Doctors that have JPouches?

My surgeon did a j-pouch on a surgeon. He complained to her because he would have to go after about 6 hours or so...she joked that he just needed to be faster in surgery. Anyway, it sounded like he was a successful surgeon still after his j-pouch and it wasn't holding him back. I thought there was at least another physician on here that had a j-pouch, so it is possible.

I believe the chances of developing Pouchitis are pretty high. I know I've gone through it already to my surprise. I learned about it the hard way since the internet didn't exist then and I had no idea it existed either. If this site http://www.badgut.org/informat...complications-1.html can be trusted though they believe your chances of coming down with it our 50/50. My guess is your chances are a lot higher than 50% of coming down with it.

quote:

how many years does the JPouch function well for until people start noticing any issues?

I've been unhappy with my pouch for over 20 years now, so the whole idea of it "functioning well" is only because at times I have better luck with it than others. My issues have been on and off with it. Way back when it didn't take me long to notice major issues with it such as blockage, Pouchitis, dehydration, etc. That's not to say I'm underminding the whole idea of living with diarrhea every day for over 20 years now. It's been nothing but miserable.

quote:

And lastly, does anyone on here know of any practicing physicians that have JPouches or IBD?

I don't but that's just one reason why I believe it would be nice if you attained a license to practice medicine. I understand doctors know a lot about J Pouches but they'll never understand what it's like to live with one 24/7. That reminds me how I have a Colonoscopy scheduled soon. The problem was my general physician who knew I have a J Pouch never informed the gastrologist that I do. Thus I'm glad I told the gastrologist, because the gastrologist was ready to perform the whole exam as if my whole colon was still there

Wow thank you both so much for your timely responses. Dog day- well it definitely sucks big time to hear that about the chances of pouchitis. From the research I do, I usually find mixed answers about it but it is disturbing to notice that most pouches eventually do deal with some kind of issues. And it's understandable knowing that our pouches arent made from colonic tissues which means they're really not meant to store stool for years and years. I'm very sorry to hear that you're been struggling with your pouch for over 20 years- I can't imagine dealing with a frustrating JPouch for that long since I've only been alive for close to 22 years. But true I would definitely love to still become one- it's been my lifelong dream. However, I'm really doubting whether my body can handle all the grueling work in med school and the long, exhausting hours of a physician. Like you said though, most doctored will never really know what it is like to live 24/7 with a JPouch. And that is so scary about the colonoscopy. Thank goodness you had the smarts to let your gastrologist know you had a JPouch and not a normal colon!

Disney nut- good to hear that you've heard of a surgeon with a pouch. That's what I have always wanted to specialize in medicine as well. But like the surgeons complaint, I too am worried about the possibility of having to go while early on in a long surgery. Plus- with my pouch so far, ive managed to get down to about 6-8 times a day which isn't bad but it's definitely not great either. On a good day maybe 4-5 times at the most, but honestly, I can't ever see myself going to the bathroom any less than that.

Thanks again for both of your comments.

quote:

But like the surgeons complaint, I too am worried about the possibility of having to go while early on in a long surgery. Plus- with my pouch so far, ive managed to get down to about 6-8 times a day which isn't bad but it's definitely not great either.

If I was going to deal with that, I'd eat very lightly, using only the right foods or be prepared to give my sphincter muscles a real work out. Although I don't like the whole idea of doing any of that while performing surgery. I know how miserable it gets too to use your sphincter muscles or else. I even remember my surgeon warning me how much I would need to count on them after the surgery was completed.

A friend of my family developed UC while overseas while in medical school, finished med school with it (it was severe) and had surgery after 9 years of med and all sorts of alternatives. He was very happy with his results and was working as a Dr. He finally finally felt like he'd gotten his life back and asked his long term girlfriend to marry him. She accepted, they got up, crossed the street, he was hit by a car and died.
It is possible but everyone's different and only you know what you can handle.a

I am a 53 yo cardiologist/electrophysiologist who had a colectomy/j-pouch at age 43 because of UC. I took 3 months leave of absence and then returned to full duties. I work 60 to 80 hours a week depending on how much call I have. Some of my cases in EP take 4 hours or more.

My wife runs and does other crazy ultra stuff. I try to keep up (I do 2 or 3 marathons a year, one ultra, and try to do one or two sprint triathlons). I hope to do a marathon on every continent including Antarctica by the time I am 60.

I remember several bouts of pouchitis in the first six months after surgery. I probably have episodes now, but don't pay much attention to it.

I accept the fact that I have my good and bad days and keep going forward. Many times, stress and diet indisgression are to blame for increased frequency of BMs, but again, I just plod along.

The nature of my job makes me sleep deprived, so I have quit worrying about it.

I've had a j pouch for 21 years. I've had only one dose of Pouchitis, and that was in the first few months. A course of Flagyl quickly cleared it up, and have never had another incident of it. My problems have all been higher up, and do with adhesions and one stricture. (which has been successfully dilated now, and staying open.) The pouch itself, has since always functioned extremely well. So even if one does get pouchitis, it isn't always a chronic condition.

I certainly wouldn't let the fear of getting pouchitis once in a while deter you from your dreams. My surgeon told me 40% of j pouchers will develop pouchitis at least once. So you may get it or you may not. And if you do, it may once be once in your lifetime. If it were me, I wouldn't even give it a second thought...just my two cents. Follow your dreams! Good luck!

My surgeon (Cleveland Clinic, Ohio) gave me an interesting perspective on pouchitis. He basically said "People talk alot about pouchitis. It's highly likely that you will develop it, but it's like the flu. If you live long enough, you are going to get it. We just give you some antibiotics and it goes away." I had never thought about it that way before. We think of pouchitis as this horrible horrible thing, and I'm sure it's not fun but it is generally temporary, gets treated like other medical problems, and goes away.

This is, of course, not talking about chronic pouchitis.

If being a physician has been your dream - go be a physician. Deal with the problems as they arise. Many people could benefit from a Dr. who has "been there." You don't have to go into gastro-related issues to be able to relate to somebody who is having to fight their own battle.

I am a firm believer of not letting this awful disease (meaning UC and now extended to J-pouch) hold us back in any way. I would really encourage you to follow your dreams as living with regret is a terrible feeling.

I'm not a doctor but I am a nurse. I will be starting a new job on Monday (12 hour shifts) and I'll be honest, I'm very nervous but I know that it all work out. Good luck to you

I say go for it. If you became anyone kind of a doctor that takes care of patients with UC/Crohn's and pouches you will be the best. If you practice in NYC I will become patient #1.

The best that could happen is you become the best UC/Crohn's doctor in the country....the worst is if it becomes to much and you try something else.

My cousin was in medical school when his brother developed a brain tumor and passed away. He became a Cancer Specialist after that. He worked on cancer research before he went into pratice and he is the most kind, compasionate dotor. He is an extra special doctor and I have no doubt you would be too.

Good Luck,KangaRoe

My daughter's friend is in his last year of residency. He got his J-pouch while an undergraduate. He did consider surgery, but switched speciaities partially because of the concern of long procedures, and partially because, while in medical school he found another area that fascinated him.

The son of a friend of mine started medical school this year. He got his J-pouch at age 12. He has had several bouts of pouchitis and other complications over the years, but he didn't let it stop him.

No reason to let it limit you.

I have friends that are Physicians and I think you're smart to at least look at what you can and can't do. Your schedule as an intern/resident and even at the fellow level can be ridiculous. I'd hope you'd balance this against how far you've already come, how much you really want it and also look at different specialties that might be better suited for the j-pouch. general surgery for example might not be the best as you could be in procedures lasting in the 7-10 hour range. Internal medicine? Probably something you could do no problem as long as you could get through your residency.

In terms of specifically pouchitis there is an escalating chance to develop the longer you have the pouch. The generally accepted stats are typically 1 year = 15-20%, 5 years = 30-35%, 10 years 45-55%.

Typically most of these cases are treated with a course of antibiotics, followed at times by the addition of probiotics for a set period. The affect of probiotics can be debated, but they work for me. Many of these cases go into remission for long periods of time, some never experience it again.

Additionally Mayo clinic's internal numbers classify about 10-20% of IPAA patients as having chronic pouchitis. May of these people require long term antibiotic treatment. There are people on this board that have successfully rotated antibiotics for decades and are still going strong.

Hope this helps

EDIT: Also research the difference between pouchitis (an infection stemming from bacterial overgrowth) and cuffitis (basically UC in the small portion of rectum left over). Any IPAA can have pouchitis, but typically hand sewn IPAA's do not get cuffitis as a mucousectomy is part of it. Stapled procedures can also sometimes have the mucousectomy, but it is much more rare. I have no statistics on cuffitis, although it's treated typically the same way UC is.

GOOD MORNING

Follow your dream .Never let a health issue stop you.Last week I was scoped for the first time since my take down.I meet a young gentlemen who is a Doctor of Anesthesia who has a pouch also.He also has been thur alot with it.We talked and talked about foods which effect us.We now are internet buddies .He practicing and living his dream as an MD
Go for it...

He told me he was not guided either properly and did he own research to get to the level of health he is in.
FOLLOW YOUR DREAM
Cassiecass

Wow thank you all for your responses and for so much positive support! I love this forum, and I feel like each of us on here has a special connection to everyone else.

Dog day- yes I agree- we all usually have to watch what we eat and make sure our muscles down below are strong and flexible.

Killcolitis- that is truly a depressing anecdote

I can't imagine what his parents or girlfriend must have felt afterwards. But sad as it is - it is life. Just reminds us how fragile and unfair life really can be.

Hfc- that's absolutely great to hear that you manage to still work as a cardiologist after dealing with UC and now with a JPouch. Also incredible that you can run so many miles so often! Must be in amazing shape. Also I like your attitude towards the good days and bad days- I can relate to that but I hope that others without a pouch will also be able to understand.

JanetC- great to hear that you only suffered from it once in 21 years! Gives me hope. Also glad to hear that your pouch has functioned extremely well- that is the best possible outcome for us pouchers.

Mgmt10- thanks for your input. While I'm not afraid of dealing with pouchitis at least once or a few times, sometimes I do think about the possibility of developing chronic pouchitis. I truly empathize with all the unfortunate pouchers that suffer from it. It's makes me so angry with the world when someone on here who's been through so much hardship and adversity finally gets their life back only to come down with chronic pouchitis.... It's exactly what we were trying to fix or get rid of in the first place!

ActiveUCer- That really is a great way to look at pouchitis. I also haven't thought about it like that but definitely puts things into perspective. Also I agree- I would love to be there for others suffering from Crohns or UC.

VstRN- Thank you and good luck with the new nursing position. I'm sure you'll do great- boy would I have loved to have a nurse like you when I was in the hospital!!

KangaRoe- thanks so much for the compliment and if I do practice in NYC I will make it a point to contact you! I'm not sure that I would want to work in the gastro field but it is something that I now think about every day. Also very sorry to hear about your cousin


Becky G- thanks for the good advice- each post I read about with doctors with jpouches really gives me hope and confidence that I will be able to do it.

LionsPride- great tips, statistics, and advice-- Really appreciate that you took the time to give me a genuine answer to my original questions.

Cassiecass- Thanks for the uplifting message. I keep telling myself to follow my dreams still and that it will all be worth it in the long run.

Once again, thank you all for your wonderful and meaningful responses. I take each and every one of your responses to heart. It's good to know that in a world so full of evil and greed that there are still so many great people out there like you all who care about others as much as I try to.