Posts Tagged ‘mesalazine’

A couple of weeks ago, I had an appointment on Monday morning at the hospital not far from my home – the one I’ve gone to for all my health needs so far – for my latest colonoscopy. I think my last one was probably in 2010, so I’m a little overdue for one. And, as I’ve had bad flare-ups every other year since about 2005, I’m pretty much due for another.

I told the doctor that I had to work in the afternoon, so he promised a ten o’clock appointment. It turned out to be eleven o’clock. Perhaps because of this, I wasn’t given a general anaesthetic like every other time I’ve had a colonoscopy in Korea. Wasn’t even given the option, actually.

Another difference to my previous experience was the laxative I was prescribed. The earlier ones were small bottles of vile fluid that I had to drink and follow up with two litres of water. This one was a powder that you dissolve in water and then drink. It had the same horrible, sweet-bleach taste, but was at least a lot milder. I couldn’t manage the whole dose in the evening, but in the morning I figured out that if you just down each 500 ml dose in one go, it wasn’t too bad. I drank an extra litre of water both morning and evening to make up for my under-dose.

The examination, then, wasn’t a huge amount of fun. I could watch the progess of the endoscope on the monitor, see the brown fluid in my gut get gurgled up by the tube, observe the flushes the doctor administered. With my lack of sleep and low blood sugar, I didn’t try too hard to follow it and instead just tried to relax. It was uncomfortable, but not unbearable (unlike the barium enema and bowel X-ray I had once on the NHS), and it was pretty weird to feel the endoscope poking my abdomen from the inside. The nurses moved me about a few times and squeezed my belly, perhaps to improve suction. The doctor took five biopsy samples, but I at least didn’t feel that.

The doctor told me afterwards that my colon was mostly healthy, but that I had – have – a ten-centimetre patch of inflammation in my upper large intestine that bled on touch. I’d already told him that my regular doctor was a specialist at Daehang Hospital in Seoul, so I got a CD with images from my exam and started thinking when I would go up for a consultation.

Later, at work, my boss gave me some fish jjigae to take home for dinner. I duly did, warming it up in the microwave for a couple of minutes. Later in the evening – while I was trying to go sleep, in fact – I started feeling a bit feverish and nauseous. I vomited up aforesaid dinner and worried about whether I’d merely contracted food poisoning or whether I’d suffered some horrific damage to my bowel and was now developing septicaemia.

The following day, I felt better, but was weak, so I took the day off work and went to Seoul to see my doctor there. He looked at the pictures from my examination and declared that I was fine. He didn’t prescribe any steroids for my inflamed bowel, nor anything for my bout of food poisoning. During the day, I was only able to eat half a small bowl of cereal and a few French fries for lunch. My guts weren’t too happy.

I recovered from all this over the next few days, but had occasional twinges in my colon in exactly the place the Cheonan doctor had told me I had the inflammation. These moments of discomfort have dwindled in frequency to more or less nothing, now, but I couldn’t help thinking the colonoscopy was more harm than help. I went back to the hospital last week for my biopsy results and they revealed no nasty surprises.

So, to keep my colitis under control, I think I just need to make sure I don’t fail to take my daily dose of mesalazine – all 3,400 milligrammes of it. At least the whole thing turned out to be a lot cheaper than I was expecting; really cheap, in fact: less than £20.

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I now have an e-ticket for a Turkish Airlines flight to Korea via Istanbul, leaving on Sunday afternoon and arriving on Monday evening. I have no passport still – I’m hoping it’ll arrive on Saturday, but if it doesn’t, my recruiter will be able to reschedule my journey. Once at the airport, I’m to be met by a ‘pick-up man’, whose duty is to buy me a ticket for the bus (although I’ll have to pay for it) and see that I get on – and presumably let the recruiter know so that they can let the director know what time to pick me up from the bus station.

I’ve doing some partial packing to see how much stuff I can fit into my backpack and suitcase. My baggage allowance is 30kg, with 8kg carry-on. I may be making full use of this allowance – and leaving some stuff behind that I had hoped to take. When I launder my last clothes on Saturday, I’ll have a better idea.

The other day, I went to the doctor to ask about whether my medication, mesalazine, would trigger a false positive on the drugs test I’ll have to take as part of my official health exam, which will prove that I’m literally fit to teach in Korea. He said that it wouldn’t and neither would paracetamol (unless I took huge amounts of it) and similar pills; steroids and sleeping pills would – but I’m not going to be using either of those.

I also showed him a couple of photos of my back that I’d taken – at his recommendation – over the past couple of months. I have lots of moles and they’ve grown and multiplied over my life – it’s hard to say, as it’s such a slow process and, being mostly on my back, they’re hard to keep an eye on. I handed over my memory stick, on to which I’d copied the two photos. He connected it to his computer and had a look at the two pictures. The third picture turned out to be a saved soft porn picture I’d saved in a different folder – I never use the automatic slideshow option, so I wasn’t expecting that. Kind of embarrassing, but the doctor took it in his stride.

On the subject of my moles, he said he would have referred me to a specialist to check out two irregularly shaped moles espcially – if I wasn’t leaving the country. He recommended I see a skin specialist before too long.

After that, I headed off to Manchester on the train. I had been thinking about getting a couple of non-fiction books, but ended up just getting Robert Rankin’s new novel – The Educated Ape and Other Wonders of the Worlds. I’m not sure whether I should make this my in-flight reading or plump for something else, as I only recently read the book’s immediate predecessor, The Mechanical Messiah and Other Marvels of the Modern Age.

I also went to see Argo, which I thought was great – a tense, funny and apparently realistic depiction of the rescue of six embassy workers from revolutionary Iran. The stand-out feature of the film, though, was the period detail – the hairstyles and facial hair, the grainy footage, the vintage Warner Brothers logo at the start. This sense of authenticity was bolstered by snippets of historical footage intercut with the movie; it was especially powerful in the early scene when the US embassy is stormed by Iranian protesters. Alan Arkin, John Goodman and Bryan Cranston were all great, along with the lesser know actors playing the six staff; Ben Affleck’s performance was understated to the point of being semi-somnolent. The climax of the film was drawn out too much for dramatic effect. Overall, a very fine movie.

The title of this post comes from a line in the film that becomes a catchphrase for some of the characters. Alan Arkin’s character, a producer, is being badgered by a journalist who wants to know the meaning of the title of the fake film within the film – Argo. Eventually, he snaps and says, ‘Argo fuck yourself.’

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Around about December my colitis started getting worse. It wasn’t too much of a concern at first – just an occasional need to use the bathroom more often that usual while my stools became less solid. Things weren’t too bad – I had no problems in the Philippines, January passed with a slight deterioration, but when I went to Malaysia at the beginning of February I still wasn’t having problems that interfered with the holiday.

Things got worse in February, though, and, one morning, after passing a load of blood, I decided it was time to go to the doctor. As a tourist in Korea, I don’t have any insurance, so I was expecting it to be an expensive undertaking. Previously, earlier in 2010, I’d been prescribed mesalazine suppositories to go along with my six mesalazine tablets per day. I stopped taking them for a while – which may have contributed to my current flare-up.

Anyway, the doctor prescribed me cortico steroid enemas for a week. These were not so much unpleasant to use, but were annoying – requiring a whole extra bedtime routine. The enemas didn’t have much effect, so once I’d finished the seven, I started using some mesalazine enemas I’d been prescribed last year along with the suppositories. I went back feeling a little better and the doctor (a different one, this time) gave me more of the steroid enemas.

Around this time, Habiba and I moved house for Habiba’s new job. Our new flat is smaller than our old one and older and mouldier. The stress of moving and the less than salubrious apartment probably contributed to a further decline in my health.

After another week of the enemas I started feeling constantly slightly nauseous, I got bowel pains as stuff moved through my lower intestine and my appetite deserted me. I’ve lost two or three kilograms in weight and my energy levels have plummeted. I can’t sleep at night and when I get up in the afternoon showering and doing a few chores is enough to exhaust me for the rest of the day.

I went back to the doctor and reported my symptoms. This doctor (another new one, who at least speaks English well – much better than the other two) prescribed me a stronger alternative to the Pentasa mesalazine pills – Asacol mesalazine pills, to the tune of nine a day. He also said that my nausea and bowel pain were irritable bowel syndrome symptoms, so he gave me additional medication for that.

None of which improved the situation noticeably. On my next visit, he gave me a prescription for steroid pills – at last. Steroids – at least in tablet form – have always been the magic bullet for my ulcerative colitis since I was first diagnosed in 2007, so I was looking forward to a rapid recovery.

That recovery has been slow in coming. The steroids give me some respite from the pain in my guts and allow me to sleep a little better and eat a little more, but they wear off after a number of hours and the pains return. Still, I feel better today than I have for a few weeks, which is something, and I still have about ten days of my steroid prescription left.

The episode has been a real pain in the arse. I haven’t had energy to dedicate to any of my projects – no writing, no roleplaying, no blogging. Even reading and playing computer games (I downloaded a port of the classic Atari ST game, Dungeon Master) have fallen by the wayside now that I spend so much time in bed trying to sleep.

My symptoms in this flare-up have been different to my symptoms in earlier years – in some ways less severe – I haven’t needed to take constant trips to the bathroom – but the bowel pain has been really trying, as has the length of time it’s taking to recover. At the back of my mind – not even that far back, actually – is the worry that UC increases the risk of colon cancer after about ten years – which is about the length of time I’ve had bowel problems. I suppose I should push for a colonoscopy – which will be very expensive and involve the consumption of an utterly disgusting laxative.

At this point, with my slight improvements in symptoms, I can only wait in hope that things will clear up further in the next few days.

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