Crohn's, Pus and Nurse Ratched

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I have two young boys, so the potty talk in my house is pretty excessive.  As it is in most households with young kids, I assume (and hope).  However, as we get older, potty talk gives way to polite conversation in which certain things are never discussed.

Unless you suffer from Crohn's, that is.

Modesty is not something that we embrace (hence this blog).  People who have Crohn's can discuss all sorts of things that most people could never imagine uttering.   Although everyone poops (as the title of that children's book tells us), most adults walk around like they don't.  Not us Crohners.  After all, there is not much sacred anymore when you have to lie face down on a table that tips forward to the point that all you can see are the specks on the tile floor, your body positioned like an A-frame house.  In this position, the doctor can then spread your butt cheeks and get a good look at your backside, like a giant peering into the attic window.  Probably not too different from stirrups at the gyno, I imagine.  "Should I close the blinds?" a nurse asked me at my last appointment.

"Naw.  I like the natural light," I replied.  If someone wanted to look in, be my guest; it sure wasn't a pretty sight.

When one has Crohn's, they become intimately knowledgeable about their digestive system.  We understand a thing or two about mucous membranes.  We can detect subtle changes in consistency and odor.  We can talk about the problems we may have with our ileum.  Or detect the smallest traces of blood in a swirling bowl of seemingly primordial goo.

Pus isn't a big deal for us.

Last week, I came down with a fever.  It was at the most inopportune time, however.  My sister, brother-in-law and nephews were over.  I started feeling chills.  My temperature was around 100º.  The chills got worse and I had a hard time controlling the shaking.  My first thought:  the flu.  After taking some Advil, I was feeling better.  But then my temperature shot up to 101.5º.  That night I was shaking so bad, I almost hyperventilated.

Over the course of the next 48 hours, my temperature fluctuated between 94º and 101.6º.  I saw my general practitioner the next day and he was pretty astute.  He did a flu swab---nothing like a long Q-tip shoved up your nose.  "This is going to make your eyes water," said the nurse.

And it did.  Gushers.

But it wasn't the flu. "Didn't think so," said my doctor.  "I think it's bacterial.  You usually don't see those fluctuations in temperature with a virus."

So he put me on a Z-Pak.  All I thought was that this was not related at all to my Crohn's and was still pretty sure I had some type of virus.  But, I took the antibiotic anyway. 

A day later, the pus came.  Lots of pus. 

Since the Crohn's moved lower and is now both internal and external, I have been dealing with discharge and pain "down there" on a daily basis.  It was actually getting better over the last couple of weeks.

Or so I thought.

The pus was pretty excessive.   And the pain increased.  The antibiotic was drawing the infection out--probably something that I have been fighting for awhile, but since the area was so inflamed it wasn't noticed when I was in the office last. 

But, there it was, dripping from my butt.  There wasn't much I could do to control it it, except to keep it as clean as possible.  Use gauze if necessary.  Frequent trips to the bathroom.

Thank God for the bidet.  That has been a life-saver.

So, here I am, several days later and the infection no longer hurts.  There is hardly any pus drainage anymore.  The inflammation is better.  Thanks, Z-Pak.

What happens next?  I may go on another round of a different antibiotic just to make sure it is cleared up.  My fear is that the problem may be a fistula or an abscess.  But my surgeon doesn't think so.  He hadn't seen any evidence a couple of weeks ago.  He actually prescribed Flagyl for me at that time, but not for an infection but for inflammation. "For some people," he said, "Flagyl helps with anorectal Crohn's.  We don't know why, it just does."

That's the thing about Crohn's: much of it is a mystery.

But, like the good patient I am, I didn't take the Flagyl.  I didn't want to take an antibiotic for 30 days if not needed.  Plus, I started taking the Chinese herbs a couple of days later so I didn't feel like it was necessary.

After telling that to my surgeon's nurse the other day, she went Nurse Ratched on my ass and basically blamed the infection on my failure to follow directions.  After a minute or two of condescending lecture, I began to wonder two things:  1) did this nurse ever play Nurse Ratched in some community theater production of One Flew Over the Cuckoo's Nest and 2) maybe I should start taking the Flagyl next week.

"You should probably start taking the Flagyl next week," she said.  She can also read minds apparently.

So, I will begin that treatment in a couple of days.  But I am still unsure if I want to go 30 days on an antibiotic.

Seems a bit excessive, especially for someone with colon issues.  Antibiotics kill the good bacteria with the bad, so this could make my colon worse---all to make my rectum better. 

Oh, the decisions we have to make: do I protect the butt or the flora in my colon?  I don't particularly like the pus, that is for sure.

And you probably don't want to read about pus again, I imagine. 

So.....hello, Flagyl.