First Gastroenterologist appointment at Adult hospital

 This is a brief update of Lucy's condition with her bowels so far which I wrote for her first visit to the gastroenterologist. 

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Lucy has a history of gastro problems all her life. She has always had incontinence and has poor control of her bowels. She suffered constipation a lot and the incontinence nurses suggested dis-impaction which we tried many times over a few years. Every school holiday we would spend with her taking Movicol until she was completely runny. The constipation would return. We stopped going to the nurses when she was 13 yrs old.

She also has an overflow when she is constipated which she has no control over.

More recently she has suffered more and more diarrhoea which was not like the overflow. 

The situation now is that she is constipated or has diarrhoea, it's very rare that her faeces looks normal. Even the more solid faeces is slimy. 

We saw a gastro Dr at the Children's hospital when her GP referred her after a particularly bad period of diarrhoea which had shown blood in her feaces. The Dr said she had found calprotectin in her sample but it wasn't very high. A second sample showed the calprotectin was even lower. The advice was to give her loperamide to make her faeces more solid and Movicol to move it through her body. It worked for about a couple of months and then she had another really bad period of diarrhoea. I gave her more Loperamide which resulted in constipation. She refused the Movicol as she didn't want to the diarrhoea back. 

We had a telephone consultation with a general Dr at this hospital about her problems and they said to use more Loperamide when the diarrhoea started so we could stop it sooner. 

Lucy became reliant on the Loperamide to stop the diarrhoea but the constipation became more of a problem. So we stopped everything. The GP suggested peppermint oil which helped a little. 

We took her to A&E after a 7 day period of diarrhoea and she was feeling really unwell on 19th July. The Dr said he would write to our GP and request they make an appointment to see a gastrointestinal doctor. We had to visit the GP and make the request ourselves and have been waiting since then. 

Since July Lucy has had four week long boughts of diarrhoea and has suffered constipation inbetween. We have stopped all medication as nothing was really helping. 

Then on 19th August Lucy was admitted to hospital after retaining urine (over a litre) and couldn't go to the toilet. They said she was really constipated and gave her two suppositories which eased the consitpation. Lucy was catheterised for a couple of days. Then she was sent home. 10 days later she retained again and the catheter was replaced. She is still catheterised. 

On speaking to the Dr during Lucy's hospital stay we were told that the retaining could be down to her Elhers Danlos Syndrome, and this could also be an issue with her bowels. The nurse at her last urology appointment told me that her urological problems would not get better unless her bowels problem were sorted and offered to write to her GP. 

Lucy is underweight and although she has never really been very large, she has also never been this skinny. She has definitely lost a lot of weight in the last two years. 

Diet: She likes nothing better than meat and vegetables. She also likes some processed food like chicken nuggets and burgers and chips. She does not like pasta or rice, although recently she has tried lasagne. She eats little but snacks between meals occasionally. Her snacks are generally biscuits, crisps or cheese puffs, but she does not eat these in excess.  She only drinks soft drinks, not fizzy. She dislikes dairy products but will eat cheese occasionally. 

Lucy is currently having a period of diarrhoea which started on Sunday night. Before the diarrhoea she said her faeces was not hard and she wasn't constipated. I ask her every day if she has been to the toilet and what it was like. 

First Visit, how it went

The Doctor was really nice. he talked about all of Lucy's history and the problems that led us to being at this appointment. He checked all her notes from the other consultants. 

He decided that it was highly probable that Lucy had IBD and will do all the necessary tests. First up she had a ton of blood tests done. It's been shown in the past that Lucy is suffering from malabsorption and there has to be a reason for that. In particular she is very anaemic and has poor vitamin B12 absorption. This can be a sign of an auto-immune condition. The Doctor was quite forward in saying it looked like Lucy has Chron's disease, but she needed testing before a diagnosis could be made. He is willing to do these tests starting with an MRI within the next few weeks. 

If after all the testing it showed that Lucy does not have IBD then she will be diagnosed with IBS and referred to the nursing team who will give her all the help she needs to manage her condition. 

He assured us that no matter what, she would get the help she needed to get better or get her conditions under control. 

Things may be looking up for Lucy, I am hoping that this is the help she needs to get better. 

Coping with a Catheter

 Lucy is coping ok right now. She's in a lot less pain anyway, and getting used to her bag. We've learnt how to change it and how to add the night time bag. She can do it herself now. She has an ultrasound scan booked on 22nd September to see how her bladder and kidneys are holding up. There was some mention of vEDS in the hospital but Lucy has been genetically tested for this so it's highly unlikely that it's the cause. The geneticist did say that nothing was certain, but we are focusing on 'unlikely.' She has her own district nurse team which are on hand if we have any further problems...hopefully this will mean no more A&E and hospital. She has boxes of supplies and a cabinet of medication. And is now awaiting her Fortisip to try and help her gain a little weight. We still haven't had the results of her MRI but I'm sure if it was bad news we'd know by now.

Next up is tests on her bladder from the Urology dept, which is booked 18th October and she may have her catheter removed then. Next step is to lean how to self catheterise. It should all be sorted by her next appointment which is 22nd November. Fingers crossed.

We are still waiting for her appointment at the gastroenterology dept. I think her gastro problems are the main cause of all of this but we won't know until she is seen. We do know that the first time she was admitted to hospital that her bowels had crushed her bladder. So we can't fix one without the other.

That's where we stand right now. She hasn't been out of the house yet, but with the right clothing the catheter can go unnoticed and she is not in pain anymore.

UPDATE

Catch up on Lucy. She had her Ultrasound on 22nd September and every thing seemed OK. Her kidneys looked better which was good. Today she went to the Urology clinic for the first time . She had the catheter removed and then had to drink a jug of water. She then had to wee, but it wasn't good. An ultrasound showed she was still retaining. She tried again. More water drinking and another wee. More came out this time but it wasn't enough and again the scan showed she was still retaining. She was given the opportunity to learn how to self catheterise but she said she couldn't do it. So she had the catheter put back in. It's obvious her bladder isn't working but we won't have any answers for a couple of weeks. Then she's back at the clinic for urodynamic studies which sounds pretty awful but we will get the answers we need to go forward.

31st October

Today we had the results from Lucy's MRI which she had on her last hospital stay. They are requesting her notes from the Children's hospital because they have spotted something on her spine. I don't want to spurt jargon that I know nothing about but we will have answers soon. On Wednesday Lucy will be having all sorts of tests done on her bladder to see what is and isn't working. Then at the end of the month it's back to the clinic to find out the answers and maybe the thoughts on the MRI scan. At the moment, it's looking like she will be catheterised for some time so she really needs to learn how to do it herself. I'll let you know how she gets on.

What Happened to my Daughter and Elhers Danlos Syndrome

This is the story of what happened to my 17 year old daughter Star, and how her Elhers Danlos Syndrome caused her to end up in hospital for nearly four days.

Friday 19th August began with a visit to the GP with Star. She had been for blood tests the week before and the GP said they would help her with her tummy problems. When we got there a different GP told us of all the vitamins that she's lacking from her blood tests. Then she looked at me accusingly and asked, 'doesn't she ever eat?' So, once again I explained about her tummy problems and how we are trying to find the foods she can actually eat without making her really poorly. So the GP wrote a request for a specialist to see her at the hospital.

Later her boyfriend came around and she was one happy girl. She was looking forward to going out for her birthday and excited about her gifts and special day. Then on Friday evening she told me she hadn't been able to pee all day. I thought it was a bit worrying so I told her I'd get some medical advice in the morning and said she should get some sleep. I was completely shattered myself and I know she was too. She lasted a couple of hours, then my eldest daughter told me Star was crying in the bathroom.

Her tummy was swollen and she was in a lot of pain so I called 111. They told they could send an ambulance but it would take about 11 hours!! But they said she needed to be in hospital within the hour. We quickly got dressed and off we went in the early hours of Saturday morning along the dark and quiet roads.

Accident and Emergency

The A&E was not so quiet though. There was even some woman lying on the floor across the entrance refusing to go home. There were security guards that had to drag her away just so we could get in. Poor Star wanted to go back home straight away. We didn't even get to say goodbye to her Dad as we were quickly hustled inside.

We booked in and was seen by a nurse after 2 hours. Star was really hurting, but there were a lot of really sick people there. When she was finally called things moved pretty quickly. She was taken into a room for an ultrasound and they could see how bad things were. She had more than 1300ml of urine in her bladder. Another hour and she could have easily burst it. A catheter was put in, the experience was a complete nightmare for Star, but she was incredibly brave. We have lots of coping strategies when things are tough to get through and she started talking none stop about the circus we'd seen on holiday, telling the nurse every minute detail. It was her way of taking her mind off things and it worked.

Then she was moved to cubicle where we spent 7 1/2 hours. Star managed to sleep a little. I did nod off a few times in wheelchair. I was dreaming of the wheelchair that Graham had sent me a picture of the day before, a reclining one with a headrest. Problem is, we could only afford it because it came from China and the reviews of the ordering and delivery process were dire. A wheelchair like that in this Country would cost us three times as much. Anyway, I digress!

Eventually she was moved up to  a ward, but they didn't have a bed. She was put in a reclining chair! In a lot of pain and not knowing what was going on she became distressed. I am used to these chairs as they are the type I have my treatment in, so I showed her how to adjust it so it became just like a bed and she was a bit more comfortable then.