The Diagnosis

“Ulcerative colitis?” she asked as she looked at the small photographs of her husband’s digestive tract.

“You see these white dots?” asked Dr. Harding, pointing to the photos. “These are ulcers covering his colon. These are what caused all of the blood your husband has been seeing.”

Edna looked at her husband who was still sprawled across the hospital bed, sleeping off the anesthesia. She remembered the fear she had experienced when Bill told her there was blood in the toilet. He hadn’t stopped bleeding since that day.

“Ulcerative colitis is an autoimmune disease. It’s much like Crohn’s Disease if you have ever heard of that.”

“No,” she said, staring at the pictures once again. The white dots were everywhere. Ulcers were everywhere. She studied the pictures with consternation.

“Well, I’ll have the nurse bring you some literature,” Dr. Harding stated. “Here is a prescription for antibiotics, steroids, and a medication called Lialda, which is the latest and greatest medication for his disease.”

“And this will fix him?” she asked anxiously.

“Ah. Unfortunately, there is no cure for this illness, but if we can get him into what we call remission, where his symptoms are under control, then the Lialda will hopefully keep him under control.”

“And how long will he have to take that?” she queried.

“Most likely he will have to take it for life, or until there is a new and better treatment.”

Poor Bill, she thought as a lump formed in her throat. Poor Bill and his pills. He hates pills.

Her head still slow from the shock of this new information, she thanked the doctor distractedly as he left. She couldn’t believe what she had heard. She didn’t even know what this illness was, but it would be here forever. She reflected on what happened before she had convinced her husband to see a physician. For weeks he had suffered, rapidly shedding weight and spending hours in the bathroom. He spent many nights writhing in agony. She had finally convinced him to seek help, and she was glad of it.

She looked at Bill as he began to stir, mumbling unintelligibly. Sighing, she stroked his head softly, and kissed his temple. He looked at her with his eyes half-open, then turned away to fall back asleep. He hadn’t heard a thing the doctor had said, and she would have to break the news. It was heartbreaking news.

A nurse arrived, moving aside the flimsy curtain that surrounded them. She scuttled about, checking Bill’s vitals and trying to wake him. “The doctor wanted me to give these to you,” she said, smiling and holding out papers to Edna.

“Thanks.”

As the nurse exited, closing the curtain behind her, Edna looked at the papers she had been given. “What is Ulcerative Colitis?” it read across the top of the first page. As she reached into her pocked for a pair of wiry reading glasses, she read the title aloud. “What is ulcerative colitis?”

She maneuvered in her chair in order to get comfortable, but it was impossible. Leaning back, she began to read. “Ulcerative colitis is a chronic autoimmune disorder of the large intestine that affects around 700,000 Americans. It belongs to a group of conditions known as inflammatory bowel disease (IBD), and is characterized by severe inflammation of the colon, causing bleeding sores or ulcers. Symptoms include moderate to severe abdominal cramping, bloody diarrhea, nausea, and fever.”

Edna stopped. That sounded like Bill all right, with the exception of nausea.

“The cause of ulcerative colitis is unknown; however, there are three main theories: genes, an inappropriate immune response in the body, and an environmental trigger. It is thought that a person inherits susceptibility to the disease, and the environment triggers the abnormal immune response. There is currently no medical cure, but there are treatment options available.”

Great, she thought. Unknown cause, no real treatments. She felt frantic as she read bits about this mysterious ailment. She then noticed Bill looking at her confused and helpless.

“Where am I?” he asked.

“You’re in the surgical center, honey, recovering from your colonoscopy.” She went to Bill, grabbing his hand and smiling, forgetting his sickness for a moment as she tried to comfort him. “Everything is fine. Just relax,” she said, but he had already closed his eyes. She gazed at him as if he were a child. He was much like a child in this state, frightened and vulnerable.

She resumed her reading, flipping through pages until she reached the treatment section. Hearing that Bill required steroids caused great apprehension. Her father had taken steroids years before for a chronic lung condition. He was the nicest guy in the word until the steroids, which caused him to be a raging psychopath. She went down the list of steroid side-effects:



o Hypertension

o Weight gain

o Acne

o Mood swings

o Psychosis

o Increased facial hair



She looked at Bill’s prescription slip. He would be taking steroids for two months. Would that be long enough for these abominable effects to occur? Thoughts ran through her mind wildly. She could imagine how a fragile mental state could compound the difficulties in their new lives.

She was completely discouraged. She looked through more pages, hoping for some good news, but knew that there was nothing good about this. There appeared to be one cure: removal of the entire colon and placement of an ileostomy bag. Bill would never go for that, and she didn’t want him to either; unless, of course, there were no other options.

Her face flushed as she held back tears. How could this happen? What were they to do? She was overwhelmed. She tried to meditate. She needed to overcome this panic. She needed to stay in control.

Bill stirred, distracting her from her worried state. He was looking at her, this time smiling. “Hi, honey,” he said lovingly.

Just then the nurse entered with Bill’s clothes.

“Looking good,” she said happily. “Are you almost ready to get out of here?”

“I think so,” Bill responded agreeably.

“It should only be a few more minutes,” the nurse said to Edna, setting the clothing on a table. “You can help him get dressed.”

“It’s about time you woke up,” Edna said playfully as she stood to help Bill dress. She untied the hospital robe and helped him stand to put on his pants.

“What did he say, that doctor? What did he see in there?”

“Ah, it’s nothing we can’t handle.” Edna remained convincingly light-hearted. “I’ll tell you all about it once we get you home and rested. I can’t be sure you’ll remember what I tell you yet,” she snickered.

They smiled at one another as Bill put on his jacket. The nurse pushed him out to the car in a wheelchair, and they were set to go.

“Are you ready?” Bill asked. “I think I might sleep for a week!”

“Yes, it’s nice to get out of there. Those fluorescent lights drive me crazy.”

“Poor Edna,” he said, holding her hand and smiling at her. “I’m glad to know I can get outta there. I was worried they might keep me. Thought maybe there was something horrible going on in here.”

“Oh, you’ll be all right.”

It’s nothing we can’t handle, she thought. It’s going to be okay.





Sources:

www.ccfa.org

The Johns Hopkins White Paper: Digestive Disorders. H. Franklin Herlong, M.D. and Sergey V. Kantsevoy, M.D.



Word count: 1222