Pilonidal Cyst Surgery and Recovery

This past Monday (March 2, 2026) I had my surgery scheduled for pilonidal cyst surgery removal with Dr. Bidhan Das. I spent the night with my parents on Sunday and enjoyed some great food and dessert (I most likely overate) given I could not eat or drink anything after 8 P.M. This makes sense given the area of the body that is being dealt with. 

I read over the instructions and had to use anti-bacterial soap on my body the night before (which I already had). We had to be at the surgery center by 6:00 AM. So I woke up around 4:20 AM to allow me time to take a shower and get ready, given the surgery center was roughly 30 to 40 minutes away. The interesting thing is the night before I was actually able to go to bed around 8:30 PM. when I typically go to bed around 11:00 PM. Once we got to the surgery center there were so many different people waiting for surgery at session early hour and almost every seat was taken (although there are many different procedures being performed at this facility). The pre admissions people were fairly good about getting me in. And then I talked to a nurse about my medical history and I felt as if I was asked five different times who I was in my date of birth, just to confirm they were doing the right procedure. A little before 7 A.M. I was taken back to a private bed with a TV and had my own personal own which is not usual for surgery centers or procedures centers I had been in before. The nurse came in and did an overview of what was gonna happen. The anesthesiologist came in and I spoke with her, and she had mentioned that I would be under general anesthesia with a breathing tube and she mentioned I may have a sore throat as a result of the breathing tube. The nurse who had originally had come in and told me Dr. Das had an emergency but would be in shortly and finally talked to the surgeon around 8:30 A.M. The whole team of the surgeon, nurse, and anesthesiologist and CRNA came in and the anesthesiologist mentioned they were going to give me general anesthesia and Dr. Das was saying "no we don't need to be doing that with a cyst of this size". He was pretty serious and even when he came in to talk to me he was pretty straightforward and simple procedure and asked if I had any questions which was different than his joking and funny demeanor when I saw him in his clinic. However, surgery is serious so I can understand that. They rolled me back to the procedure room (which are always cold). Before they rolled me back they gave me something that made me a little sleepy. Right before surgery they shaved part of my backside with a large electric razor which was interesting. I was laying on my stomach and the CRNA told me they would give me the anesthesia which felt fairly cold before it knocked me out cold (no pun intended)

I woke up and was in recovery around 10 A.M. and didn't feel too bad. Dr. Das came in and said everything went well and I would most likely need to do laser/hair removal to prevent it from coming back in the future. The rule for the surgery center was you had to wait an hour to recover and they would release me at exactly 10:38 A.M. The nurse put me into a wheel chair and they told my Mom to pull around the side and wheeled me out to the car. After I was in the car we headed to get some breakfast/lunch at a local diner in the area and then of course I needed my usual flat white as well and was feeling amazing after that. My Mom had to run a quick errand and I was sleepy so we did her errand and then I was back home and took a nap for about 45 minutes and felt much better. The doctors had told me not to drive at all that day but this was similar to a colonoscopy and I did feel a little tired driving back home but was okay. 

I went back home to rest and noticed that I didn't have any prescriptions so I called the doctor's office and talked to a medical assistant who had told me there would be three prescriptions for me Tramadol, a muscle relaxer, and Flagyl. On my rear I had an extensive bandage and was told to wait 48 hours to remove it and could not shower until that point either. I ended up going to Walgreens to buy some probiotics and some wound care supplies too. I was amazed at how much little pain I felt. The first day I didn't even need Tylenol! My rear felt like I had done 500 butt blasters though. The other thing I was shocked by was I had a normal bowel movement in the afternoon right after the surgery without any issues. 

The first day of surgery was probably the worst in terms of how I felt overall. When I was driving home I could feel every little bump possible. The bandage they placed on my rear almost covered my whole rear and I waited roughly 36 hours to remove it and took a shower (that felt amazing!) and placed on another bandage that was waterproof along with gauze as well. A nurse called me the day after surgery and asked me how I was doing and I said I was doing fine and she had mentioned to wait 30 minutes until after I finish eating to take my antibiotic to reduce the potential for stomach cramping. When I look in the mirror I can see a medium size cut above my rear but you have to look at it from a certain angle to see the whole thing (I would guess this should fad over time). To be honest I haven't had any pain more just soreness and the hardest thing is getting in and out of the car and just thinking about my movements before I do anything. The day after surgery I just worked from home in my bed laying down most of the day and it felt nice. Laying on my bottom is still sore and trying to navigate that. My walking is limited too to around 20-30 minutes per day to start off with. For a number of years I had been working with a personal trainer but taking a break from that so I get part of my Saturday mornings back with that. Each day that passes my backside feels a little less sore. The hardest thing still is sitting down but I purchased a donut cushion to help with that. Dr. Das had mentioned that within a week after surgery I would be feeling pretty good and I think his prediction about that will be correct. I have my follow up with Dr. Das in a couple of weeks so we will see how that goes but overall the surgery went well and less pain than I had anticipated. 

RIP Humira 2012-2026 and Going Generic

Recently I learned that my health insurance plan no longer covered the regular prescription for Humira. I had tried to place an order for Humira and on the day it was supposed to be delivered, the order got canceled. Initially I had called Accredo to ask them why the order was canceled. Accredo had mentioned that they had heard that one of the potential reasons could have been that Humira went to the generic form and I would have to reorder it. Luckily I had an appointment with my GI that week so saw him and he wrote a prescription for the generic form of Humira. This then led me on a journey for the next couple of weeks calling Blue Cross Blue Shield and Accredo every day to ensure that I would receive my medication. Typically I would have 3 Humira pens left however I did not want to be in a situation that I would only be left with one or no pens. When I talked to Blue Cross Blue Shield they had identified part of the problem was my doctor had to submit a prescription for the generic Humira. At first Blue Cross Blue Shield said that they had the wrong product number for Humira, but eventually were able to straighten that out. The next step in the process was getting the prior authorization which I ended up expediting as the general preauthorization process could take up to five to seven business days. After the prior authorization a pharmacist then has to review the prescription to make sure everything is okay. I was also able to expedite that as well, to only take a couple of days. A couple of Fridays ago I had checked the Accredo website and it said my Humira was ready to order and I was so happy and felt 10 times better that day! At one point I got emotional for worrying about if I didn't get my medication and ending up flaring and in the hospital. Now I have the generic version of Humira (Cyltezo) And really don't have any concerns about taking drug, given that it is almost biologically the same as the regular Humira. 

Humira in my mind has been a wonder drug. I remember, years ago, watching a YouTube video of a man who had Crohn's disease, who took Humira and explained that his stabbing pain completely went away even when he ate potato chips. At the time I was watching this I thought that was too good to be true. I started Humira back on June 6, 2012 and still remember a nurse coming to our house to show me how to inject myself. If I recall I initially started out with a dose and then took the drug every other week. I rarely had any issues with Humira in terms of both the drug and never had any side effects from the drug as well. the only time I had to escalate my dosage (to every week) and then was when I had C difficile back in 2013. 

Previously, I had posted about my progress with Humira at different points in time on this blog. Here I posted when I started Humira, here I posted the 3 month period, 5 months here, 7 months here, 2 year mark here, and 10 years here and when I switched to taking Humira every week here (back in June 2013) and then by November 2013 was back to taking Humira every other week. What is crazy is I remember like it was yesterday in May 2012 when I was living at home with my parents and throwing up and constantly going to the bathroom and not having solid bowel movements. At the time I remember keeping the TV in my bedroom on and watching Nick and Night to try to take my mind off my health situation. Those were truly the dark days for sure. 

Over the years I have not rotated the injection. In the past I had issues with injecting near my stomach site (especially when I was very thin). For me I have found that injecting in my thigh is the easiest as it is fairly stable and did a post about that here. 

I am still in amazement what Humira has done for me over this 13 year! I know other people sometimes will try a drug and then fail it. I have been known as was referred to as a super responder. Also, I am lucky that there are so many new drugs available for Crohn's disease that were not even around back in 2012 and always have the luxury of potentially switching to another drug if even dose escalation does not work. I am curious to see what the generic Humira has in store for me and looking to continue to be in remission. 

Bump on Top of Bottom and History With Fissures and Fistulas and Dr. Bidhan Das

Recently int the past couple of months I had noticed that I had a bump on the back of my bottom. I had noticed it after taking a hot shower. At first I knew it was not urgent and it did not hurt or have any blood or pus. I had decided to get it checked out and had a appointment with my dermatologist for something unrelated and had him look at it. Initially my dermatologist had said it was just me getting older and part of my tailbone shrinking. To me, even as a non medical professional, this did not make any sense.  Given this I decided to get a second opinion with a colorectal surgeon. Dr Bidhan Das. Previously, I had blogged about him discussing choosing a colorectal surgeon. I had my appointment on a Friday a few weeks ago. When I came into the office payment for the visited is expected upfront (however they tell you what the cost is). When I entered the office Dr. Das I noticed that almost every chair was taken and on the way out, I noticed that some people were even sitting outside the office on the floor. This tells me the type of popularity that he has as a doctor. As I write this he has over 500  reviews nearly all of which are positive. I was called in fairly quickly to talk about the reason why I was there. She had mentioned that Dr Das would be in in a couple minutes. This turned out to be a roughly 30 minute wait. Don’t don’t get me wrong I know some people are very impatient when it comes to waiting for doctors. The positive of my appointment was that I had made it within the same week, which is very unusual for specialist colorectal surgery. I could hear Dr Dallas chatting with other patients However, given the rooms were close to one another, I couldn’t tell exactly what they were talking about. Dr Doss was chatting with patients, and I could hear him laughing with him as well.

I have been following Dr Das's career over a number of years and even listen to him on Gut Check (sponsored by the American Society of Colorectal Surgeons), which is a podcast for colorectal surgeons so I felt like I was in good hands. Dr. Das greeted me with warmth and started the conversation with “brother how can I help?”. I explained the issue to Dr. Das and he asked me questions in terms of how long I had noticed it, pain, and other questions. He discussed common possibilities such pilonidal disease (however very unlikely since my Crohn’s is under control) or a pilonidal cyst. I pulled down my pants and he placed his hand on the right side of my bottom first and then said moving, moving, which I felt was helpful in terms of no surprises. He asked me where the bump was and I showed him and he said “Yup I sure do feel it”. Dr. Das believes it is a benign soft tissue cyst. He had recommend I get an MRI since it was a soft tissue mass but believed it was a “nothing burger”. I felt Dr. Das was compassionate, extremely articulate, knowledgeable, and spent enough time with me and didn't have his hand on the door like many doctors do. 

I ended up getting an MRI yesterday at the hospital and had scheduled it in the early afternoon and they were able to get me in. What was funny is I was able to sleep in the MRI machine and just close my eyes. There are loud noises during the MRI but it didn’t bother me. I will be curious to see what the results say. Also I see my regular GI in a couple of weeks and will be able to get his view as well as well if he thinks there are any risks to surgery. From everything I had read the risk of surgery to remove is low given the Crohn’s isn’t active.

The results of my MRI were posted last night on MyCharts (results for an MRI within 24 hours is pretty good). The results showed a 1.9 cm cyst that was a chronic hematoma (previous blood pocket). The results were similar to what Dr. Das had predicted from our visit. He had said that once he got the results we can decide if we do nothing or have it removed. Given it is nearly 3/4 of an inch in size and sometimes it is hard to lay down (at the gym)/sitting down evenly I would be more apt to have it removed. 

Another Colonoscopy, Sutab, and Zofran Round

Recently on March 11th, 2025 I had a colonoscopy as a follow up from last year since I had had a polyp that my gastroenterologist found a little concerning. I have the same routine as last time with taking the Sutab along with a anti nausea medication Zofran (I got the generic) and everything seemed to go well. 

The directions for the bowel prep would have me take the tablets first at 6:00 PM the night before the procedure and then again at 1 A.M. (the morning of the colonoscopy). However I started taking the pills around for the first round 4:30 PM. One difference that I did compared to the previous time I did the bowel prep was to take more pills in a shorter. I took the pills I would space them out every five or 10 minutes. My procedure was scheduled for 7:00 AM the next morning and actually my father had a colonoscopy scheduled right after me at 7:30 A.M. 

I began to take the second round of pills at 9 PM and probably had my last bowel movement around close to midnight. 

In the past I have have had some issues with leakage in my underwear and went ahead and wore about 3 adult diapers for protection. Previously I had used Depends however I had noticed that they riped very easily so I switched to LivDry and they felt more comfortable. When I woke up the next morning I was shocked I didn't feel any leakage. My guess as to why this happened is recent I have been doing pelvic floor exercises and in trying to do that I may have improved my anal sphincter muscle as well. 

Overall the night before the colonoscopy I slept pretty well. I didn't have to get up in the middle of the night either. Again just a guess is because I started the bowel prep earlier than the last time I did it. 

The morning of the colonoscopy we got up a little before 5:00 A.M. and I took a hot shower which was very nice as it helped with some of the pain near my rear. My energy levels the morning of the colonoscopy were fairly good even though I may have only got 6 hours of sleep. We ended up getting to the medical facility a little bit before 7 A.M. and even though I had the first procedure of the morning the actual procedure time was scheduled for 8:00 AM. The nurse who was in my station was very nice and ran an IV to give me fluids and my favorite part is when they give you a hot blanket as you're sitting there waiting (if I could have only had milk and cookies I would been in heaven!). Luckily I brought a book to pass the time as it would be roughly an hour before I would actually go back. The last time I got my colonoscopy I was told to bring my glasses but this time I was able to wear my contacts 

The actual colonoscopy is fairly cold. The nurses move you into position on your side and then the anesthesiologist injects Propofol (350 mg) to be exact and you think you can continue to stay awake and then you feel a burn in your arm and then you are knocked out. 

My actual procedure was roughly 30 minutes and I felt pretty good after the colonoscopy and recall the gastroenterologist coming by and told me that everything looked good and we would have to wait and see in terms of how long my neck colonoscopy would be. My father had a colonoscopy right after me and the gastroenterologist had mentioned that his bowel prep wasn't as good as it could have been. My father didn't hydrate for the colonoscopy until it was time to do the bowel prep. In addition to this he also had white wine and coffee which of course will dehydrate you. Me on the other hand I insured I drank blue Pedialyte throughout the day (and day before) and enough water so I felt hydrated. I do believe that hydration is a very important key in terms of bouncing back after they colonoscopy. The gastroenterologist had mentioned that next time my father would need a more caustic bowel prep. When my father woke up from his colonoscopy he actually thought he was in his home but the nurse had to point out that he just had his colonoscopy (they gave him more sedatives since he moved around during his procedure).

After my dad was good to go we ventured to a local restaurant for some omelets, hash browns, and biscuits which were really good considering it had been most a day and a half since I had eaten. I think in hindsight though I probably ate too much leading up to the colonoscopy. For example the colonoscopy was scheduled on a Tuesday and I saw my parents on Sunday for dinner and we ended up having Tex-Mex food. Before the colonoscopy I was trying to eat a couple days worth of food. My weight after the colonoscopy of course declined and I was roughly 164 pounds which is lighter than usual. After we had breakfast we ended up going to a local coffee shop and getting flat whites for both me and my dad shared one with my mom as well. The rest of the day went pretty smoothly and I didn't have to take a nap or anything. The night of the colonoscopy I went to bed very early and slept for over a 9 and 1/2 hours and it was some very amazing sleep.

The colonoscopy overall was pretty smooth and I only had a 3mm polyp in my cecum (which ironically is the same size and location that my father had his polyp as well). The pathology report showed that everything looked good so I won't have to go back for another three years which is the same schedule my father is currently on. Overall beforehand I was a little bit nervous about the colonoscopy since it only had been one year since the last colonoscopy. I was worried that the colonoscopy would show something detrimental however everything looked very good and glad that my colon is in a good place and more important way that I continue to be in remissions with my Crohn's disease. 

Cramping Last Couple of Weeks

Overall my health is doing overall well. Recently I have noticed within the past couple of weeks I have had some cramping in my stomach (near the belly button). On October 19, 2024 I went out to dinner and had some burger sliders and a brownie sundae to celebrate passing a designation and had some loose bowel movements. What is odd is I felt the cramping the day of October 19 when I had my exam. I wasn't stressed about the exam or anything and was strange that my pain occurred at the same time. My sleep has been fairly decent, although maybe once a week I wake up in the middle night to take a hot shower and go back to bed. For me what usually keeps me up is looking at my cell phone (I think even though I wear protective blue light glasses) it can create issues with my sleep. A couple of days this week I had some exceptional sleep and slept for probably 9 hours. Even with the extended sleep I had some minor cramping but not super noticeable. What is interesting is I wrote a blog post almost 10 years to the day of cramping and a mini flare up here. 

As I write this I feel just a tinge in my stomach and really nothing really to complain too much about. My bowel movements are still solid and able to still eat well without any issues. After my bowel movements the cramping does go away. My weight this morning was 166 pounds (recently it got as high as 170 pounds). My nutritionist would like to see me get down to 162 pounds which is on the low end but I think is doable. 

My usual path will be to continue trying to get to sleep and not eat anything too heavy and should be fine. I am always grateful I am still in a good position and am grateful Humira is still working after 12+ years of being on it! My nephew who will be 3 soon is ready to go Trick-Or-Treating tomorrow night so we will have fun and I rarely eat candy on Halloween too. 

One Long Night, Weight Loss, and Flare

Last night was probably one of the roughest nights with Crohn's I had had in a long while. I was in and out of the bathroom almost a dozen different times. I actually went through a whole roll of toilet paper in one night. My bowel movements have all been close and I consistently have stomach cramping around my belly button. In the past couple of days if I recall when I last weighed myself on Wednesday I was 172 lbs. and now I am closer to 168 lbs. My appetite is also fairly low as I continue to have cramping in my stomach so I don't have the sensation of feeling hungry at all. Compared to flares I've had before they only last a couple of days and then they resolve themselves. This seems to be is there some type of infection or a major Crohn's flare. Last night my sleep also wasn't that great even though I went to bed around 10:00 PM I woke up at 2:00 AM, 6:00 AM, and then finally at 10:00 AM. I had more stomach pain when I woke up at 6 A.M. vs. 10 A.M. (the power of sleep!). To be proactive I had ordered some adult large Depends because I was worried about having some possible fecal incontinence overnight period look unfortunately they did not arrive yesterday as I had anticipated however they showed up this morning. I was lucky because last night I did not suffer from any type of fecal incontinence however I wore all layers of underwear and some sweat shorts. I don't have a fever poor am I stuffed up. I seriously wonder if this was all started when I had my allergy issues and then somehow that spiked my immune system to create some type of Crohn's flare. The only thing I remember was when I had Sudafed I had some stomach cramping however when I switched out the medication to Claritin and it seemed to do better in terms of my GI system. I haven't taken any antibiotics or other medications in the past couple of days. 

My overall energy levels are pretty low and I constantly feel fatigue and tired. Even getting up I feel a little lightheaded. My game plan for today since it's Saturday is to just rest, relax, and stay hydrated to the best of my ability. Also I will try to eat very light food OK then high stomach is quite upset. Although at the rate I'm going if I lose 1 LB per day in another week that will be underweight compared to where I should be.

I called my internist before even though it was the weekend and she mentioned to take electrolytes and stay hydrated. She will send my GI as message as well. This morning I have sent my GI a message as well to explain my symptoms as well. Hopefully between both of our messages I can see my GI earlier than the following Monday. I feel like I have seen this movie before and don't feel like I am at death's door just not feeling well. 

Allergies and Potential Crohn's Flare

The past week has been interesting health wise. First I had allergies for the past week were I was stuffed up and congested however never had a sore throat or fever at all. Previously three weeks before that I had some allergies as well but it lasted only for a couple of days. Within the past couple of days I am no longer stuffed up however have been really tired with fatigue. Yesterday was probably the worst day in terms of how tired I was (even though I slept 10 hours the night before-however I did wake up multiple times during the night. My last workout was Wednesday morning and I felt as if I was really dragging during the workout. 

Last night I probably slept a little over 9 hours and when I woke up was still tired even though I had a good night's rest. My stomach was also cramping and I had to go to the bathroom maybe half a dozen times and all the bowel movements was liquid, however there wasn't much cramping. Also the past couple of days I haven't been super hungry either. Last night I did have some baked ziti and fried cheese which could have potentially contributed to the mini flare this morning. My stomach seemed a little angry and ever I had my bowel movements seemed relieved. I decided to skip my usual flat white this morning since I was worried the caffeine may accelerate the diarrhea. 

As I write this my cramping seems to have gone away however I am still fatigued and tired (however my energy levels have improved from yesterday). When I get home from work I look forward to resting. My game plan is to take a hot bath, get some good sleep tonight (since tomorrow is Saturday and I don't have to be anywhere), have a light dinner, and stay hydrated (usually with water and Pedialyte). 

On Monday I have an appointment with my doctor who will do some blood work. As a back up plan I have an appointment with my GI the following Monday just in case things don't improve (given his next appointments aren't until June). Personally I feel as if this is a minor setback and backed on history I generally bounce back.  

Another Round of Subtab, Zofran, Colonoscopy, and Day of Relaxation

Recently on February 9, 2024 I had my most recent colonoscopy. Overall the report was good and I had a 10 millimeter polyp in my descending colon however all other areas were normal. This makes sense given I rarely have had issues with my Crohn's since my last colonoscopy which I discussed here. 

Just like the last time I had my colonoscopy I decided to use Sutab bowel prep. Overall, I have been happy with the Sutab bowel prep given the other bowel preps leave an awful taste in your mouth that you literally never forget! 

I started taking the Sutab pills around 4:30 P.M. (even though I was instructed to take them at 6 P.M). Before I took the Subtab pills I took one Zofran pill for any anti nausea possibilities.  My view is "hey as long as it gets through the system right?". There are two rounds for Sutab (one the day before) and the other round is the day of the procedure. Each round has 12 pills that you take with 4 16 ounces of water. 

Around 8 P.M. is when I started to feel the salt water storm in my stomach and was in the bathroom off and on for about a dozen times between 8:30-10:30 P.M. Since I had the second round early in the morning I decided to wake up at 12:45 A.M. (again recommended time was 2 A.M.) however since my appointment was at 7:30 A.M. I was well within the 8 hour window Sutab recommends. Before I took my second round of Sutab pills I took two Zofran pills which really helped me out and felt good after that. I was up for probably an hour and at that point consuming more water was a little more of a challenge but still fairly easy compared to the alternative. Overnight I probably went through two rolls of toilet paper and for protection had 3 layers of Depends underwear to protect any leakage (it did a fairly good job in protecting me) I actually slept fairly well given all this and woke up around 5 A.M. to get ready, shower, and hop into the car. The interesting thing is at the beginning of the night my rear hurt a little but throughout the night it didn't hurt as much as it had in the past. Taking that hot shower in the morning before the colonoscopy always feels amazing. 

My procedure started around 9 A.M. and I was out by 10 A.M. After the colonoscopy I went to a local diner for a CLT (cheese, lettuce, and tomato) sandwich with some fries that had seasoning on them! I opted not to have dessert just given the amount of calories. After lunch I got a flat white coffee and felt pretty decent. Compared to my last procedure I felt as if I wasn't as tired and not sure if that is because I started the process earlier, in better physical shape (since I have been working with a personal trainer), or more accustomed to waking up earlier (since I have some personal training sessions at 7 A.M. during the week (so usually am up 6 A.M.). Also my last colonoscopy was at 10 A.M. so the hunger pains truly set in and messes with the body. I remember after the last colonoscopy I slept for a couple of hours and was still tired and was sleepy for the next couple of days. 

This past weekend was pretty relaxing and I didn't do too much. On the night after I had the colonoscopy 7 P.M. felt like midnight! Overall for the weekend I felt I slept really well. On Saturday (one day after my colonoscopy) I was able to work out without any issues. I did notice some lose bowel movements which for me is pretty rare. My weight got down to 168 pounds (mostly due to the bowel prep and just losing water weight). My appetite was in full force and I had a burger on Saturday afternoon and Tex-Mex on Sunday so I am sure I have gained all the water weight back.

FDA Approves For Rinvoq for Crohn's Disease (My Take As A Patient)

Recently on May 18th, 2023 approved Rinvoq was finally approved for Crohn's disease. The study was published in the  New England Journal of Medicine and can be found here. In terms of clinical remission in one trial 39% of patients received clinical remission when taking the 45 milligram dosage. In the same trial 35% of patients achieved endoscopic response compared to a placebo response of only 4%. In a another trial 49% of patients received a clinical response and 46% of patients achieved in endoscopic response. For both studies this was the end point measured at week 12. Currently there are 8 drugs approved for Crohn's disease (this includes RINVOQ). 

One of the big differences with Rinvoq compared to other drugs is it is a one daily pill (as opposed to an injection or infusion like Humira or Remicade). As a patient I have mixed feelings about a daily pill (given you could easily miss one day as opposed to taking a Humira shot every two weeks). The one positive though is with Humira has to be refrigerator which can become dangerous if there is a power failure or outage and don't have a backup generator to keep the medicine cold. Rinvoq is not approved to be taken with another biologic therapy or other immunosuppressant. 

The FDA just last year approved for Skyrizki which I covered on my blog last June. This article here does a great job of showing the drug development pipeline for Crohn's disease. What is interesting is almost every drug that was approved before 2019 was approved for both ulcerative colitis and Crohn's disease. This would make sense given they are pretty similar diseases. Remicade was approved for Crohn's disease in 2003 and then approved for ulcerative colitis in 2006. The biggest delay was Humira which was approved for Crohn's in 2007 but not until 2012 for ulcerative colitis. A five year timeline is a long time for people who are truly suffering to wait. Personally I am more of a fan if the drug was approved for either Crohn's or ulcerative colitis for it to be tried by patients who suffer from both (given some top notch GI's speculated I had signs of ulcerative colitis) and would allow for much for flexibility. If you look at the history of Rinvoq being approved it was first approved for rheumatoid arthritis in August 2019, psoriatic arthritis in December 2021, and ulcerative colitis in March 2022.  I think what this would say to the average patient is if an autoimmune drug is approved for one diseases there is a decent chance it may be approved for another disease. 

One current issue is access to the drug. The list price for Rinvoq is $6,125/month, however AbbVie the drug maker has co-pay assistance cards that can bring the cost down to $5/month (usually there are financial qualifications for this). As a GI online tried to prescribe the drug on May 23, 2023 (only 5 days after the FDA approved the drug and Blue Cross Blue Shield denied the coverage. There are people who have stories online of their insurance company not approving it or the cost being extremely high. The issue is further worsened by the fact that when individuals switch health insurance plans by either selecting a different health insurance plan, switching employers, or switching health insurance plans through their spouse they are denied access which is a real shame for people who just want to feel better! 

I am glad to see the FDA approved Rinvoq as this will give Crohn's patients another drug to try if they have failed a biologic drug. I am also enthusiastic to see the future development of drugs for inflammatory bowel disease and what the next three to four years look like. Although, there are eight drugs currently approved for Crohn's disease by 2026 it appears there may even be more options than are currently available. Also hopefully this will reduce the need for patients to make frequent visits to their doctor (and potentially keep patients out of the hospital) if they are able to maintain remission for long periods of time. The main question though is will patients have access to this drug and more importantly be able to afford it. I am grateful that I live in a time period where there are so many options available if I ever have a severe flare up and need to try a different drug. It really probably is the best time if ever to have Crohn's or inflammatory bowel disease.

10 Year Anniversary of Humira for Crohn's and Still in Remission!

Time really does fly by! This month marks 10 years since I first started taking Humira (my first shot was June 6, 2012). I posted about the experience here, a 3 month post here, a 6 months post here, a 1 year anniversary post here, a 2 year anniversary here, a 5 year anniversary here, a review of Humira literature here . 

In the summer of 2012 (around May 2012) I can remember crashing pretty bad with a major flare up with Crohn's. I can still remember waking up in the middle of night (at 2 A.M.) with blunt sharp pain in my stomach, throwing up, and couldn't get out of bed. These days I live a very normal life without any gut pain and rarely have a loose bowel movement. 

At first I can remember being anxious and nervous about having to inject something into my body for the rest of my life/the possible pain of injecting medication. If I recall correctly the drug started working within days of me taking it. I recall going on YouTube and looking up videos of other people who had taken Humira and remember this one guy saying that he really wasn't in pain and could finally eat potato chips again without having to worry about pain (I didn't think this would happen to me). The only time my dosage changed for Humira was after I had a flare up of Crohn's (post c difficile and fecal transplant). Other than that though I have stayed at 40 mg injection every other week.  

One improvement I have seen within the past few year is the Humira citrus-free version. This new version seems to have resulted in less pain when injecting. Typically I leave my Humira out for 15-20 minutes. In this post I mentioned why I don't rotate my Humira shot (per instructions). 

In conclusion Humira has been a miracle drug for me and has worked quite well! Hindsight is always 20/20 and I was initially diagnosed with Crohn's in December 2011 (but I probably had Crohn's beginning in October 2020) I wished I had started Humira earlier! At the time I was in graduate school and my family and doctor agreed to stay on Prednisone and Asacol to get me through. Humira has forever changed my life for the better.  

FDA Finally Approves Skyrizi for Crohn's Disease

Yesterday the FDA approved Skyrizi for Crohn's disease. As someone who actually lives with Crohn's (but currently in remission) I am always grateful that there are continually more FDA approvals coming for Crohn's disease given how many people/families have to deal with it. 

The FDA has three phases of drug development. The first phase generally looks at whether a drug is safe or not. The second phase looks at safety and if the drug is effective. The last phase looks at how effective the drug is. The two major phase three trials done were the ADVANCE and MOTIVATE studies. Between the two studies over 1400 patients were looked at. The type of patients in the study were patients that were not in great shape with their Crohn's. For example one measure they look at in these studies is the Crohn's Daily Activity Index (CDAI). This is one metric for how well a Crohn's patient is doing not only with their GI issues but also their well-being. For example my score is under 100. The scores can range from 0-600. Patients in the studies for Skyrizi had a CDAI between 220-450. So for example these patients would have had more than 4 soft bowel movements per day. In the ADVANCE study the researchers looked at those who actually failed a previous biologic before taking Skyrizi. This is important since many people with Crohn's will start on one biologic and then have to continually try new biologics until they find that works. 

In results from the ADVANCE trial show that 45% of patients taking the 600 mg treatment were in remission (compared to just 24.6% in the placebo group) after 4 months. What is interesting though is that in the MOTIVATE trial (were patients had not failed a biologic the remission rate was lower at only 42%). 

This result is quite remarkable is quite comparable to other biologics out on the market. According to inflammatory bowel expert from Dr. David Rubin at The University of Chicago patients that start the drug "feel better within a few weeks" as the "drug works fast". 

What is interesting though is that for Crohn's 600 mg is required (and has to be given through an IV infusion for the first dose followed by 360 mg every 2 months afterwards. It is interesting to note that Skyrizki was also approved for psoriasis back in 2019. Usually drugs that are approved for psoriasis have some chance of getting approved for Crohn's given that both diseases are autoimmune diseases. 

Skyrizi falls under a class of drug of IL-23 inhibitors. The inhibitor is just trying to tamp down the immune from overreacting. Currently there are three IL-23 inhibitors currently that have potential for Crohn's. The first being Skyrizi (which was just approved). Another IL-23 inhibitor is Tremfya which had good results in Phase 2 trials. The last IL-23 inhibitor is mirikizumab (which is made by Eli Lilly-as far I can see I don't see a street name for the drug yet). However mirikizumab has shown good results recently and almost half of patients in a clinical trial were in remission for ulcerative colitis (after taking the drug for one year). One recent paper suggests that IL-23 inhibitors may be superior to anti-TNF treatments like 

Personally I am pretty amazed at how many drugs have come on to the market for Crohn's since I was originally diagnosed back in 2011. Although having Crohn's can be awful and not fun it really is a golden time in terms of drug development. If you think about a drug potentially putting 40%-50% of patients into remission ends up being many hundreds of thousands of people feeling better. Also patients in remission allows gastroenterologist more time to work with other patients. 

Minor Flare Up, Right Shoulder, and Upcoming Trip

Overall my health has been pretty good the past couple of months. This past week I have felt a little on the tired side even though I have been getting the right amount of sleep. It was strange since I went to the doctor this past Thursday (more on this later) and went for an x-ray and after the x-ray I noticed a minor flare up on Thursday and Friday. During the flare up I actually gained weight to balloon up to 171 pounds (currently back down to 168 pounds). Lately I have had some cramping and just taking it easy with light sandwiches and soups to not have anything too greasy or salty.

I went to my internist on Thursday after I had some minor right shoulder pain for about a month or so. Gradually over time it has seemed to improve. Honestly I don't know how it happened but I think since I use a weighted blanket at night (which can be quite heavy) I may have used my right hand/arm to pull the weight up and somehow strained it. Currently, I just have pain when I move my arm side to side (like putting on a seat-belt or moving my right arm side to side). The pain is very very minor and most of the time I don't notice it as it doesn't radiate. My doctor had prescribed physical therapy, some cream, and to take 500 mg of Tylenol for a couple of days. I haven't taken any Tylenol since I am concerned that taking it may flare up my Crohn's. My physical therapy appointment has already been scheduled for after I get back on vacation. 

Next week should be exciting as I plan on taking a vacation (I haven't been on one in a while!) to London to see my twin sister, my new nephew, and brother in law. The trip will be a little over a week but should be relaxing and we will get to see my nephew get baptized. I took my Humira last week but since I will be gone a while I plan to take it tomorrow night. 

Although, I have had some minor set backs recently, all in all I feel pretty well. Last night I went to bed around 10 P.M. and was pretty tired and got some amazing sleep. Amazingly my flare pain seems to be nil today!  

Cramping Appears To Have Resolved!

My cramping has seem to have dissipated today (Saturday). Thursday was probably the worst in terms of feeling an overall blunt cramping near my lower abdomen. Also late Thursday night I kept having to go to the bathroom around 11 P.M. and midnight. My bowel movements were normal but I could feel what I call the "alien" or massive pain/cramping until I completed my bowel movements. It was interesting because the cramping was always in the exact same area. I know sometimes the cramping or pain can move around but this 

In terms of what I have been doing to help out the pain, I have been making sure I get ample sleep. So last night my Oura ring tracked 8 hours of sleep. You have to remember it does take me a little while to get to sleep so when I get 8 hours I feel pretty good. The previous night before that I only got 7 hours of sleep which made me feel sluggish and tired and also seems to have an impact on my gut health. The other change I have made is I have been trying to eat light (nothing greasy or too heavy). Lastly, I have been making sure I have been taking hot baths to help relieve the pain. 

I feel great compared to where I was a couple of weeks ago when I both have constipation and cramping and the constipation seems to have gone away and the cramping has been greatly minimized. Even though things are going well I will try to keep at it with ample sleep, eating light, taking hot baths, and increasing my fiber a little bit. 

Cramping Past Few Weeks Part II

 

As a follow up from my last post I still have had cramping for the past week or so. Compared to my post though I am sleeping pretty regularly (roughly 8 hours of sleep per night) and the cramping has gradually appeared to have gotten better. 

I asked my GI given the constipation if I should do anything different. He told me to keep taking hot baths and make sure I eat fruits and vegetables. In addition to my GI I also work with a nutritionist who had told me to add more fiber to help the constipation. In addition to this drinking more water as well would help. 

The other thing I changed as well was I took my Humira (4 days before I was suppose to). The other thing I did as well was normally I just inject my right thigh but this time I directly injected Humira into the fat of my stomach to maybe get it closer to the source. 

My weight has also shot up as well. Currently I weigh around 170 lbs. and I normally weigh 165-168 lbs. It is an odd experience since I haven't known I was hungry due to the cramping in my stomach. The odd thing as well is usually when you have cramping with Crohn's you are losing weight. For instance around lunch time I am usually starving and earlier in the week I didn't feel an empty sensation which seems to trick my brain and causes me to eat more than I should. The past few days things have seemed to fall back in line and I fell almost back to normal. 

My game plan the next few days to take some vacation to rest and relax. I think this would a good test to see how I feel (without any stress) and also to examine my sleep as well. Also I plan to stick to eating apples, drinking plenty of water, and also trying more of a high fiber cereal. 

Cramping Past Week

As usual I don't blog too often here since my overall health has been generally good and I have been in remission with Crohn's for almost a decade (thanks to Humira). This past week (starting probably Sunday night) I felt cramping in my stomach. To be more accurate it was more of a blunt pain in my lower abdomen and not any type of sharp pain. The pain was right below my belly button but above the groin area. The pain lingered on and I tried to do my usual routine of: eating lighter (okay and sometimes not so light)/hot baths/cold packs on my stomach which seemed to help some. Monday and Tuesday night I slept more than I have slept in a long time. Also what was strange was I was going to bed extremely early (around 8 or 9 P.M. which is a couple hours before I go to bed). For example on Sunday night I slept for 8 and half hours. My average sleep time has been a little under 8 hours. On Monday night I slept roughly 9.25 hours (I was in bed for almost 10 hours) and felt so exhausted but really didn't know why given I didn't have a stressful work schedule nor was there any other activity or anything else that was stressful. 

The other somewhat bizarre thing is when I ate food my cramping actually tended to subside (maybe all along I just had hunger pains). Also I have noticed that my bowel movements have been a little harder to achieve since I seem to be a little more constipated but my movements are manageable and don't hurt. Also I haven't seen any blood or any usual looking stools exiting my body. 

Today (Friday) I have very minor cramping and just about to 100% which is great. This week was somewhat of a bummer being tired, cramped, and wanting to go to bed early. The game plan is I am due to take my Humira this weekend and that usually helps (it takes a few days) but should do the trick. 

10 Year Anniversary of Crohn's: My Journey and What I Have Learned

Time really does seem to fly by. On December 7, 2011 I was diagnosed with Crohn's disease. I remember being in the office of my gastroentologist (GI) with my parents and him telling me my diagnosis. During Thanksgiving 2011 I was hospitalized and my weight had declined to 125 lbs. Normally during this period I was around 150-170 lbs. Before I had Crohn's I was diagnosed with IBS and had this pain in my side (the kind of pain when you are running laps in P.E.) and took some medication to keep the IBS at bay. At first when I was diagnosed I was unaware of what Crohn's disease was. I can still remember when my GI told me when he my very first colonoscopy he said my colon was rotten and on a scale of 1-10 in terms of severity my colon was an 11. In hindsight I am lucky I didn't need an operation at the time. What I remember most from that period of time was taking large amounts of Prednisone. At one point I was up to 80 mg of Prednisone per day which made me feel like I was bouncing off walls, irritable, have a moon face, and constantly hungry. There were times I remember eating 5 times a day! The other thought I had was some initial depression since now knowing you had a chronic disease and knowing I would always and forever have it. My GI and I agreed to stick with Prednisone until I graduated from grad school. I graduated in May 2012 and then moved back home to live my parents for a while. At that time I was really crashing and can remember waking up really sick going to the bathroom quite a bit. At this time my parents had moved into a new house and remember waking early going to the bathroom watching T.V. for a little bit before drifting off to sleep. In June 2012 I started Humira and that has been the best thing I have ever taken and has dramatically changed my life. I would say 95% of my days now I honestly don't know I have Crohn's. These days I rarely have a loose bowel movement and every now and then have a stomach cramp but generally in overall good shape. 

Back in 2013 I was diagnosed with c difficile after taking an antibiotic. I had tried Dificid which worked for a while and then stopped working and at the time it was difficult to find a provider that would perform fecal transplants. Back at that time very few providers were actually performing fecal transplants. These days doctors at large hospitals and institutions all over the country and around the world are providing for them. Back in May 2013 I was patient number 44 for a fecal transplant at the Mayo Clinic in Rochester, Minnesota. Since I was able to see the magic of having a fecal transplant change my life I have been interested in learning its application not only for Crohn's and inflammatory bowel disease but also Alzheimer's. I blogged back last October how an 82 year old man had c difficile and Alzheimer's and was given a fecal transplant. Six months post fecal transplant his mental state greatly improved going from mild dementia to a maximum Mental Mini Score Exam of 30. To add fuel to this fecal transplant fire in October of this year again I learned there was a case report of a 90 year old who greatly improved after a fecal transplant. I truly home fecal transplants are studied much more in depth to see if they can be applied to people with Alzheimer's and people with Crohn's disease. 

We truly live in a golden age for drug development for Crohn's. The FDA has approved many new drugs for Crohn's even since I was diagnosed. The biggest drugs approved have been STELARA, Envtivyo, and Tremfya which recently has shown great results (65% of clinical remission in Phase II trials for Crohn's were published this past week) Even more recently as I write this Rinvoq has shown positive results in Phase III trials for Crohn's as well. Almost 40% of patients who took Rinqoq were in clinical remission after taking it. The other big improvement I have noticed is the bowel preparation for Crohn's/colonoscopy. When I was first diagnosed I remember having to drink all this Miraxlax and Gataorade. I actually remember the night before the colonoscopy falling down and I somehow ended up with a little white mark on the left side of my nose even thought it has been 10 years! Recently when I went for my last colonoscopy in August 2021 I was able to take Sutab (which just got approved by the FDA in November 2020) and I reviewed it here and all in all thought it was easier to use than the Miralax and Gatorade. Although Crohn's is very unfortunate if you had to have it now would be the best time in history given the therapy treatment available. 

To me one of the amazing things is how many people actually read this blog. As I write this this blog has been read over 140,000 times! Not only do people in the United States read this blog but everyone around the world! My initial goal was just to have a repository for my own journey with Crohn's. These days my hope is someone will read it and be able to use the information to improve their Crohn's or inflammatory bowel disease situation. I am really amazed that I have published over 225 posts. When I started I probably thought ya it would be nice to start but had no idea I would be blogging for 10 years! One of my popular posts was back in October 2012 reporting some positive data on a drug called Stelera. At the time the drug had shown positive results but it wasn't approved by the FDA until September 16, 2016 (almost 4 years after I first blogged about it-hopefully the FDA read my post). 

The most important things I have learned since being diagnosed with Crohn's is most importantly to be grateful for every day and to have compassion for other people who may be going through something difficult. Given before I had Crohn's I honestly never had any medical issues. Growing up I remember having donuts on Saturday morning and on Sunday sometimes we would have Cinnabon's and having to have bowel movements a few hours after. Living with Crohn's has taught me yes there will be good and bad days but to really cherish the good days. The only thing that I have noticed (which honestly was probably true before I had Crohn's) is I tend to get a stomach ache if I eat something very rich (chocolate dessert/something greasy). My general view of my stomach is thinking of it has a brown paper bag and if the food you eat will leave a grease stain then it probably will cause some pain or cramping. The other thing that really has helped me is getting a good amount of sleep (this can be a game changer from my own experience), taking hot baths, and using cold packs on my stomach. The first time I took a hot bath I remember feeling as if it changed my world. The cold packs help manage the pain even though I know it doesn't technically "help". 

I am truly grateful for the medical care I have been provided and honestly never would have though (especially during my dark days early on) that I would have achieved remission for this long. To me I have been incredibly lucky that I haven't needed surgery to removal my bowel/overall have been in good health and when I compare myself to the average person and even people my age I don't feel as if I have had major differences in my health. Everyday I am able to work at a job I enjoy, work out, travel, and really don't have any restrictions. I truly am a lucky guy. 

Eating Right, Relaxation, and Crohn's Remission

 Recently I took the past Thursday and Friday off from work. This comes after passing the Enrolled Agent exam (3 exams) last month and I really haven't taken much vacation from work this year. Friday I felt the best I had in quite a while. The nice thing about not going to work is you don't have the stress of worrying about what you need to do/have to do when you are off. However, I do still have a tendency to check my e-mails even when I am off (you know to make sure things don't blow up). Related to this I have been listening to an audio book called "A World Without E-Mail" by Cal Newport which essentially attempts to get you to check your e-mail less frequently given it tends to cause burn out (which I would agree with). Especially these days everyone is always "on"-nights, weekends, holidays and stresses everyone out. I tried for a day or so to check e-mail only once or twice a day and it felt nice. Unfortunately, this only lasted a few days since I guess we are all creatures of habit. I have notice stress does contribute to flare ups for my Crohn's. The main triggers for me are sleep, stress, and what I eat. Out of all those factors I would say sleep is the most important. Poor sleep leads to the more stress and making poor food choices. Taking Thursday and Friday off allowed me to get plenty of rest, eat light but yummy food, work out, and really just enjoy the day. 

In addition to this Friday evening I got a massage (at Massage Heights) and was amazed at how I earlier in the day had some light cramping but after the massage went away completely! A couple of months ago I saw a chiropractor off and on which does seem to help but I haven't made an appointment in a while. Saturday and Sunday (today) were somewhat of a lull. I woke up late on both days (super late today) and notice that if I look at my phone before bed too much is when I have issues. If I read before bed I am usually almost always better off. To try to help me sleep I have white noise videos from YouTube of the ocean, winter storm, or something else to relax me. One thing I have looked at is the Oura Ring which currently is about $300 and they just came out with their 3rd edition (however it looks like they will charge a monthly fee after 6 free months). I am curious at possibly looking at this for myself. Given sleep is pretty important and affects your productivity, mood, and ultimately life it may be worth the small investment. 

The key component is the good sleep because that essentially sets everything else. So many times I have either had major cramping or gained weight because I didn't sleep well and then would just be grabbing whatever. These small steps have made a difference in staying in remission with Crohn's. 

Rhino Virus and Current Health

Recently the past couple of days I have felt quite stuffed up with a runny nose and lots of congestion. At first I thought it was allergies (and even when I took an allergy pill it helped) however today I woke up pretty tired and was concerned I may have some type of infection and didn't want to go into work and possibly infect other co-workers. Last night as I drove home from work I was my nose was just dripping with gross stuff. 

This morning I called my doctor's office to schedule an appointment (since it is a Friday) and it would stink to not be able to have any relief before the weekend. The doctor's office required me to get a COVID test first (I have received 3 Moderna vaccines and given I was only congested and stuffed up the odds of this were pretty remote). At any rate I took the swab test this afternoon and it was negative (shocker). I then saw my doctor who said I could have a rhino virus or some type of sinus infection. When my doctor looked inside my nose she said it was quite inflamed and swollen. In terms of what I would take to help me she wrote a prescription for doxycycline which I am going to take for 5 days. Also she recommended that I take a probiotic given my compromised immune system which I agreed with. She had said I could take Claritin D if needed (I went ahead and got that) and also to get Flonase which I actually haven't taken in many years. I took all my medications with some light food before. Speaking of food I noticed this morning I had an odd taste in my mouth when eating which was bizarre but may be related to the fact that I am sick. 

The nice thing about this weekend is it is Daylight Savings Time so that means hopefully I will be able to rest and get an extra hour of sleep (hopefully). I slept pretty good last night but was still tired this morning but I think gradually I will feel better. Currently as I write this I am on the couch and a little sleepy but sure I will gain my second wind later on tonight. I feel overall pretty good and don't have any symptoms of being stuffed up or a runny nose even though I took my medications roughly an hour ago.

A few years ago in November 2019 (around Thanksgiving time) I was battling a upper respiratory infection. It seems as if around this time every year I come down with either allergies, some type of virus, or cold. Also I received my flu shot last weekend too! I thought I was all set for the holiday season but apparently not. All and all thought I can't really complain about my current health as I am in remission and have a slight set back with this virus or whatever the heck it is. I will be hydrating this weekend, resting, and just relaxing. 

Sutab Review For Crohn's Patient and Colonoscopy Update

This past week (August 25th, 2021) I had a colonoscopy to monitor my Crohn's. My last colonoscopy was back in August 2018 and my gastroenterologist wants me to go in every 3 years for an update which I covered here. 

One thing that was different this time around was the type of bowel prep I took. The last time I had my colonscopy I had Suprep Bowel Prep Kit (which includes a very gross tasting bowel prep-12 ounces to be exact). My thinking when I had this bowel prep was "hopefully I don't have to do this for another 7-8 years). This time around I was prescribed Sutab. Given I saw Sutab was approved by the FDA for bowel prep I thought I would try this given I am not a fan of the Mirlax and Gatorade. Honestly, I can say I still have that yucky taste in my mouth even though I last had it 3 years ago! 

The nice thing about Sutab is it is just pills and water (that's it!). Having to do bowel preps before I thought this would be an improvement over the previous method. My gastroenterologist allowed me to take Zofran (his prescription was for 3 pills) and I decided to take one pill before each prep (I took the first one an hour before my first Sutab pills). The way Subtab works is you take it twice (the evening before your procedure and then early in the morning of the day of the procedure). 

I started taking the Sutab pills a little after 6 P.M. and then around 9 P.M. there felt like there was a storm in my stomach. It wasn't until around 10 P.M. that I had my first bowel movement. After that I would say I was in and out the bathroom a few hours then able to sleep until 2 A.M. when I took the next dosage of Sutab. With each Sutab you take 12 pills (these pills are easy to digest too) and then drink 32 ounces of water. I found that I was actually drinking more water even after taking the pills because I was thirsty. Even though I was in the bathroom a dozen times during the night I felt as if it was easier than the previous bowel prep. I also did not feel nauseated as some people online have reported (I credit the Zofran) with helping that). 

Around 2 A.M. I woke up (and watched Frasier on T.V. to pass the time) and popped in one Zofran pill 10 minutes before I started my second batch of Subtab pills. I dumped the pills out on the table (the closest I will ever be to becoming a drug addict!) and took them one by one. For the second round I probably consumed all the pills over 20-30 minutes (as compared to the hour and half for the first found). 

I would say this time around my rear didn't feel as raw as it did the last time I had a colonoscopy. The morning of the coloscopy I took a hot shower which did provide some relief to the pain I was feeling in my rear. One thing that really did help me as it did 3 years ago was having adult diapers. I ordered Depends years ago and rarely have used them since I don't have any flare ups from Crohn's. I did notice the night before the colonoscopy I had involuntary bowel movements. To me the adult diaper is somewhat like wearing a bulletproof vest for your rear in a sense. Since I am fairly conservative I used two adult diapers for protection. One thing I did different during the day is I had Pedialyte which I think didn't make me feel as dehydrated. 

I weighed myself after I took all the bowel prep and weighed 170 lbs and this morning weighed 166 lbs (after I was all cleaned out). After the procedure me and my mother stopped by a local diner placed and I had a CLT (cheese lettuce tomato sandwich, French fries, and hash browns with some pecan fudge pie and ice cream). The last time I had ate was around Monday night at 10 P.M. 

Compared to the last colonoscopy I was more sleepy and dazed post the colonoscopy even though last time I stayed up from 4 A.M.-8 A.M. to watch TV. My colonoscopy was schedule for 10 A.M. this time around but you typically check in, go back and get comfy on a bed and a nurse will ask you questions, and then they finally wheel you back. My glasses were on but I was taken back to the doctor around 10:20 A.M. and then put to sleep and I woke up groggy and had some food went home and took a nap.

In the days after the colonoscopy I probably felt more tired then usual (however I think my body was just trying to catch up on the sleep). In the report prepared I noticed on the report that I had a anal stricture which concerns me a little bit if there is anything I need to do to fix. However, it looks like the rest of the colon was okay (inflamed a little bit from the Crohn's as expected). My gastroenterologist told me this was nothing to worry about since it was just caused from the previous inflammation from the Crohn's and nothing new. Also honestly I don't feel any pain near my rear and just have felt a little constipated. 

All in all I am glad I took the Sutab bowel prep and would do it again. The only thing I would change would be maybe starting the prep at 3 P.M. and the second round at 10 P.M. to allow for better sleep the night before. Given the pills take 3-4 hours to get through your GI track I would haven't to been worried staying up thinking when I will have a bowel movement. I am just happy that I am still in remission and don't have issues and had a clean bill of health. 

Current Status and Upcoming Colonoscopy

Well it actually has been almost one year since my last post! I really can't believe I haven't blogged in that period of time. The main reason for not blogging is I haven't felt a need to (which is a good thing given I have been in good overall health). My game plan is within the next year to blog more often and focus more on research (new treatments available for Crohn's disease). 

Overall my health has been very good in the past year. I still rarely have any type of loose bowel movements and rarely in pain. Every now and then I might have some cramping that comes and goes for a couple of days but hey if that is all I have I would say I am winning the battle with Crohn's. As usual the biggest factors seem to be stress, sleep, and what I eat. There have been times were I feel some cramping and then I sleep for 9 hours and feel like a million bucks the day after. 

Recently I have been stressed because I took the second part of the Enrolled Agent exam (for non tax people it covers business income taxes). I had been studying months for the exam but within the past couple of weeks really tried to work hard. Every morning I would wake up and study around 7 A.M. until around 8 A.M. and then use that time to get ready for work. During lunch I would close my office door and get in about an hour, and then after work study for a few more hours. The pressure of both studying and working I could feel the burden. The last few weeks I have felt more of a cramp in my lower intestine. What is interesting is after the exam my cramping went away completely! 

My colonoscopy is scheduled for this coming Wednesday (August 25, 2021). On Monday I have to go in to get a COVID test (I got my 3rd booster vaccine at a local Walgreens by me last week). The only main side effect was a slight sore arm. I was able to get the third vaccine since I take an anti-TNF drug (Humira) and I had to sign a self attestation form that my immune system was compromised. My view was given the minimal side effects of the vaccine and given I have already had two vaccines it is somewhat like  My last colonoscopy which I blogged about here was in July 2018. The big difference from this time is I will be take Sutab prep pills (they were approved in late 2020 by the FDA)  instead of taking the usual Gatorade and Miralax combination. Actually the last time I had my colonoscopy was better than the previous colonoscopy but I can still have the after taste in my mouth. I read some reviews online of Sutab and some people complained that they had to vomit. Well one way around this is I had my GI prescribe Zofran to get around this. I will probably write a follow up on my experience after the procedure. I am curious to see how the procedure goes and move importantly to make sure I am still okay in terms.