h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Hi WD!

Just stumbled across your article on Crohn's Disease (please don't leave it lying around.....!) which I think is excellent, and well worth a place in the guide when it's done.

I'm an ex-sickboy (well, hopefully ex) and I've got by through knowing as little about it as possible - a kind of complex denial approach! I couldn't tell if you were writing as a medical student or as a patient, but if you do want any comedy steroid stories, just let me know! It might also be worth mentioning the MMR """""""link"""""", too!

Best wishes

Otto

That boy needs therapy....

Hiya!

I'd completely forgotten about this entry... but I started it in my clinical firm in the beginning of the year, when I was with the Gastro team - and there was a lot of patients who came in with Crohns and UC, so I started it, got distracted, and I haven't really got back to it yet.... In fact, the main reason why I didn't carry on was I wanted to find out who Crohn was, but nothing seems to crop up on Google et al...

I am a med student and not a patient, but I tried to get the patient's perspective by talking to people in outpatients, and also in A&E...

I may just have to finish this now then

If you could give me any information on the receiving end of treatment and management, then please do! I'll, of course, credit you as a co-author

Thanks for reading it, and I'm grad you liked it! (I promise to keep my space a little tidier - I can't being doning with leaving half-finished entries around like this - what would Health and Safety say? )

Stay ,
WD

Hi WD!

I'll have a go at writing something soon. In deference to your chosen profession I'll tone down my comments about quackery! ("have you tried peppermint tablets?") I think I thought you might be a patient because it's an odd thing to write about, and partly because of the Steven Redgraver reference on your space.

I'll post something here soon....

Best wishes

Otto

Hi WD,

Found some stuff

Crohn's disease is named after American physician Burrill B. Crohn, who's name was the first listed "in a three-author landmark paper published in 1932, which described the disease."

Source: http://www.ccfa.org/Physician/crohnsb.html

Symptoms also include diahhorea and anaemia...

Some ramblings - feel free to use, edit or discard. Perhaps this could be under a "one researcher's experience" or something...

Diagnosis.

A serious difficulty that sufferers face is getting properly diagnosed in the first place, particularly as it often first appears in young adults, who are supposed to be healthy. It is often confused with Irritable Bowel Syndrome (A183403), which is a completely different condition which is much more common, and has some similar symptoms. In my own case it took two doctors, eight separate visits, five types of medication, and four stone of weight loss before I finally managed to get so much as a blood test. By this time, people I barely knew would stop me and ask if I was all right, and the doctor's receptionist didn't have to ask my name anymore when I arrived. I was in constant pain, couldn't eat or sleep, and was probably only days away from needing hospital treatment.

The final straw was when I dragged my disease-ravaged frame to see the doctor and was on the verge of being diagnosed peppermint tablets, which "sometimes help". I wish I'd read this entry (A174188) on how to get a doctor's attention. Finally getting a proper diagnosis was actually quite a relief, as this meant that I had a right to be feeling dreadful (rather than being a hypochondriac with a low pain threshold and irritable bowel syndrome), and also introduced the faint and distant possibility of something actually being done about it.


Fun with Steroids.

Crohn's Disease is often treated with Prednisolone steroids. These aren't performance enhancing drugs (in fact rather the opposite), but are quite effective but with some unusual side affects. One of which is the appetite of a very large horse who's just finished a 24 hour charity fast. I was regularly eating five or six meals a day, which was a big improvement from five or six meals per week. It felt very strange and (for a student) was very expensive, and involved spending most of the money I'd saved by not eating! Breakfast, lunch, afternoon snack, evening meal, bedtime meal. Very, very weird! It was quite nice in some ways, to be able to enjoy food again, to (mostly) keep it down, and to be able to feel unclouded, uncomplicated hunger, without the shadow of impending agony.

Even more bemusing was the listed side effect "mild euphoria". This unerved me, because it meant that I couldn't be sure whether I was happy because I was feeling a bit better and it was spring, or because I was absolutely off my face on drugs. With hindsight, I believe that I spent several weeks wandering around grinning at everyone and eating anything that wasn't nailed down or a pot noodle.


What to do if a friend has Crohn's Disease

Crohn's Disease can be embarrasing - it involves digestive functions which are not usually the topic of polite conversation - and your friend may be reluctant to talk about it, or even to tell you.

Someone with active Crohn's Disease is likely to be in a lot of pain most of the time. Sometimes sufferers will want to go and curl up in a corner and wish they were dead, but other times will want distraction and company. Bear in mind that anything food related could be tricky, as could any activities that involve being any distance from a bathroom. Sufferers are often low on energy, partly through low iron levels in the blood (anaemia), and partly because of a reduced calorie intake, so sports or strenuous activities are not a good idea.

Different people react to illness in different ways, but it was my experience that just being around people was very helpful. I didn't want to be asked how I was endlessly (though a bit of concern never went amiss), I wanted to talk about other things (or, more often, just listen to others talking). A bit of distraction goes a long way!


I hope some of this is useful...

Best wishes

Otto

That's really great research there

I'll incorporate it all soonish; somehow I managed to talk myself into writing something about Charing Cross Hospital too... but the Crohn's entry will be my priority

- it sounded like you had a really tough time of it trying to get help... Apologies from my (to be) profession for that - something should have been done sooner and you shouldn't have been fobbed off with peppermint tablets at all.

You've been really helpful Otto - the view from the bed rather than the bedside is often missed and this will really give a nice dual view of this condition - which is what it really needs

I know this may seem a bit cheeky - but did you ever have a flexi-sig? I have been told by many doctors and patients that it really is, well, an experience that medical students should appreciate for patient empathy...

And of course, I shall credit you too

All the best

Stay ,
WD (who will work on this ASAP )

Hi WD,

Thanks for your comments - I'm glad it's useful.

I don't think I've ever had a flexi-sig - I'm not sure what one is, but I don't much like the sound of it. Feel free to ask - it doesn't bother me, it's all in the past (I'm in a complex form of denial which pschyologists reckon is the best possible mental attitude for staying healthy...)

I had a barium meal once, which wasn't much fun - sitting around in a hopsital gown and 1990s obligatory student DM boots and then being x-rayed by a student radiographer with the over-professional mannerisms of the newbie, and who looked about twelve.

Crohn's is difficult to spot - GPs just don't see it very often, but it's hard not to be a little bitter. The first GP I saw was very into the "treat the patient, not the illness" mentality, which is I believe is very fashionable at the moment. Problem was, he put it all down to pre-university nerves and stress. Never mind that I wasn't nervous or stressed, but rather than looking forward to it! I'd much rather the illness was treated, thanks!

The peppermint tablet GP later diagnosed a broken toe as arthritis, despite the rather obvious injury history. The man is a quack - anything that can't be cured by paracetamol or prozac is beyond him....

I'll do some thinking, and see if anything else about CD occurs...
I take it you know about Steven Redgrave...

Best wishes



Otto

Hiya Otto

Flexi-sig; short for flexible sigmoidoscopy (you see why we shorten it...) - having a look round the bottom end of your bowel with an endoscope camera thingy... I've been told it's not the best experience in the world...

GPs (and the current batch of medical students) are now being taught to give the 'holistic' and fluffy sort of patient consultation; which is great in some aspects, but has its major shortfalls, as you have no doubt discovered...

As per Steve Redgrave - the insulin dependent diabetes was among the side effects of his colitis medication I think (I'll have to check what he has - UC or CD) - but the main reason why I haven't got round to writing his bio yet is that details of his early days are sketchy at the least - there's certainly not as much info on him - which surprises me, than the tennis players which I've written about... George Best will have to be done soonish.

Argh! I've talked myself back into doing more entries again haven't I...

Cheers Otto - I'll get back to you once I've popped your bits in

Stay ,
WD

Hi again,

I'd be very grateful if you could send me the Collina video grab thing. I'm going to use a picture of him to scare intruders. Mind you, there's a Swedish ref who's quite scary as well - he looks like he takes every foul as a personal slight.....!

My email address (without the obvious bit) is

[email protected]

Thanks a lot!

Otto

Front page! Whooo-hoo!

Reading it back now, I think we produced something pretty good between us - nice one!

Can I also say that I think that the Grim Reaper Idea is probably the most elaborate exam avoidance tactic I've ever seen!!

Otto

Curses!

If it wasn't for you pesky kids....

Ah well - my presence on the Who's Online list is a bit misleading though, I'm definitely in the same room, just revising

The GR was something which had been swimming round my head for a while - ever since Bossel first mentioned the term in a different thread

Front page - and it does look lovely - thanks for reminding me that I had this entry hanging around, and especially for all your help in making it It's both personal and factual, as I think Jimi X put it

Thanks again!

WD