talkhealth Blog

“Also known as a vicious cycle – two or more conditions require the other conditions to be fulfilled, but these other conditions also require the original condition to be fulfilled.”

This is a very literal definition of a catch 22, but in a more general sense, my Crohns disease is filled with numerous Catch 22’s were a symptoms requires a medicine and the medicine causes a side-effect that impacts the symptom or medicine or both.  It’s vicious cycle that goes round and round.

For example, the inflammation in my body has caused my heart rate to significantly increase, tachycardia.  The medication I use to lower my heart rate, blocks adrenaline secretion (Beta-Blocker).  When you block your adrenaline, you often feel sluggish and extremely tired.  So when you add this additional tiredness to my chronic fatigue from my Crohns Disease, I spend most of my days totally exhausted!  

What do people do when they are tired and need energy?  They drink caffeine.  Guess what caffeine does!? It raises your heart rate.  So I take medication to lower my heart rate, which makes me tired, and if I drink caffeine to combat that tiredness, it can raise my heart rate. It gets complicated!

Another one of my favorite examples is pain and IBD.  When I have pain with my Crohns, it typically means something is stuck in my digestive track due to inflammation and scar tissue. Tylenol and other non-narcautic pain meds don’t help my pain, so If i really need relief, I would have to take vicodin or another opioid.

Well fun fact, opioids slow down your digestive track.  If I take pain medication to help with the pain of being obstructed, chances are that it is going to make the obstruction worse due to decreased mobility.  So then how do you combat the pain of an obstruction without making the obstruction worse?  For me, you often just live with it.

Also with my Crohns, I have developed migraines and trouble concentrating.  Well, the medication my doctor prescribed for the headaches can cause tachycardia, increased heart rate. 

If you remember, I already have trouble with that.  So then you ask, would you rather have a migraine or a fast heart rate?  If the migraine gets too bad, do you take your rescue therapy, codeine? which could cause an obstruction, or do you just endure the pain?  If you take codeine, then it’s going to also make you sleepy.  So do you drink caffeine to stay awake, which might increase your heart rate? Or do you  just endure being tired?  See what I mean about complicated?

On TPN I am not supposed to be eating anything.  However, one of the treatments for my Crohns is 20 mg of prednisone daily. One of the prominent side-effects of prednisone is increased appetite.So while I am not supposed to be eating, I am taking a medication that increases my appetite.  
This makes an already nearly impossible task of not eating, even more difficult.  Once again, I’m left with a catch 22.

It leaves me wondering, does it ever end?  Will there ever be an answer to these problems that doesn’t cause more problems, or is that just the nature of medicine.  The perceived benefit of taking the medication outweighs the negative side effects.  I don’t know the answer to these questions, but right now it feels like the medication being used to put out one fire is causing another fire. The end result is that I experience an overwhelming number of “catch 22 fires” in my not so normal life.