Put all this discussion aside. He has an area that has eroded from all his stooling and the immunosuppressive drugs. The erosion has caused what is called a “fistula”, the holes that you see.
He must do the sitz baths and we need to keep tapering the immunosuppressive drugs as quickly as he can tolerate- prednisone and budesonide first; then sirolimus.
IF a patient does not heal with sitz baths and decreased doses, we very rarely have to divert stool from the area temporarily to allow the area to heal. The diversion is done by doing a temporary colostomy (or bag for catching stool on the stomach wall). This is not even in our thinking for now and I hope never, as he has been tolerating the decreases in prednisone pretty well.
Sorry for misunderstandings.
Take care,
Dr. Kernan
I feel really bad as this may prevent us from going to see Casey. While I know Casey will understand, I know Cody feels awful. He and I are both upset by this but like he says "It will all work itself out".
We really need a break and this has to all fade at some point. He feels bad about making me miss things and always taking care of him. I am just tired and I guess sometimes it does come out. He is such an amazing young man and we should all learn from him.
Keep up the fight, Cody!!
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