GI followup
Today I saw my-- GI doctor (a fellow), DR Cerefice for the last night (he accepted an attending position in NJ; but my attending, Dr Peura will still be my attending). He caught up on my health issues and we discussed how I've been feeling.
I did tell him that there was a while that I was eating nothing but fish and vegetables and started feeling a little bit better (that is, not in that constant pain and nausea). Until about 3-4 weeks ago, I again started up that cycle of feeling ill again; constant pain and constant nausea. I told him that there were certain days that I just don't sleep because of the pain and the nausea. He does want me to continue to small meals, fish/veggie/no gluten diet. He thinks that along with my motility issues there are other things that is happening that they still can't put a finger on so they are trying different alternatives in medications, diets, etc to see what works best. They do think it is a never problem that may even need to be referred to a pain management specialist. They both think that perhaps my stomach/intestines, etc is highly sensitive to pain (passing of food/liquid down the GI track). Other suggestions are as follows:
--I asked about the possibility of something wrong with my appendix (as I had a friend with exact symptoms as me and she later had a ruptured appendix which nearly killed her). Dr. Cerefice and Dr. Peura told me that there is a thing called "inflamed acute appendicitis", which will cause pain and nausea and then go away. He said I could at times have this, but told me that it's not normal if I'm always in pain and always nauseated; HOWEVER, he did tell me that if I am in pain and am nauseated and esp have a fever no more than 101, he wants me to go to the ER. Actually, that's really what he wants me to do no matter what. They don't think my gallbladder is in anyway affecting this pain and nausea.
--For the next two months, I am to keep a food diary of EVERYTHING I eat/drink; even documenting fluids I ingest if there are days that I can't eat. Dr. Perua wants to look at the diary and see if there is a a common theme going on (such as similar family foods, etc; there are also foods that one can't eat if they are allergic to "outside things"
--Even though I'm taking Cymbalta for depression (and at one point wanted to try to get off of it), they both want me to stay on it because the same neuro-receptors in the brain works on the stomach as well. They wanted to add another anti-depressant but they want to try the OTC probiotic Align first. If after 2 months I don't feel any better, they are going to put me on a second anti-depressant (Elevil) used for patients with chronic stomach pain (or any other types of pain).
-Dr. Perua and Dr. Cerefice is also cautiously monitoring me with different tests / same tests every so often due to my history of neurofibromotosis (NF). I can be just a very very small nodule of NF that can cause this that is not yet visible. As of now, they don't see anything in my stomach/in my intestines to show NF, but that doesn't mean, it could be around the area.
--They both believe that if this does not work, they will have to send me to the Pain Management Clinic at UVA because they better help in pain management. The idea of fibromyalgia came up as well and that is something to consider once it is decided whether or not I need to go to Pain Management.
Another thing that I brought up was the idea of holding a full time job. I told him that with how I feel I just don't know how I can handle a fulltime job or even if any company would hire me because of my illness. We talked about going on disability and he did say that there are several people who has stomach pain that is so debilitating that there is no choice but to go on disability. However, he wants me to try the Align first, go back for a visit, and then try the other antidepressant before proceeding with this idea of disability. I kind of don't agree with him in this area, not because I don't want to work, but because it takes a long time for disability to go through. So what I may do is go ahead and fill the things out and have my PCP fill out the medical things. However, Dr. Cerefice and Dr. Peura does understand (and agree) how working full time won't be ideal for me right now.
So, although, the answers aren't completely there, I'm willing to try out these alternatives. I'm not to thrilled about being on more medications and just want it to be GO AWAY!!! I'm really learning to trust God in all of this knowing that He provided a means (medication) to help and I should try out if I need too. There are days I feel extremely discouraged and frustrated. I'm reminding myself that there is a reason behind this and that God will see me through this. In fact, as I said my "goodbye" to Dr. Cerefice and told him how pleased I was with him as my doctor and best of wishes in NJ, he responded by telling me that it was his passion to help people and that he believed that God really called him to this field. I told him what a caring doctor he was and never had a GI doctor like himself and and told him I thank God for him and I wish him the best. He then responded and said "Well, remember, God puts us through things we don't understand and even though I can't figure out what's wrong with you, doesn't mean, God won't lead others to help; he reminded me to keep trusting in God" That warmed my heart so much! I KNEW there why I felt a special connection with Dr. Cerefice. I'm really going to miss him as my fellow doctor!
Please continue to pray as I try this new probiotic as well as well as being under the care of a different GI fellow. I'm doing well sticking to my diet and eating small portions; but there are times I can't eat and rely on fluids (which causes a lot of my tiredness and sleeplessness). I pray I don't have to go to Pain Management, but if I have to then I will. Thanks for all who has prayed!
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