Health update

Two weeks ago:

“You should soak your hiney hole in a nice warm bath.”

I swear Matt said this last night.  Not even in a goofy way.  Totally straight-faced.  And there it is: the dynamic of our relationship summed up in one giggle-inducing line.

My health has not been good the last week or so.  You know when you go to the GI and they ask how many times you go to the bathroom daily?  I’m always sitting there, my sweaty butt clinging to the thin paper on the examination table and I have absolutely no idea what to say.  You might as well have asked me what the cold fusion was.  “Oh, I dunno, four?”  So, I counted this past week, and it’s about twelve times a day and this number is just jaw-droppingly startling to me.  (And while we’re on it, how can I not be remotely thin at this point?!)

I have not felt this bad in a long time.  Yesterday I upping my Pentasa dosage and cut irritants out my diet (yeah, yeah, I know – it took a while).  I realized I developed quite a fondness for coffee, devilish liquid it is.

Along with my poor bum, my throat is sore and immobilized; I am having difficulty swallowing and went to bed at Annie’s bedtime last night.  And this morning?  I woke up with an eye that was pink.  “Oh, HELL NO,” I said to the mirror, “This is riDUNKULOUS.”  And that’s when Matt said I should call off and I started crying and saying things like, “You and your infinite sick days!  I have so much on my plate, you have no idea!  I just can’t NOT go in! 


Today:


I wrote the above two weeks ago, just as I (and the family) was coming down with an annoying case of pink eye (viral, as Matt and I then had a cold that ebbed and flowed and never really seemed to go away until just now).


Things are good now, but with Crohn's, I realize I rarely feel great.  I often feel just okay, and get through the day with bathroom runs dotting the afternoon and evening - 2 o'clock, 4 o'clock, and oh god, I have to catch the train but should I go again?  That's at the cusp of 5 o'clock.


There are no bathrooms on the train.


That is whack.

So, here's to eating with a more watchful eye, taking my meds diligently, and praying that my luck with the train never runs out.

Post-pregnancy: Crohn's and baby love

This was the front of our holiday card this year.  The photo is courtesy of Matt's super duper coworker who moonlights as a photographer, Jamie (check her out if you're in suburban Philly!), and the card is from Minted.  


Annie is tucked away in her Moby wrap with Dad, so that finally (woohoo, finally!) means I have a few moments to type.  


On Crohn's:  I went through a good week where my digestive system was absolutely, pitifully out of whack. It started about five days after Annie's delivery, which was not very fun as I was still in the heat of recovery from my (sigh) episiotomy.  You know you have a good marriage when your husband, very straight-faced, says after one of my bathroom runs, "Is your butt clean? (Thank you, honey.)  You should soak your butt in a bath so everything can heal."  (In truth, I ran several baths were I stole Annie's Burt's Bees bubble bath and I really do think it made everything better.)


Everything has settled down (I think I may have simply eaten some food that didn't agree with me) and I'm continuing with my maintenance medication, Pentasa.  My GI said to up my dosage following my delivery, but because my symptoms are currently in-check, and I'm breastfeeding, I'm very hesitant to do so.  There has been very little research on mesalamines and breastfeeding (although it is certain they do pass into the mother's breast milk), but due to the drug's category B status, there is currently little direct evidence of side effects to the baby except for an increase in diarrhea, although I still feel very "iffy" about the whole thing.  I think it's all about a balance of what's good for her, and for me, and it's something I will discuss when I see my doc in a few weeks.


On Motherhood: I spoke to my boss the other day and said very succinctly, "I love her to death, but I don't think I'm in love with motherhood yet."  I know it sounds harsh (and I thought about whether or not to even type this), but these past few weeks I've just felt out of it.  I miss being a part of humanity (even the crush of my god awful commute at times!).  I miss walking around the corner at work for a cup of coffee.  I miss my alone time where I could cuddle up with a good magazine in bed.  And even though I'm getting a decent amount of sleep, I am exhausted. Now when friends reach out (often over Gmail chat) I slowly peck out my responses with one hand, as I'm invariably holding and feeding her with the other.  How comes no one writes about this stuff?


The last few days, though, have been an absolute ball of bliss and I'm so relieved: her personality is coming out more and more and I'm finally interacting more and more with the little bugger.  I'm learning her grunts (and no, she does not coo, but grunts like an extra on The Walking Dead, and it's the dearest thing ever) and yesterday she had a blast grunting at her reflection in the mirror!  She even smiled!  We dance and look at the Christmas tree (she is absolutely, positively transfixed by the lights) and I'm starting to finally feel like more than a feeding trough.  I think she's beginning to really know Matt and me, and by golly, I think she likes us!  I return to work on February 13th, and I can safely say that date gets harder and harder to think about each and every day, and I've already had a few crying spells about it: 13 weeks just seems too young to put a little one in daycare.  It doesn't feel right at all, but it's our game plan for now.


Well, time to feed (but of course!).  Later we may go on a Trader Joe's outing and who knows what else the day holds in store for us.  I do know, however, it will be wonderful: I'm loving these little moments with Matt and Annie (or Jo-Jo as he calls her).

Leech Baby!

I cannot tell you how many times I’ve been asked about my butt boil.  I’m truly touched.  My gluteus maximus is truly touched.  You have been so kind to us both!

So my butt boil (coded “boil of the buttocks” on my office visit receipt – I can’t make this stuff up) is a measly nothing compared to its former self.  My GI does not think I have a fistula and it was a freak occurrence.  I pray and shimmy my behind to the butt gods!  She warned me repeatedly about flare-ups post-birth, however, which is very common, and ordered some blood work.  Today she called me with the results, and I can only say the following: I have a leech baby.

“Your albumin levels are exceedingly low,” she said.  “My what?” I said.  “Your albumin levels.  And protein.  Basically your general nutrition.  Since you refused to get on the scale at your office visit, can you tell me how much weight you gained during the pregnancy?”  My response: “I’m not sure; I stopped looking about 1.5 months ago.”  (Hells no I wasn’t going to burden myself with that information!)  Her response: sighing (although I really do believe she was sort of tickled at my idiocy).  “Well,” she continued, “with Crohn’s and your surgery you’re already not absorbing enough nutrients, but now the baby is sucking everything else.  I’m sure the baby is fine, but I wanted to ask how you’re feeling.  It’s rare to see numbers this low.  I’m going to fax them to your ob/gyn.  It’s nothing to be terribly concerned about; basically, the baby is like a parasite, getting all the nutrients it can.  I’m very glad you got pregnant at a time you were feeling well; this is why you have to start off on the best possible footing.” 

My response?  “I have a leech baby!” 

I wrote this to Matt saying to feed me a Cornish game hen tonight with a side of steak.  His response: “With the baby coming we cannot afford that but I’m sure Penny will let you have some of her special lamb dog food.”  No one takes me seriously!

Now, I’ve been pretty tired the last couple weeks (this week it’s hit pretty hard), but that’s normal, and sleep is starting to be disrupted, and I’m busy at work.  I told Matt that I am surely the world’s most amazing pregnant lady since I’m not only pregnant, but pregnant with a leech baby, and still am out and about.  (He has yet to email me back after that one.)

Speaking of leech babies, our child has had many nicknames throughout the pregnancy.  There was “monster baby” when we thought he or she was going to be a ten pounder.  There is “alien baby” because we believe all newborns look like extraterrestrials.  Of course, “Cletus the Fetus” was a popular one.  The other day, after getting a higher heartbeat for the baby, I asked my ob/gyn if there was a cause.  “Did you just eat breakfast?” she said.  I said I had a banana and she said, “Oh, you must have a monkey baby!”  She then got terribly flustered and apologized about five times for calling the kid a monkey baby, and all I could think was, “Look, lady, monkey baby is probably the best thing it’s been called this whole time.”

Today our baby is considered full-term.  And I just can’t wait to meet that little sucker.

(Get it?!?!)

My Nether Regions Get A Lot of Action

I’m sick of being sick. Not anything like “woe is me” (although I have my moments), but I now have two conditions that involve the nether regions (if we’re including infertility), and by golly, there is nothing savory about that.

I am on progesterone supplements, or, as a woman of my standing likes to call: “vagina pills”. Classy. I insert them three times a day, one of the times in the mid-afternoon at work. Some people get coffee at 3 pm. I get down and dirty.

My latest ultrasound showed…nothing. No eggs (or, they call them follicles). Which makes me think: “Can a woman shoot blanks?”

It did show some scar tissue and small puddles of liquid from my Crohn’s. Now, instead of viewing my pelvic cavity as a desert, I tend to think swampland.

Due to my work trip, I missed a critical monitoring week, and have to start over again. This enraged me as my long cycles tend to transcend seasons, so at this rate we’ll figure what’s going on sometime near Thanksgiving.

Infertility is very easy for the guy – when did a guy ever bristle when he was told he needed to have sex? I’m sure even giving a semen sample is rather enjoyable. I hate men. They get higher salaries, more clout, and they can pee anywhere.

Oh well, I guess we get them in the end since we tend to live six years longer. Nevermind they can be lonely years in a body that doesn’t work too well. That’s what I cling to as I swagger to the bathroom with, yes, those vagina pills.

Patience Is Not My Strong Suit

I'm not really sure when the progression from playing house became full-blown adulthood. Living in our apartment Matt said being an adult is paying a mortgage, but three years ago when we acquired that monthly vestige of adulthood, he said no, no, it's definitely when you have kids. He had no answer for people who chose to rent, or chose not to have children.

But sitting in an office on Friday night, listening to a fertility doctor dictate a letter into his recorder about our case, I sat back, with my husband next to me, and thought, "So this is it; this is being an adult." At some point we crossed over: maybe it was then, or maybe it twelve months ago when we decided on having children.

I never, ever thought I'd be here. When I'd hear stories about failed IVF attempts, or women trying for years, I'd sympathize and think how lucky I was that woman trying wasn't me. But here we were, a year later, being told my ovaries were peculiarly small and Matt's situation wasn't looking too much better.

New words are entering my lexicon: progesterone supplements, FSH levels. IUI. I've been told so many times that "you'll be blessed with a child when the time is right" or "take a long weekend somewhere". These people invariably have children, and now, almost in a perverse way, I feel validated. No, it won't happen "when the time is right" or if we go away, and no, Godly intervention won't help either. Matt and I are pragmatists. We are not religious (although I've thought about praying but decided against it because if there is a God, he/she will surely realize what a selfish twit I am that I haven't prayed in 12 odd years, and all of the sudden decided only to smack my hands together for my own, baby-makin' good).

Above all, this is a medical matter. Ninety-three percent of couples our age conceive by the six month mark. Of those who don't, only 15% of those couples conceive in the next six months. Obviously, something is not right.

Our fertility visit was thorough. That really is the best way to describe it. We were there from 6:30 until 9:30 pm. Matt had his semen and urine tested, and I had an ultrasound, blood test, and an examination. We met with the doctor twice: before the tests, and after. I came with copies of my medical chart: details of when they first found the abscess deep in my gut, notes on my three months on Clomid, a write-up from my HSG. I told him about my Crohn's, about the scar tissue, about the surgery. When he said my ovaries were quite small for my age, and ruminated that perhaps scar tissue at one point had restricted their blood flow, I envisioned dried-up and hollow pea pods - a fertility wasteland.

We have many tests to do before determining next steps, and much medication to take. Writing about this now, I'm upset, but recounting it to a friend Friday night I laughed it off - of course we're sub-fertile, I mean, did I expect this to be easy?!

And sometimes I'm fine, it's all fine, and we'll make a go of it and trust ourselves to the shots, the blood tests, and all modern-day medicine has to offer. And other times I catch myself crying. A women I barely know had been struggling with having a second child for quite some time, and I saw her last week, but now with a swollen belly. It was at the gym, and my legs stopped swinging on my elliptical machine and I just watched her as she made her way to the locker room. And I felt betrayed.

I closed my eyes and told myself to just concentrate on Diane Sawyer on the television in front of me. To just watch her as she spoke about top kill, and the sheets of oil in the Gulf. I know that's a real tragedy, and not this.

But I couldn't help it, because infertility is a club swaddled in embarrassing emotion (jealousy, contempt, pity), and I was envious she was leaving, just as I was getting my bearings.

Thank You!

I want to thank all contributors and members of Team Gutsy. Last week was blustery and cold, but we managed to walk in the name of intestines to the tune of $830!

I want to thank my mom who encouraged me to join the walk, and who also volunteered her time to make the event a success. In truth, I almost felt silly walking because I've been feeling so darn good since my surgery a little over a year ago. But I guess that's the whole point, right?!

IBD doesn't have the societal clout of other conditions, and (okay, I'm stepping on my soapbox a little) I don't think people truly understand the havoc it could wreck, or really what it is (a bad tummy ache that makes you go diarrhea versus an autoimmune disease). Okay, I guess we can't ignore the diarrhea....there, I've said it!

Thank you again for supporting the CCFA. Many people I don't even know personally donated to a member of my family, and I to them I am truly grateful. Thank you, thank you, thank you. Of every dollar raised, 83 cents goes directly to research. We walked for the Lehigh Valley, PA chapter of the CCFA, and our little group of intestinally-challenged compatriots raised $60,000!

Thank you.

And NOW, the photos:
(All photos courtesy of Daniel Burke Photography)

See that dork in the black? That's me. My sister and her boyfriend are to the right. Matt's family followed (if you see the lad with the big hair, you found him).


Someone tell that person the trail is to their left; they may be lost.


I want THAT guy on my team! I bet he can teach me a thing or two about happiness. (And rocking red sneakers.)


You know, my dog Penny was there, so I'm not sure why these mutts got a photo opp and she didn't. (I know, I know...I'm a such a rabid stage mom!)


This woman looks absolutely FIERCE AND FABULOUS despite the gail-force winds. I'm in awe!


How the heck did I miss the face-painting?!?!


Thank you again, Team Gutsy!

"Take Steps" Against Crohn's and Colitis - Go Team Gutsy!

Members of Team Gutsy in 2009 in Philadelphia.

I often equate my surgery scar to a battle wound. Who knows if this is really a defiant nod to how badass I am (fine, there is nothing badass about me – today I’m wearing a lace top for Christ’s sake) or a coping mechanism when I look in the mirror. My scar is thick and grayish purple and digs in a few inches above my belly button to a good five inches below. A plus about being overweight? My belly button fat roll envelopes half the thing. When standing, it looks very much like a butt. With my abdomen swollen from fat, the hard scar is taunt, and the muscle sewed and skin stapled tightly. Because of this, my flesh drapes onward and outward, creating a very rear-end-looking front-end. And yes, Matt and I get a kick out of this.

Later this month will be my surgical anniversary. I will always have the scar, but it’s startling how time can heal the other undesirables. Time has also nurtured a sort of surgical ego, much to Matt’s chagrin. “Matt, do you know, like, I have this flippin’ 9 inch vertical scar, I mean, I had this OPEN SURGERY and they were scraping away in there and chopping my intestine up and I got up and WALKED by Noon the next day?!” “Yes, K, I know,” he would reply, sighing. But that’s never enough for me, because I would haughtily snort back with, “I don’t think you’re understanding this here, Matt. People who have LAPROSCOPIC surgeries often don’t do that!” “I know, K, you were very impressive,” he’d say, not looking up from his computer. “Matt, look at me! Your wife is HARDCORE! I know BOYS who don’t that! I mean, the pain of surgery was NOTHING compared to the pain before surgery.” To this, he’ll often try to change the subject, most often to what’s for dinner or saying the dog has to go out. And I obviously have not gotten over my rampant surgical egotism because I’m mentioning it right now.

I’m celebrating by fundraising and walking in the Crohn’s and Colitis Association of America’s “Take Steps” Walk in the Lehigh Valley, PA on Saturday, May 8th. This is the second year Team Gutsy will be walking. If you are in the area, I urge you to join us, or if you have an extra five or ten bucks lying around, I would love if you considered donating to the cause.

Visit Team Gutsy's page HERE.

Coming Home

Long time, no post, huh? I'm in San Francisco for business, and it's all much more sexy than it sounds (trust me). But I like saying that...."I'm in San Francisco for business....". I'll let it linger there on the tongue.

I do not have a job where I travel across the country, but by chance I am here, sitting in a hotel room (facing a highway and not the bay, alas), and taking stock of things. Traveling always puts me in a contemplative mood. I sometimes travel regionally for work and I relish the alone time. I think Matt does, too. You're never very alone with yourself and your thoughts in everyday life, you know? I like removing myself from my suburban life for a bit, even if it's just a late train ride from New York or a hotel in central Pennsylvania. I like missing home; it reminds me what good I have.

This trip is no different, and I needed to take stock. To breathe in. To exhale. I haven't had a deep breath in three months. I wish I dealt better with stress, but my body tightens and it's fight or flight all day long. And poor Matthew. Every night I cry and he looks on, helplessly. Matt is never stressed. It's a gift because I often am. But, he admits, he has it easy. He loves his job. He is in perfect health. Above all, he has the perfect wife (okay, okay, it's a joke!).

Stress and Crohn's do not mix well, but my intestines have behaved. Usually before a flight I run to the bathroom no less than three times, my nerves working their churning magic. I hate flying, and I hate the thought of limited bathroom access. But this week's flight I sat at the gate, eating my bagel and...was fine. This afternoon I have the window seat home. It's enough that my bowels constantly inconvenience me, but now I have to inconvenience two other people when I ask them to get up to use the bathroom? Those two innocent souls have no idea what they're in for.

I was at dinner with a dear friend last week. We talked about work, about my health, about my fruitless baby making, and how I thought I'd have more to show for myself by my late twenties. She is her early thirties and said, "I hated my twenties! Do you remember how depressed I was? I'm so much happier now." So now I think everyone has a late twenties rut, and agony likes company, right?

I'm enjoying how this trip put things in perspective and how much I want to walk through the front door. For me, that's where it begins, and ends.

27 going on 60

I am the only person I know, who, in their late 20’s, gets short of breath (in the bad way) when thinking of retirement savings. I can’t help it.

My co-worker Courtney called me neurotic as I sat fidgeting in her office chair waxing poetic about long-lost private-sector pensions. I recently found out about how lush teachers’ pensions and benefits can be, and have been nursing a mean jealous streak ever since (and the urge to ditch it all and become a teacher). I tell Matt things like, “We need a Vanguard account!” (Note: I know nothing about mutual funds or Vanguard accounts…I just like to say it). Matt tells me to, essentially, shut-up. “We have 40 more years to figure this out,” he says. The thought of working 40 more years is almost as depressing as our bleak financial future. Sometimes he says, “You might not even be around 40 years from now, so quit worrying.” (Lovely.) He follows that up with, “We’re young – who do you know who puts money into their 401(k) like we do?!” to which I reply, “EVERYONE!” and bury my face in my pillow. In a moment of panic this week I upped my 401(k) contribution from 10 to 15% and demanded Matt do the same. I also like to say we need a Roth IRA. I have NO IDEA what a Roth IRA is but I heard Suze Orman talking about them, and I want one.

Two weeks ago I announced, over omlettes, that we needed a budget. “We need to control our spending!” I huffed. Mid-chomp, Matt said, “What spending? I don’t buy anything,” to which I replied, “Well, I do.” We then logged on to view my credit card statement and, after subtracting things like food and gas, I was left with what I spent on a skirt and dress and some odds and ends I picked up at Target. I replied that they were obviously necessities and they didn’t count, but the crux of my argument was that, “You’re a guy; you wouldn’t understand”, which I don’t think he bought. So much for our budget.

I wouldn’t call us particularly thrifty, and we’re definitely not spend thrifts. We’re just…normal. I will forever be a champion of economy cars and the thought of having a Coach bag just ticks me off, but I love going out to eat and furnishing our home (relatively cheaply, of course). And damnit, if that frilly skirt is $100 bucks but I swear, swear, swear I’ll wear it all the time and I love it and I won’t buy another thing that month, then YES, I’m buying it. Look, it’s all about balance. And a good skirt.

I bring this up because I also worry about medical expenses. For example, like many of my surgical Crohn’s brethren, I have to bear a monthly B12 shot for the rest of my life. The negotiated rate with my insurance carrier (I am on a high-deductible plan, so I essentially pay in-full until I meet my deductible, but all “in-full” prices are the negotiated and preferred cost through the carrier) is $156. One hundred and fifty-six dollars for a shot of …a vitamin. Per month. Negotiated rate. The “negotiated” rate for Pentasa, my maintenance drug, hovers slightly under $500 a month. So, yes, I worry about money. And insurance. I think I should.

It is a bad thing to have Crohn’s and be a neurotic worrier. Stress makes my symptoms worse. And duh, stress also inhibits your ability to conceive. Last month my ob/gyn told me I need to reduce my stress. This statement elevated my stress. Couldn’t she see that was futile? That I’m having trouble with work, with trying to had a kid, and by golly, with the fact we have no retirement savings and no solid plan in place?! I thought that but all I said was, “Okay.” That’s pretty much how it always goes.

Matt will often sit me down and say, “What can I do to help you relax?” The first answer is always food. Tortilla chips or chocolate are often involved – but that really goes without saying. After that, it gets a bit grey. I’d like to believe I’m the least high-strung member of my family – it’s in the genes. But I ask for impossible things. Past answers have been, “New intestines and/or immune system”, “my own dog hotel business” (no laughing!), “you making 200k a year or winning the lottery”, and “a 30 minute back rub” (trust me, the last one is impossible). He’ll respond with, “Well, what about one of those puddings in the fridge?” “With whipped cream on top?” I’ll ask. “Yes.” “Deal.”

Now if you’ll excuse me. I have to go study for a test I have tonight that I’m worried about.

PS: You may have noticed (well, probably not, who am I kidding?!) that my posts have been less frequent. I’m enrolled in a class that will hopefully prepare me for a professional certification exam I’m taking in May. It would be a lie to say I have no time to post, but I love to watch t.v. on my time off. I adore t.v. I am nothing but an uneducated commoner, what can I say?! Posts until the end of May might be less frequent, but don’t worry, they’ll still be filled of my complaining (about health care, money, oh, you name it!) and of course food (that’s a given!).

YAAAWWNNN

No one really talks about the general fatigue that accompanies Crohn’s. Now, granted, I am lazy (incredibly so, at times, as my laundry has sat on my floor for 2.5 weeks now), but ever since college I’ve felt more tired than usual. This was before I was diagnosed with Crohn’s and simply thought I have a very sensitive stomach. In the following years my symptoms worsened and could no longer be ignored, and I was diagnosed about a year after I graduated from college. But in school I recall going to my mother’s doctor – who I never had a particular fondness for (okay, my sister and I think she’s a witch) – and explaining I’d been feeling terribly sluggish and she essentially said it was in my head and to lose some weight. Lovely.

And it’s difficult to understand a disease that isn’t visible, and may even be controlled and in remission. I look fine, and recently I feel fine, but I’m often just, simply put, very tired. And I’m not talking about the exhaustion that comes along during a flare and you’re flat wiped out (but that too). I’m talking every day, excuse-me-while-I-yawn, a-good-3.5 hour-nap-in-bed-would-be-nice, how-am-I-going-to-get-through-the-workday tired.

This past week I’ve been wiped out. I come home, put on pajamas, and lay (lie? I never got that one right). I’m stressed, and thus, utterly exhausted. This blog post is not well-written: I cannot even muster the energy to pop in a witty quip! So it goes without saying I am completely excited that we’re having a big snow storm tonight. My bed is fitted with flannel sheets, I have silly glossy magazines galore, bad t.v. to catch up on, and I have all the fixin’s for potato and leek soup and homemade bread. I also just enrolled in a course to prep me for a professional certification and have 200 pages to read on labor laws and risk management this weekend. Sigh. I’m hoping the warm bread and the flannel sheets make up for it.

Have a terrific weekend, all. Snuggle with someone you love and have a cup of hot tea. Also, some delicious recipes are coming.

My arch nemesis

In my last post I said I had ice cream all weekend with minimal bad side effects. I AM A FOOL! Ice cream has done me wrong yet again. As I sit here, moaning, I've decided no more ice cream. Ever. But damn if that Moose Tracks wasn't the best darn thing I've had in weeks...

PS: By "forever" I mean a few months. Tops.

We're gonna need some industrial strength Draino in here!

Note: I am delving into my journey (and I guess that’s what it will now be called) to have a child because my difficulties are, in part, related to my Crohn’s. No more, no less.

I’m going to try to avoid any further Draino references…but it’s hard. Yesterday I had my HSG. You know, the test where you the doc shoots some dye up through your cervix and down your fallopian tubes to ensure they are clear and an egg can travel down to (hopefully) be fertilized. First off, I would like to say the radiologist was beautiful in a “I’m a 2nd year resident and a little awkward but I’m tall and endearing” sort of way. He had me at “Hello, are you Ms. Hopkins?”, and if I were not married (oh, and trying to have a baby), I would have surely made sure to glance at his left hand to see if he was married. Secondly, my fabulous doctor asked if I’d mind if her med student watched the procedure. Maybe some women would balk at the thought of lying naked (from the waist down) on a table with your legs spread and a 24-year-old boy watching, shifting his weight from one foot to the other. But that is not me. “I have Crohn’s: there is no indignity I haven’t faced, so no problem, bring him in!” I said theatrically with a swish of my arm. So it was me spread eagle, a petite little radiology tech, my doctor, the goofy-looking (sorry, Brendan – that was his name) med student, and the gorgeous (in the nerdy way I like) radiologist. The more the merrier, I say. Of course, I immediately got down to business and asked the really important question: “Will this hurt?”

“You will have bad cramping – and you won’t like me for a bit – but it’s over in a minute,” my doctor replied. That would have been fine, but the woman lied. First they insert the speculum and then they wash your cervix. This is cold but no biggie, and women who have had children are probably thinking, “Get over yourself, sissy.” Fine, I deserve that. They then attach a big syringe-thing (I know, you’re like, “Where did this woman learn all this medical jargon?!”) into this long metal thing and insert it so the tip is through your cervix. Still no biggie. Then they say, “Okay, we’re starting” and start releasing dye into ye ol’ tubes. This is when I screeched, “You LIED!!” to my doctor, “This hurts!”. The rad tech was patting my shoulder and saying it was just another minute, and the radiologist had the x-ray machine above my pelvic area and was snapping photos. Everyone was looking at the screen and saying, “Oh, look at that, it filled beautifully” (thank you), but then, “I don’t see anything in her right tube”. Upon not seeing any dye they pumped more in and I am not lying: I have never felt worse abdominal cramping. My abdomen felt like it was expanding and contracting and it was very reminiscent of my severe Crohn’s episodes that sent me to the Percocet. I’ve heard this test is no big deal, it doesn’t really hurt, so I kept my mouth shut this time. After all, there was a cute radiologist in my presence – no need to make a scene. (Later in the day I read it is indeed painful if there is blockage, so I feel somewhat validated for my outburst.) In about a minute it was over – but the horrible cramping persisted for the next two hours or so – and I got my verdict: One of my tubes is clogged. I have a dud tube. (These are my words.)

The fallopian tube that wasn’t functioning is probably scarred and blocked by scar tissue, which may have been present long before my surgery, or not, due to the rampant inflammation in my pelvic area. I got off the table – blood trickling down my leg (“spotting” is normal after an HSG) – and got dressed. And this is the upshot: We are waiting for the results of my Day 3 (as in cycle) blood work – taken last week – and Matt’s, how do I put this?, oh, yes, semen analysis. If both are normal (I am indeed ovulating, and Matt’s sperm can indeed swim), I will be put up to three months of Clomid, which is a fertility drug, and if that doesn’t work, I will leave my ob/gyn’s care and go to a fertility specialist immediately. If any of these tests come back with a “hit”, we are going directly to the fertility specialist. She said if I do get pregnant on Clomid, I am a high-risk pregnancy because of the Crohn’s, but more particularly, because of this dummy of a tube (again, my words). Apparently, my chances of an ectopic pregnancy are much greater, so I will have to be closely monitored for the first few months. She said the fertility doctors may want to remove the clogged tube proactively due to the risk, or look into attempting to repair the tube – and remove the scar tissue – laparoscopically.

I got into my car and called Matt. Because he is Matt, he took this news as good news: “Hey, you have one good tube!” he said. We have dealt with so much disappointment, things like this aren’t wholly bad news, and in reality, it isn’t. One functioning tube is huge, and with fertility meds, can be as good as two. But I see it as the beginning of another round of tests and doctors (and possible surgery) and a whole new set of concerns. Hell, I’m frustrated. I'm sad. And very bitter than men do not have to go through this. I have also caught myself, with black mascara tears running down my face, saying, “I hope women who can easily have children realize how fortunate they are!” with rancor in my voice. This is when Matt tells me to calm down, and it will happen for us…eventually. He then asks if I want some chocolate or candy, because, like a child, I am pacified by sweets.

So now I’m just waiting for our other test results. I want to get a move on – get started on next steps, and get “Operation Baby” underway. Until then I suppose I’ll simply look in envious adoration at young families at the grocery store. With that said: someone please keep me away from Babies ‘R’ Us.

Those averse to bathroom talk, please beware

Recently, before the holidays, my work employed a quaint little exercise in lieu of gift-giving. Everyone in our department had an envelope on our desks, and we were each given blank index cards which equaled the number of co-workers I have. We were to – anonymously or not – write what we enjoy about that person and any holiday wishes, and slip it into their envelope. Definitely a bit hokey, but well-meaning, and I was the first to write out my cards and slipped them in their assigned envelopes. I did mine anonymously and most of mine were short, sweet, and to the point, even goofy at times with things like “You simply have the greatest head of hair ever!!” or “You’re a wise guy, and that’s definitely appreciated (well, mostly)” and “You’re absolutely terrific, but I don’t know about that dog of yours!” for a co-worker who regales us with tails (typo on purpose) of her very neurotic dog.

A few days later my co-workers began filling my envelope and they wrote the most beautiful, prosaic compliments and filled the card (I instantly felt ashamed as I obviously didn’t comprehend the scope of the exercise and was immediately pleased my cards were anonymous, which was short-lived, though, as everyone else signed their name making the anonymous perp very, very obvious). One of the things that almost every single person wrote (out of about 15 or so) was they enjoyed how I “say it like it is” and was so “genuine and candid” and they enjoyed my sense of humor. It was all very sweet: and a narcissist's dream (which I hope I am not, but I still reread them all at least five times), but I wanted to open this post with this story because I was hedging on whether or not to write about my next topic. Then I remembered I had already written about workplace bathroom etiquette, the very personal longing to have a family, and now, how my colleagues have encouraged my candidness, so I’m going to dig right in and discuss. By “it” I mean FLATULENCE. Oh, and farting. And all of that horrific bloating and distension that accompanies Crohn’s. (Do you see why I was a tad hesitant at first?)

I bring up the bloat because I was terribly gassy the other day. The type of gasiness I had to tell everyone about (because, obviously, everyone likes to share how gassy they are). First I emailed Matt and said I was “going to die in a horrible explosion” due to my gas. He gets this a lot and wrote back “Poor K.” That was it! Because I didn’t get the pity I was in search of, I thought about telling my co-workers but (rightly) hesitated: I have already been accused of TMI (“too much information”) because, well, I tell it like it is and a few months back started a diatribe against women who get Brazilian bikini waxes and the men who like them. (Look, you have hair there for a reason…it’s called chafing!). Now I just embarrassed my own parents, but I will stand strong!

Dealing with gas at the workplace is a nuisance. How do you safely, discreetly, “discharge” of the this gas? Just as importantly, how does one discreetly unzip their skirt so a big, fat stomach can breathe? Don’t kid yourself: these are major issues that demand answers.

About five years ago, relatively early in our relationship while living together like the sinners we are, Matt devised a procedure for eliminating gas that we simply call – to this day – “The Procedure.” When I complain of the bloat, he simply says, “Do you want to do The Procedure?” This is where this post gets tricky and you may never look at me again the same, or revisit the site. (But you’ll be missing out on a lot of top-notch knowledge like The Procedure.) This is important stuff, and The Procedure is nothing to joke about. Also, I swear that I didn’t come up with this…it’s allll Matt.

This is what you do: the person who is having the gas attack lays on their back on the floor, legs up in a V shape. Their partner (and really, no one other than your partner should be told to go through this…like the vows said….”for better or for worse”) grabs both ankles and pushes the gas-o’s legs back, toward their head. This creates the perfect positioning for eliminating excess air. The person standing can also rock the person’s legs back and forth, building up gassy tension. Like I said; this was all Matt’s idea.

Now don’t look at me and say “eww”. I do this in the privacy of my own home – never right before we have visitors…come on, I have some manners!—and everyone has excess gas occasionally. For us with Crohn’s, it can be frequent as our intestines are inflamed and narrowed. Really: since my diagnosis, my frequent farting quotient has sky-rocketed. I know it’s not “womanly” and “becoming”, but neither are any of the other elimination methods the body employs. Sometimes you just have to help your poor torso along.

I have a friend—who lives in a small space with his significant other—who has never smelled his partner’s eliminations. While I respect some mystery in the bathroom, this baffles me. I am also sort of in awe. You see, not only does Matt do the procedure with me, but either one of us will use the bathroom while the other is in the shower. Or, when Matt has to use the bathroom, he’ll very debonairly say, “I have to poop!” and skip off (or shuffle, but it’s usually said with a certain glee and a bounce in his step…he’s an odd one). Afterwards, he’ll often regale me with tales of his “best poops”; the ones that nary required toilet paper (I suppose, this is very much like a dog, but this has never happened to me).

I don’t write this to embarrass myself, or embarrass Matt (maybe a little bit of the latter), but to continue my quest to just “say it like it is”. We all – Crohn’s or not—get gassy once in a while, and while the human body is a beautiful machine, it does have its eyebrow-raising moments.

I want to dedicate this post to Matt – my partner in crime – and, last but certainly not least, Gas X. Thank you for all you do.

Another year, another issue (also known as "Intimacy with a speculum, part 2")

It's almost my blogiversary! I started this blog in January, late at night, crying, in pain, mad and a little defiant. Now it's morning on Christmas Eve, and I'm not in pain, but still a bit mad and defiant. Some things never change (like the fact I once again ate leftover truffles for breakfast....oh, Kathryn....).

The focus on the blog this past year was my deciding to have my first Crohn's surgery, the preparation for that surgery, and my recovery. Now it would be a sham to write about any pain: I'm feeling pretty terrific. I have my good and bad days, and skipping to the bathroom will be a forever indignity, but I am blissfully pain-free. Because of that, and knowing this wretched little disease has a nasty cyclical nature, Matt and I decided - with the encouragement of my GI, surgeon, and ob/gyn - to push our "let's have kids!" timeline up by a few years and start at the ripe old age of 27. I never once thought I'd want a baby in my 20's (the expense! the sleep deprivation! the utter exhaustion!), but once I make up my mind about something, there's little else I think about, so let's take a deep breath and get going, shall we?

Which brings us to now. For a girl who talks about defecation, her ass, and all the naughty bits in between, I still gave pause to writing about sex (yikes!) and procreation: poop is funny, but making a baby is something you do behind closed doors (well, I guess pooping is too, but come on now, it's still funny). But, because nothing is easy, and I possess little to no decorum, and Matt gave his blessing, and ah, yes, this is Crohn's related, some posts on this blog will now focus on the anticipatory song and dance of trying to conceive. Let me explain:

Yesterday Matt and I went to the ob/gyn. (Insert your own joke here.) I was ready to go into battle. I was ready to lay it all out on the table and say, due to my situation, we should "look into things" before the usual "one year of trying". As soon as I said "scar tissue", "six months", and currently "feel well", she was writing out four scripts. Suffice it to say, I love this doctor, plus we share the same first name, so extra kudo points for her. I also was feeling a bit hypocondraticy (I know that's not a word, ok?) but now feel validated. (Last year when I wasn't feeling well I ignored it for a month, while chugging OTC pain pills, and look where it got me. So now I run for the hills when I get a cold.)

First, Matt is going to get tested. Strangely, Matt was very excited about this, and immediately said to me, after the doc left, "I'm gonna ACE this test!" So basically they're going to test how many sperm he has and their mobility and all of that, so we can finally put to bed whether they're "lazy" or not. Matt said they have the speed and agility of Michael Phelps. I said only after he was caught smoking marijuana. So we'll see.

Next, I have two blood tests: pre and post ovulation. On top of that, I'm having an HSG done, also known as a Hysterosalpingogram. Say that ten times fast. Basically, in the hospital, they shoot dye up your yahoo and make sure it can easily flow through your tubes and scar tissue is not blocking the way. Because I've been told I have a lot of scar tissue down there, and my abscess was wedged on one of my Fallopian tubes, there is some cause for concern. If those babies are clogged, then we may look into surgery or IVF. The blood tests will confirm that everything is working properly and I'm ovulating. If things are functioning, then we might move to Clomid, which increases egg production. Basically, there are a lot of "if's": it's very reminiscent of last year.

A colleague, who has gone through all of this, told me to get ready to "be naked and have your everything out there for everyone to see" and that it "hurts". I told her she's obviously never been to a colo-rectal surgeon, and while some women fear their yearly pap smear, it's vacation-time for me (last year, we had a very nice conversation on Northern California's wine region during my exam, thank you very much). A speculum in your vagina is one thing, a speculum in your you-know-what is another ballgame entirely. I lost any sense of shame many years ago. Trust me on this one.

Although I joke (come on, how can you not?!), I don't take any of this lightly. First of all, it's sobering that I didn't have to talk my ob/gyn into taking investigative measures: she obviously sees that there can be a problem, here. Secondly, if there is a problem, the cost of fertility (and I'm talking in the most literal way) is mind-boggling and not covered by insurance. The same women who told me about the HSG also spent over $30,000 last year on fertility treatments...and has yet to conceive. So, "yahoo" jokes aside, no, I don't take this lightly.

I know I'm opening up myself for ridicule, but that's nothing new, but if I have a very typical case of Crohn's, then perhaps other women with the disease are having tough times conceiving, too. Heck, maybe I'm fine, and I'll get pregnant next month. I don't know, but I'll be sure to take you on the ride with me, speculums and all...

Thanks for reading.

Nuthin' like like some early-morning B12

So I'm still waiting for this supposed energy I should acquire after getting a B-12 shot. Where is my energy, damnit?! I should be leaping tall buildings by now. Instead I'm sitting at my desk wondering why I have heartburn.

This morning I received my fifth B12 shot. It's a minor - albeit forever - inconvenience. Your terminal ileum is the only part of your body that absorbs B12, which is necessary for "normal functioning of the brain and nervous system, and for the formation of blood" (thanks Wikipedia!).

Because I had the whole of my terminal ileum removed (plus some) back in April, a blood test a month and a half ago showed I was B12 sufficient. Since then I've been off to my PCP for early-morning shots. I received a shot every week to get my liver stores up, and now am on monthly maintenance. Shots are necessary - the pills just don't cut it.

On the Internet, B12 enthusiasts claim it gives them loads of energy, and can even assist in weight loss. I emphatically say both these claims are untrue: I'm pudgy AND tired. (Again, let's ignore my nacho habit and lack of a regular sleep schedule.)

What I'm wondering is this: Does anyone do home B12 injections? Since it's something so benign, and I'll be doing it forever, I thought I'd ask. I also want to freak Matt out with my sharp needle.

A big thanks

I go to the gym and meet with a trainer weekly. I’ve been doing this – off and on – for almost two years, and the reasons are twofold: 1) She yells at me when I haven’t been to the gym for the rest of the week (which is often), and 2) I’m trying to be healthier (I’m proud to announce I now have muscle under my fat instead of just more fat). She has this powerful truth-telling force that makes me mutter all the unmentionables I’ve been eating. Friday morning I spilled to her about the Illini Bars and a late-night nacho feast I had last night…after a work event that included dinner and dessert. She chewed me out and then commanded I bring her a brownie from my next batch. She calls me grandma and asks if I brought my Geritol as I schlep my sweaty body from one machine to the next. She’s a petite wisp of a woman who could, with no doubt, take me out…without breaking a sweat. She’s not afraid to say you look puffy. Simply put, I like her.

So I was at the gym Friday morning (we meet at 6 am - the ONLY time I go in the morning is when I have to meet with her; I originally chose a trainer who only does mornings so when I quit – which I knew was 100% inevitable – my flabby ass wouldn’t have to run into them later in the day) and I realized, “Holy smoly, it’s been a year since I was admitted to the hospital!” I was in the gym shower, dancing (dancing!) to “Don’t Stop Believing” by Journey (oh, just try not to dance to the most spoofed song of all time) when I realized this. In a lot of ways this moment was a revelation. I was dancing at 7 am – when I had gotten up at 5:15 am – after a work-out…and I don’t dance (well, at least not sober). So I took notice of this moment – caught myself in it (don’t you just love when you do that?) – and although things aren’t perfect, dangit, I feel GOOD. I was first admitted to the hospital on November 14, 2008.

I had been feeling sick for two months prior being admitted. First it was constipation-like symptoms, which of course was all very foreign to me (on occasion I have snickered at Metamucil commercials). Then night sweats. Then horrible pain deep in my pelvis. To make a long - and very Crohn's typical - story short, I had a fistula, large abscess, and some nasty looking bowel. Via TPN and daily bags of antibiotics through my PICC line, I delayed surgery to this past spring. If you're followed the blog since then, I started in January, after a healthy holiday reprieve, when the pain returned and I had to decide if I wanted to first try biologics, or surgery, knowing surgery can be a slippery slope. In my typical melodramatic fashion, I agonized over it for months, until something had to be done. In retrospect, surgery was the right choice. My surgeon and GI confirmed the foot of intestine they removed was not salvageable.

I'm mentioning all of this because I know my blog hasn't been strictly (or even, loosely) Crohn's related as of late, and I want to explain. I know I'm posting devilish recipes. Or relaying silly stories. But I believe this is the life-cycle of a Crohn's patient. I know I am very fortunate that my surgery has given me relief. I know this can end tomorrow, but what's the sense in living like that? Yes; pains give me pause, but I'm learning to live in the moment, and keep myself healthy. I made the decision to no longer pursue my MBA (nothing tragic there; I was one course in), but why add additional stress when I know it's a trigger (my first class ended right as my increased symptoms started). But it was hard to make this choice as I saw colleagues excel or better themselves.

Posting that zany story about my ill-fated walk in Valley Forge Park, or trying a spinning class, was a triumph for me. A year ago (and as little as about six months ago), I could not walk erectly as the pain was greater: I hobbled, my back hunched. And forget about a spinning class.

Oh, and there's the icky things too: I avoided wearing light-colored skirts or dresses as I had nasty and painful fissures that often bled as I made my seventh trip to the bathroom. I took to wearing extra-long menstrual pads daily.

So now it's time to celebrate the triumphs. I'm not disgusted by my thick, violet scar from surgery - it's a damn sexy battle wound and has become just as much a part of me as my belly button. (But I will not lie, I am slightly jealous of my friends three-week-old C-section scar that is barely visible, so kill me). I'm happy that I can, within reason, eat my favorite foods again - curry and all. I'm happy that I can have an early-morning work-out, and then have enough energy to dance in the shower, and feel nothing. Glorious, glorious nothing: there is not much better than having your body function as it should, and not feel it so pathetically struggle.

I've been humbled by reading my fellow Crohn's bloggers' stories; I know I have it good right now, but I won't be happy until we're all eating buttery popcorn, or even dancing in the shower to Journey.

Thank you for reading: then...and now.

******

(In my typical cheesy fashion, I've included a live performance of "Don't Stop Believing", below. Admit it!; it makes you smile....but MAN, those are some tight jeans...cough, cough...)

Your last meal?

What would you want your last meal to be? Pecan-encrusted pork chops? A little too frou-frou, uh? How about something that shouts egalitarianism from the rooftops, say a burger and fries? From McDonalds, of course. And add a shake, too.

Scratch that: let’s load on the sweets. Since it’s November, we’ll include all the pies (pumpkin, pecan, and apple to start), and maybe a decadent chocolate cake. Homemade buttercream icing – definitely.

In an era of nothing being too taboo and everyone being wholly irreverent (which I relish, if you haven’t realized), an article on Slate made me drop my soup spoon during my lunch break. It talked about death row prisoners’ last meals: can they really order anything? What do they choose to eat? Nothing was remarkably surprising about it: many chose filet mignon or, indeed, a burger and fries. The filet mignon often resulted in a hamburger steak, and the guy who requested 24 tacos was given four. Basically, if the kitchen could make it, it would, and improvise when necessary.

I am vehemently against the death penalty (for matters practical and those not so tangible), but whatever your politics, the article – and the links in the piece*—were startlingly sad for a Wednesday afternoon. What if you were the cook preparing the last meal – who were often prisoners themselves: would you add extra butter and substitute the skim milk for whole (and what does it matter now)? Add a garnish to the plate? Say a prayer as the plate was covered and brought to its final patron?

This wasn’t supposed to be a treatise on last rights, the judicial system, or any of that: I want to talk about food. For someone saddled with Crohn’s, I adore food. Right now I’m dreaming of roasted vegetables (pass the rutabaga, baby) and think there are few things more delicious than a Cortland apple or a chewy brownie with cold milk.

My last meal wouldn’t be anything fancy, but quietly forbidden in its own simple way. I would have a mound of spaghetti with fatty meatballs and the richest, most tomato-y marinara know to man, with buttery garlic bread. For dessert, I would have a sample: tiramisu, crème brulee, and chocolate truffles. If eaten today, this meal would leave me bedridden. Anything fatty is a deal-breaker and makes me run for the hills (correction, I would only stiffly walk to the hills, and only if a bathroom was located there), so the ground beef is a no-no. I think the garlic bread slathered with butter speaks for itself. Acidic tomatoes are a nightmare, and the desserts? White sugar and fatty cream (oh, luscious luscious cream) are toxic. (And boy oh boy, I love and eat all of these things a little more than occasionally.)

Crohn’s be damned, what would your last meal be? Please leave a comment for a hungry girl!

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*The article has links to the state of Texas’ correctional website, which records the final statements of inmates, which were strikingly sobering. Some inmates reiterate their innocence. Almost all denounce what they did and allude to God. The most unsettling statements say, “Warden, I’m done now” or “Warden, I’m ready”. I don’t know why I read so many – it’s the worst form of voyeurism I guess – but definitely thought-provoking.

Houdini Hookworms

Nothing says love like a hookworm.

This is a 100%, genuine Crohn's-related post - I swear!

Okay, so you know how Matt gets these crazy ideas in his head? Well, if you don't, just go with it. The other week my darling husband was listening to Radiolab (which he loves quite possibly more than yours truly) and heard an interesting story of how parasites can we used to cure folks with autoimmune diseases. Actually, let me be more graphic: parasites in the form of gnarly, grotesque HOOKWORMS. He then lectured me (the boy thinks he's a parasitic expert or something) on how this fringe of (deranged - I added that) people who had all sorts of autoimmune conditions infected themselves with hookworms and then, magically, went into remission (if you want to be all scientific about it, it's called "Helminthic Therapy").

He said the podcast spoke specifically to colitis and Crohn's. He then emphasized (a bit too much) how we could "just order them on the Internet". Them being the HOOKWORMS. I'm, sorry, I can not go easy on the caps when I'm speaking of such creatures. He actually said the following: "You know, I bet I could infect you with HOOKWORMS and you wouldn't even know it." He then stomped around and got irritated when I curtly said I would never, ever, EVER, infect myself with a wormy parasite. He then said I was being irrational and I could be cured. So, thank you, Radiolab. Really. Because this song and dance has be going on for three weeks now, and I swear the boy is spending late nights Googling parasite farms.

And if I open a jar of hookworms on Christmas, so help me God...

*******

UPDATE: Just saw how my Crohn's blogging compatriot, Bright Side, touched on this subject a few hours ago! I guess it's just a wormy sort of day.

Trials of TPN

This post isn't supposed to be about my pseudo-pathetic (fine, fully pathetic) quest to find more friends, but I will say last night's dinner went quite well (I think? I hope? Hopefully they feel the same way). It was good to get out, and talk to someone other than the dog (although she's always a wonderful, if stoic, companion).

********

I saw this on another Crohn's blog, and am shamelessly stealing. What? You think I should come up with original content or something? I'm a busy girl (stop snickering).

Okay, so this is an essay that appeared in Esquire magazine recently about a man's struggle with Crohn's, and being on TPN. TPN, for those not in the know (and who would know, except us sorry Crohnies?) stands for "total parenteral nutrition". I was on TPN for several weeks in November and December of last year after my bout in the hospital for my abscess. With TPN, you acquire your nutrients from a milky bag of vitamins, calories, and proteins that is pumped into your veins throughout the day. It is a lonely and solitary experience, as the pump churns and sputters for hours on end, often clogging when you inadvertently sit on your line or kink it as you shift your weight. With so much fluid going into my body, I had cold night sweats and semi-hourly-nighttime bathroom visits, where I had to lug my bag of nutrients, and my battery-operated pump, to the toilet with me. Prepping to hook myself up to the TPN was a ten-minute medical ordeal of sterilization (everything had to be clean as you had an open port to right above your heart, where the TPN was pumping). When I wasn't pumping TPN into my veins, I was hooked up to antibiotics, all in a vein attempt to further decrease my orange-sized abscess, which was nestled between mounds of gut and my pelvic bone.

I was on TPN no longer than three weeks, and my total time on TPN/clear liquids a month. This man was on TPN for two months, with no clear liquids - a sentence I can only imagine.

Enjoy.

The Man Who Couldn't Eat

Crohn's Questions / General Observations

General Crohn's questions/thoughts:

Question 1:
Does anyone else feel worse as the day progresses? I'm usually good in the morning, and then start my bathroom trips in the afternoon into the evening. At night, my abdomen often feels quite sore as I lay down. Of course, my digestive system has had a rest in the morning from the sleep the night before, and I suppose the PM BM breaks (oh lord, I'm so not witty at all) are because I'm eating again for the day (breakfast, lunch, and so on). It's just a daily vicious cycle.

Question 2:
Because you go to the bathroom a lot, are you hungry a lot? (I like to attribute my very manly appetite to this.)