Advice for additional vitamin intake

[Skwinty]

Yes, she has an ileostomy.
She has about 2 maybe 2,5 m small intestine left.

She is not on medication and has not been on medication for many years, so I guess the original diagnosis was ulcerative collitis.

To give you a better idea of what happened, when she became sick, she went to a naturopath. This was before I met her.

The naturopath kept her at his clinic for a week trying to heal her with his natural products.

Eventually her sister forcibly removed her from the naturopath and took her to hospital.

She weighed 22kgs on arrival and after a few days and many litres of blood and fluids she weighed 32 kgs. She spent about 4 months in hospital.

She was 28 at the time. This was in 1987.

 

[Skwinty]

Please, I have stated a few times now that my wife sees a medical doctor on a regular basis and this thread is about my education.

I do appreciate replies, but for goodness sake, please stop telling me that if I cared for my wife I would take her to a doctor.

I apologise if my original OP led you to believe that I was trying to play doctor here at home.

I do administer her intra muscular injections, but I have been trained to do that.

When I met her in 1994 she had already recovered from her operation and has lived a normal life since.

 

[JJM]

Please, I have stated a few times now that my wife sees a medical doctor on a regular basis and this thread is about my education. ...

I took it that way, and I especially thought that the comment about Jenny McCarthy was out of line. I think the education was that this is a situation with no generalities beyond, perhaps, get a second opinion if you are not sure the doctor is being thorough. My health care plan has provision for a nurse to consult, and I think she would help arrange a second opinion; and I know my brother's (different) plan does so. Or, perhaps it would be enough to bring the problem more forcefully to the regular doctor's attention.

Best wishes for the two of you.

 

[Emet]

I have read that Ulcerative Collitis and Crohns are psychosomatic diseases, is this a correct description?

IANAD, but at least according to the following web sites, I would say no. (or perhaps unknown)

Ulcerative Colitis
Many theories exist about what causes ulcerative colitis. People with ulcerative colitis have abnormalities of the immune system, but doctors do not know whether these abnormalities are a cause or a result of the disease. The body’s immune system is believed to react abnormally to the bacteria in the digestive tract.

Ulcerative colitis is not caused by emotional distress or sensitivity to certain foods or food products, but these factors may trigger symptoms in some people. The stress of living with ulcerative colitis may also contribute to a worsening of symptoms.
http://digestive.niddk.nih.gov/ddiseases/pubs/colitis/

What Causes Crohn's Disease?
Although considerable progress has been made in IBD research, investigators do not yet know what causes this disease. Studies indicate that the inflammation in IBD involves a complex interaction of factors: the genes the person has inherited, the immune system, and something in the environment. Foreign substances (antigens) in the environment may be the direct cause of the inflammation, or they may stimulate the body's defenses to produce an inflammation that continues without control. Researchers believe that once the IBD patient's immune system is "turned on," it does not know how to properly "turn off" at the right time. As a result, inflammation damages the intestine and causes the symptoms of IBD. That is why the main goal of medical therapy is to help patients regulate their immune system better.
http://www.ccfa.org/info/about/crohns

I stand ready to be corrected, as again, IANAD.

And best wishes to you and your wife.

 

[rjh01]

Does anyone have any links or good books for Skwinty to read?

If you want a good education that maybe you could go to a library, maybe one on a medical campus and read up on your wife's condition.

 

[ria_rokz]

I'm not a medical expert, but I understand the fatigue issue. Has she had her vitamin D levels checked lately? I'm not sure what's available where you live, but here Vitamin D comes in drop form so it can be put into water or juice or milk. It is more expensive than the tablets but I suspect it's cheaper than sprays.

 

[This is The End]

Obviously the following does not dispute the aforementioned discussion of internet medical advice versus seeing an authorized medical professional but:

I wonder how many of the people saying "just go see another doctor" live in a place where doing so doesn't cost a couple hundred dollars.

 

[fls]

The reason I brought up the slacker issue and fatigue, is because she has counselled many other people who have or are about to get a colostomy bag and many of them can't function normally.

Ie, they do not go to work and spend most of the time sleeping.
Now, I am not saying they are slackers because I don't suffer from the disease and so I am ignorant of the symptoms.
Please don't get me wrong here.

I just wondered about the connection between fatigue and suggestion.

I have read that Ulcerative Collitis and Crohns are psychosomatic diseases, is this a correct description?

No.

There are associations between exacerbations or flares of Inflammatory Bowel Disease and stress. But overall, it has little to do with the course of the disease.

Fatigue can be a symptom. In particular, it is associated with active (as in inflammation is present) disease, so it wouldn't be a surprise to find that those people who are in a more active state are less functional than your wife.

I do know that she responds well to the B12 shots, especially if I have forgotten to administer for a while.

Those people who receive placebo shots in controlled studies also respond well to the 'B12' shots. Also, if her fatigue waxes and wanes and you happen to wait until it waxes before giving her a shot, it is more likely that it will subsequently wane (regression to the mean), rather than getting worse.

You mentioned a probable vitamin A, D and E deficiency and fat and water soluable supplements. Are these similar to Vitathion?

It doesn't look like it. Googling Vitathion tells me it contains vit. C and vit. B1.

Linda

 

[Skwinty]

It doesn't look like it. Googling Vitathion tells me it contains vit. C and vit. B1.

Linda

Thanks for the additional information.

As far as Vitathion is concerned, I meant similar in mechanism, ie a dry powder that effervesces in water.
That type of application should be effective in my wifes case, or not?

I expressed that question poorly.
I am nearly 60 and I take Vitathion on a daily basis and find it quite effective (anecdote alert ).

 

[fls]

Thanks for the additional information.

As far as Vitathion is concerned, I meant similar in mechanism, ie a dry powder that effervesces in water.
That type of application should be effective in my wifes case, or not?

I expressed that question poorly.
I am nearly 60 and I take Vitathion on a daily basis and find it quite effective (anecdote alert ).

As I said earlier, you'd want to avoid tablets (anything that depends upon some time in transit to break down), so that type of preparation may be effective. Note that just because vitamins are in liquid form or in a packet that is dissolved in water does not necessarily mean they are in a water soluble form.

Linda

 

[Skwinty]

After doing a bit of research and reading Lindas advice, this is the plan of action.

The next time my wife goes the MD she will request blood tests to determine her current levels of vitamins and minerals. Hopefully this barrage of tests will not break the bank.

Once it is determined where the deficiencies are, she will address those deficiences through the following:

1. Increase/decrease the frequency of the B12 injections.
2. Address any C and B1 deficiency with Vitathion.
3. Address any ADEK deficiency with an ADEK chewable table to increase the absorbtion rate.

What I understand about the vitamins is:

Vit A D E & K are fat soluble
Vit C & B1 are water soluble.

I still need to research the optimal method of boosting mineral intake should that be required.

Is this approach and conclusion correct?

 

[Professor Yaffle]

After doing a bit of research and reading Lindas advice, this is the plan of action.

The next time my wife goes the MD she will request blood tests to determine her current levels of vitamins and minerals. Hopefully this barrage of tests will not break the bank.

Once it is determined where the deficiencies are, she will address those deficiences through the following:

1. Increase/decrease the frequency of the B12 injections.
2. Address any C and B1 deficiency with Vitathion.
3. Address any ADEK deficiency with an ADEK chewable table to increase the absorbtion rate.

What I understand about the vitamins is:

Vit A D E & K are fat soluable
Vit C & B1 are water soluable.

I still need to research the optimal method of boosting mineral intake should that be required.

Is this approach and conclusion correct?

Sounds reasonable to me (but IANAD). But maybe just ask the doctors advice on correcting any deficiencies - he/she may be more familiar with the best methods given your wife's condition.

 

[Skwinty]

Sounds reasonable to me (but IANAD). But maybe just ask the doctors advice on correcting any deficiencies - he/she may be more familiar with the best methods given your wife's condition.

Thanks PY,
The B12 injections are already part of the doctors orders and I am sure the best methods will be recommended.

Ideally, I would not like to add additional intramuscular injections that I will have to administer.

 

[fls]

After doing a bit of research and reading Lindas advice, this is the plan of action.

The next time my wife goes the MD she will request blood tests to determine her current levels of vitamins and minerals. Hopefully this barrage of tests will not break the bank.

Once it is determined where the deficiencies are, she will address those deficiences through the following:

1. Increase/decrease the frequency of the B12 injections.
2. Address any C and B1 deficiency with Vitathion.
3. Address any ADEK deficiency with an ADEK chewable table to increase the absorbtion rate.

What I understand about the vitamins is:

Vit A D E & K are fat soluble
Vit C & B1 are water soluble.

I still need to research the optimal method of boosting mineral intake should that be required.

Is this approach and conclusion correct?

Your wife may also want to mention her increasing fatigue.

Her doctor can recommend specific supplements (i.e. you don't have to cobble together some recommendations beforehand).

"I want her to have these tests and take these vitamin supplements" sounds like "I want to play doctor." "I understand that she needs to pay attention to whether she has adequate vitamin and mineral intake, especially fat-soluble vitamins, so should she have her blood levels checked and take supplemental vitamins and minerals?" sounds like "I want to be educated and involved." The latter is appreciated while the former is annoying (from the doctor's perspective ).

Linda

 

[Skwinty]

Your wife may also want to mention her increasing fatigue.

Her doctor can recommend specific supplements (i.e. you don't have to cobble together some recommendations beforehand).

Thanks Linda,

I think the reason that I am thinking along these lines is because she has discussed these issues with her doctor and yet the issue never seems to be addressed, other than the B12 injections.

I don't go to the doctor with her, so I am trying to prime her as to what she should be saying to the doctor.
I am also thinking of what she can do with over the counter vitamin supplements.

I apologise for sounding like doctor spock and an insufferable jerk.

 

[rjh01]

<snip>
I don't go to the doctor with her, <snip>

Maybe this is part of the problem?

 

[Perpetual Student]

Please, I have stated a few times now that my wife sees a medical doctor on a regular basis and this thread is about my education.

I do appreciate replies, but for goodness sake, please stop telling me that if I cared for my wife I would take her to a doctor.

I apologise if my original OP led you to believe that I was trying to play doctor here at home.

I do administer her intra muscular injections, but I have been trained to do that.

When I met her in 1994 she had already recovered from her operation and has lived a normal life since.

Stop apologizing! Some of the negative comments you have recieved here are both inappropriate and insensitive. It is quite clear that you are seeking background information and some general professional opinions. I do the same thing from time to time for myself and my wife. That does not mean I do not rely on the specific personal advice from my physicians. During an office visit physicians understandably have a limited amount of time and cannot indulge their patients in long discussions. Becoming informed about specific problems (using a number of medical websites and forums like this one) has armed me with the tools to make the most of the discussions that my wife and I do have with our physicians. This is one of the main benefits of this forum.

 

[fls]

Thanks Linda,

I think the reason that I am thinking along these lines is because she has discussed these issues with her doctor and yet the issue never seems to be addressed, other than the B12 injections.

I don't go to the doctor with her, so I am trying to prime her as to what she should be saying to the doctor.

Yeah, it helps if she is prepared to press her point. Is this a family doctor? They may not be familiar with these issues. If you can contact her/him beforehand, it may be useful for your wife to prime the doctor by stating that she wants to go over the adequacy of her vitamin and mineral intake and the possibility of supplementation in the setting of ileostomy and colectomy. The doctor will be more receptive the idea if they've had a chance to become familiar with the issues before the appointment.

I am also thinking of what she can do with over the counter vitamin supplements.

I apologise for sounding like doctor spock and an insufferable jerk.

Your understanding of the information (like the difference between water and fat soluble vitamins) that helps when picking a specific preparation is more relevant than picking a specific preparation. It's an opportunity for an argument that probably won't matter, is all.

Linda

 

[Skwinty]

Stop apologizing! Some of the negative comments you have recieved here are both inappropriate and insensitive..

PS, I apologised because I felt partly to blame for the responses I received, due perhaps to my style of writing.

I came here for solid advice and specifically from Linda.

Also, you catch more flies with honey than vinegar.

Becoming informed about specific problems (using a number of medical websites and forums like this one) has armed me with the tools to make the most of the discussions that my wife and I do have with our physicians. This is one of the main benefits of this forum.

I agree completely with your sentiments here, which is why I still participate in this forum, even though there are posters who

a) Don't read your posts with due diligence, not that they have to of course.

b) Make inane and inappropriate comments.

Fortunuately I have what is colloquially known as a "dikvel" or thick skin.

 

[Skwinty]

Yeah, it helps if she is prepared to press her point. Is this a family doctor?

The doctor is not the family doctor, but my wife specifically goes to her and has been doing so for a number of years, so she is familiar with my wifes condition.

I suspect that she does not see the ileostomy as a problem as my wife looks quite healthy for a 50 year old.

I think the doctor probably concentrates more on my wifes hypertension and does a good job on that score. That is why I want my wife to pursue the malabsorption issue quite aggressively.

Your understanding of the information (like the difference between water and fat soluble vitamins) that helps when picking a specific preparation is more relevant than picking a specific preparation. It's an opportunity for an argument that probably won't matter, is all.
Linda

Whatever understanding I have is gleaned from you and others on this forum.

Thanks to all.