical care this year that we'll be able to deduct it from our taxes. The IRS's rules include being able to deduct for lodgings and transportation costs, but I'm not sure how stringent the rules are (i.e. I didn't HAVE to go to Mayo). If you do think of making a trip there then maybe you'd be able to deduct at least part of the costs.
-------------------- jen
"It's one of the most serious things that can possibly happen to one in a battle -- to get one's head cut off." -- LC
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Re: capsule endoscopy
