Saturday, October 15, 2016

Coping with Ulcerative Colitis

Credit: Hummuskiller
I am writing this as I am drinking four 450cc barium sulfate containers for an MRE. It's disgusting, and the Crystal Light is not helping.

I didn't realize that I had anything to work out mentally or emotionally with UC. It's mild, it's moderately controlled, and I'm used to big life shifts (getting a chronic disease doesn't hold a candle to becoming a doctor). But in the past few weeks I've had two experiences that showed me how lonely UC has made me, and have helped me.

I was on L&D and was getting ready to do a C-section. I clicked into her chart and saw that she had UC. It always makes me feel a little bit of companionship. The C-section was with one of our pricklier attendings, Dr. M. Of all our attendings, she is the most challenging: she once asked me if I listened to patient's lungs after I'd ruled out PE (hard to explain if you don't get that). As the section proceeded I nicked an arteriole. "Are your cases always bloody?" she asked derisively.

I decided to be silly about it, since the patient was under general anesthesia. "Very," I replied. "It's always awful." To my surprise, Dr. M grinned at me. Had I cracked Dr. M? We continued to banter back and forth as we opened the abdomen. By baby time, we were chatting amicably.

"Bummer that she had to get general," Dr. M observed as I anchored my hysterotomy repair. "It was her platelets, from her methotrexate. Come on," Dr. M went on playfully, "can't you tie better than me? Me with my arthritis?"

"You have arthritis?" I asked softly. Arthritis in a surgeon is a bit of a sensitive subject, because your career is in your hands. When you're mask to mask over an abdomen, few people in the OR can hear you, so I asked quietly.

This post conforms to the blog rules.
I guess I
should have
this here for
me? Or Dr. M?
"My gosh, it's gotten so bad in the past few years," she muttered. "The colitis is better, though."

My eyes grew wide. "You have ulcerative colitis?" The word "colitis" doesn't go with the word "arthritis" unless someone is talking about UC, or a very unlucky and uncharacteristic type of Crohn's.

Dr. M. looked up from the field and met my eyes. "Yeah, I have ulcerative colitis," she said.

"Me, too." I said. I completely forgot I was operating, I forgot about anything except for Dr. M. Here we were, operating across from each other and on a patient with our condition.

Dr. M turned her attention (and mine) back to the fascia. "I remember once when I was a resident in the middle of a 72. We worked the whole weekend then. And there was a vag hyst to do, and I felt so bad that I asked the third year to do it. And she made such a stink about it."

I was amazed. A "vag hyst," or vaginal hysterectomy, is a gem among procedures for OB/GYN residents. For a senior resident to give away a vag hyst, she must have felt terrible. (Like, interferon-soaked, uncontrollable diarrhea and tenesmus terrible. Sort of like I feel now that I'm in the middle of the fourth barium dose.) I didn't say anything and we went through the rest of the C-section quietly. There was a companionship that didn't need words. I was flooded with a strange relief.

Someone else knew what is was like to have UC as an OB/GYN resident. Someone knew what it feels like to be rounding and to suddenly need to find a bathroom that people don't mind smelling. Several times as an intern I had over ten patients to see and in the middle of them I suddenly had to go down a flight of stairs and into a guest bathroom, the only one I know of where people won't complain about a BM.

The second experience isn't as much of a story. I have scishow and vlogbrothers on Feedly and clicked on this Hank Green video because it seemed medicine-related. To my surprise, Hank Green has UC. Unsurprisingly he has really smart things to say about it. That's all for now; I can't finish this last barium bottle, but it's time to get the MRE. (Thankfully, there's glucagon in the near future to make me feel better.)

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