That is quite honestly what this entire post will be about this fine Friday evening. I’m sure I’m sorry, but not really. Don’t worry; I’m sure I’ll throw in some PIC/weight loss/depression musings in here somewhere, too, as that is as the kids say “my bag.” And off we go!
First, some probably unneeded backstory, but this is my post and I can write what I wanna! You don’t know me! You don’t know my life! But you do because I write about it!
As many know, I lost my father (where did he go?!) almost three years ago to the dreaded C word. No, not “cunt,” but rather cancer. That nefarious, devious thing it is, stealing and ruining lives. Goddamn the stuff, and I’d be remiss not to exclaim heartily with my fist tightened, upraised and shaking: FUCK CANCER.
It was stage 4 metastatic colon cancer, caught somewhere between the stages of “let us ravage this poor soul’s gastrointestinal tract and hey, just for kicks, let’s take a trip to the liver and lungs while we’re at it. Just, like, go nuts inside this guy, you know?” At the end, I don’t know if there was a system inside my father that didn’t have cancer in it, and I’d place a hefty bet that it even advanced upwards to his brain, but when you’re as riddled with the stuff as my good ol’ da was, when he died, none of us had the thought to do an autopsy because cause of death was pretty clear-cut. Again: fuck cancer.
The fact he died of colon cancer is enough to cause concern in myself to be proactive in my health and ask for a screening colonoscopy several years before the recommended age of 50, and even the suggested 10 years prior to the age of onset in a first-degree relative, as he was. What makes this tale even more captivating is also the fact that there has been seven (7) deaths on the Hoffmeyer side from colon cancer, as well. If not a colon cancer diagnosis, a different disease of the GI tract has been given: ulcerative colitis, Crohn’s disease–which Dad also had–irritable bowel disease/syndrome, etc. If there’s an ailment of the large and/or small intestine, chances are good that any member of the Hoffmeyer family has it. Needless to say, at the ripe old age of 36, I had my first colonoscopy; not just because of the terrifying family history, but this old gal was having some symptoms, as well. Alternating constipation and runny stools, and some pesky pain in my lower right abdomen.
Aside from having to force the prep liquid down my throat–a sickenly sweet fluid and tons of it, each gulp of the two-step preparation causing me to nearly vomit, my stomach churning it around and around–it was a pleasant experience. You take the prep, you shit like an opened fire hydrant for a few hours until you think you can’t possibly have anything left inside your guts, but ope! Here comes more! and at this point, you’re convinced you have managed to liquify all your internal organs and just flushed your kidneys and ureters (oh wait, is that part of my right lung?) down the toilet, it mercifully stops. Then, you wake up in the morning, have a responsible adult with you to drive you home after the procedure, get taken back to the pre-op area, get an IV and doses of sedation, get asked to count backwards from 10 and I think I made it to sounding out the “s” in seven before the next thing I knew, I was back in the recovery area having my blood pressure taken. Easy peasy, lemon squeezy.
My colonoscopy results came back abnormal. I have ulcers in an area in the colon (aka large intestine) that normally are indicative of Crohn’s disease. The gastro doctor I saw took biopsies of the area, sent them off to pathology, and they came back “inconclusive,” to which my doctor said it was probably from taking too much ibuprofen, as chronic use is known for causing erosion of the lining of your GI system.
Friends, I didn’t cotton to that. Yes, I take ibuprofen as I have a rotten knee and braces on my teeth, so I have been known to pop some gel caps in my day to ease the pain of one or the other, or if I’m feeling extra feisty, both at the same time. Keep in mind, however, this is a rare occasion, as the knee thing is been a chronic issue for over 25 years and at this point, I am so tolerant of the knee pain that my leg will have to be dangling from a frayed tendon before I take any pain medication for it, and even then, I reach for the tiny hoard of opiates I have in my bathroom for such a special occasion. This isn’t a pain ibuprofen will touch. It’ll try, bless its little ibuprofen heart. As for the braces thing, that has also become a thing I’ve acclimated to mostly and the last time I took the stuff to ease my head from hurting was two months ago. Essentially, my point being is if I’m in any sort of physical pain, I just deal with it until I can’t tolerate it, then I turn to a two-year-old prescription for oxycodone left over from my last surgery that’s been collecting dust in a drawer and then I go to bed. Ta da! What I’m trying to say is, I don’t crush ibuprofen up and snort lines off the back of my toilet. I don’t give myself ibuprofen enemas. I don’t roll around naked on my bed in thousands of pills of ibuprofen. How this doctor reacted to my colonoscopy results suggests that he believes all of the aforementioned scenarios.
I’m not usually a forceful, direct, or assertive woman. I despise confrontation of any sort, and will often grin and bear it as to avoid causing any hurt feelings towards another person. However, there have been a few rare times in my years on this earth where a tiny voice inside me goes “eh…I smell some horseshit here” and I will muster up courage to say something. This is one of those times. I didn’t buy the whole “chronic NSAID use” thing and I contacted this doctor again and asked if there were other tests we could do because my pain reliever usage vs. the initial results of this procedure didn’t settle well with me. I was symptomatic. To his credit, he agreed, and a fairly new blood test called PROMETHEUS (that just sounds elfin’ cool) was ordered and through the miracle of science, it tests for different antibodies produced by the body indicating some irritable bowel disease that might have been missed with colonoscopy. Hey, it happens. Sometimes the disease is too far into the small intestine to visualize, as I don’t know if you know this or not, but the colonoscopy only scopes the colon and only kisses the junction where the small intestine meets the large.
If you guessed PROMETHEUS came back inconclusive, you’d be right. I had also undergone genetic testing to determine if I was the lucky carrier of Lynch Syndrome which is often seen in families who happen upon the same cancer diagnosis, and if you’re the winner, that means your chances of developing certain cancers is just, like, fucking ridiculously astronomically high. I’m talking about 80%-ish. It’s mad. Fortunately for me, I am not a Lynch carrier, my results were still abnormal and I do have an increased risk of getting colon cancer, but my percentage is a measly 35% greater risk. Pssshhhh. Lame. Forever coming up short, I am. I can’t do anything right!
This was all between July and September 2018. I had also done a hydrogen breath test somewhere in there to see if I had small intestine bacterial overgrowth (SIBO for short), and that was negative–a result I had to strong-arm my way into getting from this doctor’s office nearly 3 weeks after I had done it because fuck me, I guess?
Side note: this gastro office has been highly unpleasant to work with on many levels. First, it’s nearly impossible to call and speak to a person unless it’s the billing office and those bitches must hover over their phones because they’re the only ones who answer their goddamn telephones. There’s the patient portal thing which allows you to contact via email, but those messages aren’t checked often and responses are just as slow. I got a letter in the mail reminding me of the appointment I had three days prior a few times, too. Pair that with the general dismissal of my ongoing and persistent symptoms? Yeah. Frustrated be thy name.
I just let my issues rest for a few more months. I had started losing my weight in July and thought maybe because I was eating fast food for three meals a day and drinking liquor almost every day might have been the cause for my stomach woes, and honestly, I wouldn’t have been too far off base with that assumption, but by the time November rolled around and I was down a decent amount of weight by then and my diet had completely straightened up and I had mostly given up drinking alcohol, but I was still having gut troubles, I decided it was time to ditch the doctor and sought the counsel of the dietitian I was seeing.
We then started the Low FODMAP diet in hopes that maybe the stuff I’m eating is making me miserable. Maybe I have a gluten intolerance. Maybe I’m also sensitive to fructose or sucrose, or any number of other foods that dastardly cause gut pains.
I’m loathe to use the word “diet” here in regards to FODMAP because whenever I tell people I am on the FODMAP diet, their eyes get all big and full of wonder, but in the way that I can tell they’re thinking “ooh! Maybe this will finally be the diet that helps me lose weight!!” No. When I say “diet,” I mean diet as in very specific items of food I am able to consume, not something Marie Osmond and her giant beaver teeth hawk on Saturday morning tv. You won’t see Dr. Oz peddling FODMAP on his tv show next to açaí berry colonics. You won’t lose 18 inches and 40 pounds with FODMAP, but rather, you’ll hopefully lose the feeling of your lower abdomen filling up like a balloon due to intense bloating and farting so much that you are just certain you have blown a hole into the seam of your trousers.
FODMAP can be intense as it is restrictive. If you love apples and bananas and have an orgasm over asparagus, I have bad news for you, my weird friend. All three are off limits in FM (I shall refer to FODMAP as FM from now on because it’s a real pain in the patoot typing out FODMAP). Get a hard-on over garlic and onions? Well, tuck that thing into the waistband of your underpants, chum, because garlic and onions are no-no’s on FM. FM identifies all the foods even normal people have troubles digesting, like cauliflower and broccoli, thanks to excessive gas and/or heartburn, but then takes it all the way up to 11 for people trying to identify food intolerances and hopefully a way to figure out what foods cause so much grief, learning how to cook without said foods, slowly doing a challenge phase to specifically pinpoint which foods are the culprits, and then hopefully going forward knowing what foods are cool and which cause you to expel lava from your anus.
At first, FM and I got along well. It honestly isn’t as awful as it seems. I haven’t been able to eat apples normally for two years anyway thanks to my braces, so cutting them out of my diet was no big whoop. Bananas, on the other hand, was rough. I enjoy the things, especially the brown, speckled, overly ripe kind. But guess what? The more ripe a banana gets, the more sugars it releases, and that is where trouble starts. I can have bananas, but they have to be goddamn near green and no one likes underripe bananas. No one. And it’s also a bit of masochism thrown into it because as I mentioned, I dig the bananas and I have to decide if it’s worth the gut ache later to eat a ripe one or not. More often than not, I will eat it because YOLO, but not as often as I used to. With FM, I’ve been able to identify that I have a fructose intolerance, so that was neat. I can also eat onion/garlic prepared in one meal and be okay, but if I have leftovers with onion/garlic in it and eat said leftovers for a few more meals over the course of two days, I will wish I was dead. My abdomen distends so much and the gas that comes out of me is nothing less than horrific. Like, PIC (oh! There he is! I did write about him!) used to let off some real disgusting butt bombs, and for the first time since he’s moved, I am truly glad he is absent because the farts I have been letting rip would make anyone cry, they are that noxious. And by “noxious,” I mean the kind of farts that make you angry at yourself for letting rip because the smell is ungodly, but because they’re farts and farts are always hysterical, you end up cringing and laughing at the same time. BRRRRRAAAAPPPPPP OH MY GOD, WHAT IS WRONG WITH ME? and then laughing at yourself. Farts, man. Farts.
And now for the poop! I don’t know how hip some of y’all are, and please excuse my talking about my turds, but it’s all part of the story, so…for the past year, my poop has either been massive and admittedly impressive to so loose it borders on diarrhea. Back and forth, back and forth. The last three weeks, though, has brought on a bout of constipation that I have no idea what to do for. My current eating regime suggests that I get plenty of fiber, thanks to healthy servings of fruit, vegetables, and whole grains like steel-cut oatmeal. By all means, I should have the bowels of a goddess, clean as a whistle and in that coveted sweet spot of poop: not too hard, not too soft, and a dream to expel. The kind of poops that make you feel alive. Instead, I have the feeling I need to poop, go to the bathroom, prop my feet up on my trusty Squatty Potty (trademark symbol here), and I wait. I’ll let a ridiculously long fart go, then maybe a little turd will come out, fart some more, sit some more, strain some more–sometimes to the point where I’m certain I’ll burst that hidden aneurysm in my brain and die on the toilet–only to be met with another tiny, hard turd.
Constipation is awful. I’ve never, ever dealt with such a long spell in my adult life. I’ve been a good pooper until now. I’ve tried taking Miralax, which caused some ease in pooping for my morning constitutional, only to revert right back to the strain-fart-strain-fart-fart-tiny turd cycle. I’ve also gone between 3-4 days without pooping now. That, my assumedly traumatized friends, is highly unusual for me. I usually poop daily, sometimes as often as 2-3 times a day. Nope. Those days are apparently gone now. The last three weeks has been awful. I even resorted to trying to take magnesium citrate, which is the highest over-the-counter laxative a person can get before resorting to the stuff prescribed for colonoscopy prep. Meaning this stuff is potent. The bottle promises a bowel movement within 30 minutes of consuming. I reluctantly chugged the suggested dose last week, braced myself for some Montezuma’s Revenge, but was only rewarded with more gas, so I went to bed. Convinced I was either going to wake up in the middle of the night realizing I had just shit myself and my lovely bed or that I needed to go poop NOW, I was rewarded with disappointment instead. Nothin’. Y’all, that’s some impressive constipation if mag citrate can’t make you poop. That’s the point where you need either an enema or an exorcist, which oddly enough, is sometimes the same thing.
Since December and doing the FM thing and noticing my symptoms have not resolved and in certain aspects have gotten worse, I decided time was right to seek a second opinion. This is getting stupid. I called up to Omaha to a gastroenterology practice there and requested an appointment with them, and this morning was my appointment.
In the hour I spent with the new doctor, I am already feeling slightly inflated ego-wise due to my decision to switch doctors. This guy listened, he asked questions, he seemed genuinely concerned about me and my issues, and was appropriately horrified at my “alarming family history,” and offered his advice and professional opinion on what we need to do about me. It has been decided that I will have a repeat colonoscopy to see if the ulcers are still present, and if so, proceed from there. It’s of his thought that my initial colonoscopy did not show chronic NSAID overuse, but instead the first showing of Crohn’s disease. As fucked up as this sounds, I am so glad he thinks that. A Crohn’s diagnosis will be admittedly awful because it’s nothing to scoff at and at its worst, can be severely debilitating to a person, both in symptoms and management, as some people require weekly infusions to manage it, while others are lucky and can get by with taking a daily medication…for life, but still. Popping a pill once a day is far better than having to have a port inserted and undergo infusions.
If it turns out to be nothing again, well, he wants to work on symptom management and dietary changes/restrictions. I got more out of this guy in an hour than I did over the last 9 months at the other practice here in town. Incredible. I’m too busy being happy over having someone actually listen to me and my problems to be angry at this, and if I can be an advocate for getting second opinions, please allow me this small luxury. You are not stuck with the first provider you pick. If some wackadoo does or says something you don’t pick up his jive, you’re absolutely allowed to part ways and find someone else to express your issues to and hopefully, you end up with someone far better this second time around like I was. Shit, for real. This new guy could have told me I have cancer and I have weeks to live and I’d still be as happy as I am now.
Obviously, I hope the second colonoscopy doesn’t show anything and that I am in fact a crazy bitch and making my symptoms up for needed attention because Crohn’s disease is incurable and a lifelong ailment, and correct my somewhat ill-informed medical knowledge on the matter, but I do believe those with Crohn’s have a higher risk of developing that goddamn colon cancer…I mean, look at my dad. He was diagnosed with Crohn’s when he was 41 and died of colon cancer 25 years later. I hope that isn’t my fate, as well, but you also have to keep that knowledge at the back of your mind and want to be as proactive as you can in getting a definitive diagnosis of anything, something so you don’t keep feeling like you’re out of your goddamn gourd until oh, oopsies, hey, sorry about that colon cancer we maybe could have prolonged a bit had we diagnosed you properly with a bowel disease when we had the chance, but you also can’t let that dig at you.
At this point, I’m just tired of feeling like hell a majority of the time. I’m exhausted, I’ve started getting night sweats which is new and different or maybe I have tuberculosis, I don’t fucking know. The constant pain I have, the bloating, etc. It’s tiresome. I’m worn out. I want to eat popcorn knowing that hey silly goose, that’s the Crohn’s making you wish swift death upon you, not “why god why can’t I eat popcorn without wishing swift death upon me?” Popcorn is one of those foods that’s a great snack option because it’s high in fiber and relatively low in calories, but also a nightmare to people with IBS/Crohn’s because the fiber will destroy your life. It is also a thing I eat regularly and another one of those YOLO foods. Oh well.
Well, I’m pooped! Ha ha ha ha ha! Pun intended! I’m silly! Before I go, let me stick to my literal word and get a quick shout-out to losing weight! Yeah! And I miss that PIC guy! I also have depression and anxiety! Hey! Did you know I smoke, too? No? Well, I do!
I feel this post deserves some massive and truly heartfelt thanks for reading due to the nature of the content. Not everyone can read a 3,600 word essay on the wonders of the gastrointestinal system and farting, so kudos to those who toughed it up and stuck it out. I hope it was entertaining, informative, and my deepest apologies if you learned more about me and my bowels than you ever, ever cared to know. Maybe you feel a little bit closer to me now. Don’t worry; I’ll try to fuck up this intimacy somehow. Just ask PIC!
Alright, I’ve reached the self-deprecating portion of the evening which means I need to stop writing now.
As always, thank you for reading, and again, so sorry for talking about my guts.