Dreamer Easy

I HAD AN INJECTION

and I neither died not freaked out!

Admittedly, the Valium helped. And it was only intramuscular B12. BUT STILL. First shot I've had since 1995.

My B12's actually not terrible now, but a squirt of the stuff every few months will make sure it stays OK. My iron's heaps better and my vitamin D is fine. My cholesterol is up lots, though, which is just what you'd expect when you suddenly stop taking a cholesterol-lowering drug like Questran. Dr K has given me a cholesterol-lowering drug to try out.

My blood sugars are still rubbish - 15.5 after breakfast ffs, hb1Ac 9.0 ffs ffs. Off to the endocrinologist we go. GIMME THE INSULIN, DOC, I CAN TAKE ANYTHING. Except oral erythromycin.

People with Crohn's disease do not have reduced life expectancy.

I know what the hell is wrong with me now, so, yesterday, I bought a book about it. In the past when I've read about IBD it hasn't been at all helpful, just terrifying. Now I can see what applies to me and what doesn't, what's going on in there and what isn't.

When I was 18 I thought I was going to die and I've been waiting for the other shoe to drop ever since. I have told myself for most of my life that I'm never going to reach old age. But the thing is:

People with Crohn's disease do not have reduced life expectancy.

On average. Thanks to modern medical treatments. The illness does predispose you to cancer, but - I have to check with the specialist about this - I think mine is actually in the wrong part of the innertube to have that effect.

Of course, I also have diabetes and depression, either of which could total me. Staying alive and whole is still going to take plenty of work. But:

People with Crohn's disease do not have reduced life expectancy.

*steps outside and is run over by a bus*

This is so weird. I'm pretty sure this is the first day in 23 years that I haven't taken any Questran at all. I keep remembering to take it, then remembering not to. But so far, the OTC drugz I've substituted seem to be working fine - just one Immodium and one Colofac this morning. Blimey! Early days yet, but I'm full of hope instead of bile acid sequestrant. :)

What the capsule endoscope saw is "consistent with mild Crohn's disease". I'll learn more when I see the doc again in December. I have no idea what our next step is - if any.

I fell ill in late 1987. The capsule endoscope didn't come into medical use until 2001. I may be wrong, but it's possible that this actually could not have been diagnosed before then!

Capsule endoscopy next Tuesday. Blimey!

... but I got a letter from my specialist, who's identified some slightly dodgy areas in my innertube, and thinks I may have mild Crohn's disease. On reading which I jumped around hooting.

At this stage, IIUC, Crohn's is a suspicion rather than a diagnosis. I'll find out more, and what are the next steps we'll take, when I see the doc in September.

Right, off to enter into the abyss of myself, or rather, let the professionals enter into it for me. Delicately phrased report on any findings later. Goddess bless and protect me. And, while I'm at it, Goddess bless and protect you lot, too. :)

Oh good heavens. I think I may have an intolerance to oyster mushrooms. Apparently they're high in arabitol, which can irritate the gut. I had a rather unhappy afternoon after lunching (otherwise excellent) Vietnamese vegetarian food, and I was also struck down after Chicago TARDIS last year after devouring an omelette containing the things. I may have to add the little beggars to the list of substances which really ought not to pass my lips, including dried apples and textured soy protein.

In between catastrophising about my obviously imminent demise, I've been reading up on the vitamins and minerals I'm lacking, and I have a rather embarrassing suspicion that in fact my diet is deficient in them. It's been a long time since I thought about my nutrition in any other way than "Is this low GI and low fat?", and I'd just assumed that guzzling supplements would cover any gaps.

I knew a bit about B12, which is the bugbear of vegetarians. It's absorbed in the same bit of the small intestine that's supposed to absorb bile salts (aka bile acids), the terminal ileum. I don't absorb these properly, so it's not unreasonable to assume I'd also be having trouble absorbing B12. Might need shots or something to get around this.

I've been Googling up a crash course on iron and vitamin D - neither of which are absorbed in the terminal ileum. The Recommended Daily Intake for iron for a woman of my age is 18 mg. I may need more because of my menorrhagia. If I absorb every bit of the iron in my supplements, I'm still only getting 15 mg. Plus - and if I ever knew this, I'd forgotten it - the type of iron found in animal flesh, haeme iron, is more readily absorbed by the body than the type of iron found in vegetables (eggs, too, and my supplements). Luckily I'm actually pescan, rather than properly vegetarian, so I can get more iron by eating more fish and prawns. Should try some clams and oysters, too. Plus taking vitamin C at the same time improves absorption. I'm investigating which are the best sources of vege iron.

As for vitamin D, the doc's got me on 3000 IU a day - if that builds up my reserves, then we know it's not a malabsorption problem. Plus I'm trying to get 10 minutes of sunlight a day, to give my body a chance to make its own supply.

Think I'd better go see the dietician again, too. I've started keeping a food diary again for this purpose.

(Good grief, there's a lot of bs online about nutrition! The above notes come from reliable sources, like guvmint info sheets, and I've been comparing what different sources have to say and checking some of the science in pubmed. It helps me enormously to blog about it - helps me remember and plan.)

ETA: My path results say that metformin, one of the drugs I take for my diabetes, can be involved in B12 deficiency. Verrry interesting. Also, Questran, which I take for the bile acid malabsorption, can cause vitamin D deficiency. Verrrrrry interesting.

I have anaemia, plus B12 and vitamin D deficiencies, despite all the supplements I've been taking. The likely explanation is that the dodgy bit of my innertubes is becoming even dodgier, failing to absorb certain nutrients, no matter how much I gobble them. I have to go see the innertube doctor and take a jillion vitamin D tablets.

ETA: Oho. And for ten points, which medication used over the long term can cause vitamin D deficiency? Why, it's Questran!