latest prep for colonoscopy possible imuran treatment
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crystal552000
- Little Blue Penguin
- Posts: 38
- Joined: Sat May 08, 2010 8:14 am
- Location: kansas city Mo
latest prep for colonoscopy possible imuran treatment
Sorry I haven't posted in a while but these last 6 months have been pretty rough on me, with having two children 7 and under and not feeling up to par. I just had my 3rd colonoscopy last week however something bizarre happened to me during the prep. I was asleep at like 3-4 in the morning when I woke up just covered from poo it was somewhat disgusting so i got up to go to the bathroom and clean up and when I wiped it looked like snot literally slimy and all. I have never out of all 3 preps had an accident like that in the middle of the night nor the snot like poo. Not sure if this is normal or something I should be concerned about. Still taking 9mg a day of entocort been doing that for over a year can't come off or lower dosage. The doctors are talking about putting me on immuran if the inflammation doesn't seem to be under control according to the latest scope results still waiting. The doctor told me that it is my choice if I feel i can live under my current circumstances he will leave me on the entocort, or if i want he can put me on the immuran. I don't know what to do here I feel like I have to try and get back to normal if not for me for my children but am I just asking for more trouble?
I vaguely recall seeing mucus during the colonoscopy prep. I think that's typical in MC, and probaly a sign you still have active inflammation. Why a third colonoscopy? In what time span have they done 3 colonoscopies?? They are not without risk, so I'm wondering why they are being ordered so close together. Given your ongoing symptoms, why do they have to look again to confirm you still have inflammation? Did they order a stain on the biopsies to look for mast cells this time? If not, BE SURE THEY DO! Most of us wish we knew about this option back when we had our diagnostic colonoscopies.
Have you tried eliminating any foods yet? I would imagine that's preferable to starting a heavy-duty drug like immuran, which will have its own set of side effects.
I'm sorry you're not feeling better on the Entocort. I have kids ages 4 and 6, so I know how crazy your day-to-day life can be. Mom needs to be healthy!!
Please keep us posted on your decision.
Have you tried eliminating any foods yet? I would imagine that's preferable to starting a heavy-duty drug like immuran, which will have its own set of side effects.
I'm sorry you're not feeling better on the Entocort. I have kids ages 4 and 6, so I know how crazy your day-to-day life can be. Mom needs to be healthy!!
Please keep us posted on your decision.
Hi Crystal,
Zizzle is correct, of course - the mucus, (and the nocturnal "accident"), indicates that you are in the midst of a full MC flare. When the inflammation is at a severe level, the intestines produce copious amounts of mucus, in order to try to protect the surface from whatever pathogen or inflammatory agent is causing the inflammation. IOW, the Entocort is obviously not able to overcome the source of the inflammation, because all it can do is to try to suppress the inflammation - it cannot prevent it from forming in the first place.
If you want to return to a normal life, you really need to give some very serious thought to modifying your diet, as Zizzle suggested. Your inflammation is due to certain foods in your diet that are causing an autoimmune reaction, (which is an auto-inflammatory process).
Personally, unless I needed an organ transplant, I would never consider using a powerful immune system suppressant such as Imuran, to treat MC, but many individuals with Crohn's disease feel that it is a satisfactory way to help control their symptoms.
Several members have tried to use Imuran, but results have been mixed, so far. The best results have been for a member who also has Crohn's disease, but be aware that he is following a strict diet, which he feels is controlling his MC symptoms, and the Imuran treatment is to control his Crohn's disease, (which it seems to be doing).
I'm also very curious why you are having so many colonoscopies. Requesting a repeat colonoscopy is almost always a clear sign of a GI specialist who knows very little about treating MC, and he or she is using his patients as "guinea pigs" to learn on. It's almost always best to steer clear of guys like that, and to let them learn on someone else.
That's just my opinion, of course, but if your GI specialist really knew how to treat MC, she or he would have suggested diet changes, by now, rather than offering more powerful drugs, (especially for a patient who is still relatively young).
Tex
Zizzle is correct, of course - the mucus, (and the nocturnal "accident"), indicates that you are in the midst of a full MC flare. When the inflammation is at a severe level, the intestines produce copious amounts of mucus, in order to try to protect the surface from whatever pathogen or inflammatory agent is causing the inflammation. IOW, the Entocort is obviously not able to overcome the source of the inflammation, because all it can do is to try to suppress the inflammation - it cannot prevent it from forming in the first place.
If you want to return to a normal life, you really need to give some very serious thought to modifying your diet, as Zizzle suggested. Your inflammation is due to certain foods in your diet that are causing an autoimmune reaction, (which is an auto-inflammatory process).
Personally, unless I needed an organ transplant, I would never consider using a powerful immune system suppressant such as Imuran, to treat MC, but many individuals with Crohn's disease feel that it is a satisfactory way to help control their symptoms.
Several members have tried to use Imuran, but results have been mixed, so far. The best results have been for a member who also has Crohn's disease, but be aware that he is following a strict diet, which he feels is controlling his MC symptoms, and the Imuran treatment is to control his Crohn's disease, (which it seems to be doing).
I'm also very curious why you are having so many colonoscopies. Requesting a repeat colonoscopy is almost always a clear sign of a GI specialist who knows very little about treating MC, and he or she is using his patients as "guinea pigs" to learn on. It's almost always best to steer clear of guys like that, and to let them learn on someone else.
That's just my opinion, of course, but if your GI specialist really knew how to treat MC, she or he would have suggested diet changes, by now, rather than offering more powerful drugs, (especially for a patient who is still relatively young).
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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crystal552000
- Little Blue Penguin
- Posts: 38
- Joined: Sat May 08, 2010 8:14 am
- Location: kansas city Mo
3rd colonoscopy
my first colonoscopy was done about 5 years ago and the gi doc i had then told me I had enteritis colitis, he told me to take entocort for 6 weeks it would go away and I would be fine, I never was fine however I lost my insurance and quit seeing that doctor after having every physician tell me that because im only 26 at the time now 29 nothing could possibly be wrong with me, finally by the time i turned 28 i got the referral that i needed to see another gi doctor, this time he told me before going in to the second colonoscopy that it most likely was mc and he had to do biopsies mostly from the right side. It turned out that's what it was so i continued with this doctor because he almost knew instantly what was wrong with me. The 2nd test was just done last may, and now this one last week. He told me that it could be I have IBS along with the mc and he wanted to be sure the inflammation is still active and not something else going on, if I am still showing inflammation he is diagnosing me with refractory mc, if I have no signs of inflammation than IBS was what he was thinking how ever I had your thoughts also it's obvious that I am still flaring. Along with diet over the past 6 years I have experimented with food. I went down to rice, chicken, and bananas for 2 months and symtoms did not ease up at all. later I went gf free as per my pcp directed me to give it a try and still nothing. I cannot afford the enterolab I have been unable to work this last past year and am on medicaid, they don't like to pay for anything extra. Last year after living with this condition for 5 years and no help I was to the point of not wanting to get out of bed 12 hours was my sleep requirements and that was just so that I could do basic functions. My brain wasn't functioning right to where I was day dreaming and driving but it felt so real and stammering on my words couldn't get what I wanted to say out it was a very difficult time for me.
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crystal552000
- Little Blue Penguin
- Posts: 38
- Joined: Sat May 08, 2010 8:14 am
- Location: kansas city Mo
As to the lactation issue
It has gotten better but still no resolve, I have since quit seeing that pcp due to the lack of his trying to understand what was going on with me, I am going to see an old doctor I used to see before all of this and she was always concerned in my blood labs, and checked them quite frequently because of my vitamin deficiences I go see her next month
Interesting that they will pay for 3 colonoscopies in 5 years!! It's certainly not the frequency accepted for MC follow-up. I'm sorry the diet changes haven't helped. I hope this next colonoscopy turns up something new. Again, please ask for mast cell staining to rule out mastocytic enterocolitis or mast cell involvement aggravating your MC. If mast cells are involved, your sensitivities may be to histamine in your food, not just the proteins. In your case, I would defiinitely want to rule that out.am on medicaid, they don't like to pay for anything extra
Crystal,
Thanks for the clarification. I definitely understand what you've been dealing with. I spent several years with fatigue and brain fog so bad that I often found myself in a semi-conscious, or day-dreaming condition, while driving - not much fun, to be sure. Somewhere, in old posts, I have previously written descriptions of that phenomenon, and how it felt, at the time. I also know what it's like to have to deal with the disease without insurance, and without adequate money for testing, nor medical help - been there, done that, and I agree, it's definitely no fun.
With the added information, my perception of your GI doc is that he is ahead of many of his peers, in that he is well aware of the disease, and anxious to learn more about it, but unfortunately, he is totally lost, and wandering in the wilderness, if he is willing to recommend a second colonoscopy within a year or so of the last one, let alone 2 months after the previous one. If he had any experience, he would recognize your clinical symptoms as proof of the presence of inflammation due to MC, (without the need for a colonoscopy). The most disturbing part, though, to me, at least, is that he actually feels that "IBS" is a disease, and he's trying to "diagnose" you with it.
"IBS" does not exist as a disease. "IBS" is merely "doctorspeak" for "I can't figure out what's wrong with you". It probably stands for "I Be "Stymied". The drug companies are also behind the push to claim that "IBS" is a legitimate disease, because they are spending a lot of money on research, and they actually have established some prescribed drug treatments for "IBS". That's probably the motivation that's pushing him toward trying to diagnose "IBS" in your case. In the real world, though, "IBS" almost always turns out to be undiagnosed microscopic colitis, celiac disease, on non-celiac gluten-sensitivity. Trust me, there is no such thing as "IBS". It exists only in the minds of confused doctors, and drug reps pushing drugs to treat it.
If our intestines have been inflamed for years, it can take a long, long time for the damage to heal. It took me a year and a half on the GF diet before my gut healed enough, and I finally got all my ducks in a row, and cut out all of my food-sensitivities, and I finally reached remission. After that, I remained on a very limited diet for almost 2 years, to allow my gut to finish healing. Over 2 and a half years after I started the GF diet, (a little over a year after I was in remission), a fat malabsorption test at Enterolab showed that I still had residual small intestinal damage that hadn't healed.
This is a very tough disease. Defeating it takes a lot of determination, courage, and most of all, self-confidence. The ironic part is, self-confidence is probably the most difficult state of mind to even imagine, let alone maintain, when we're sick as a dog, and virtually chained to the bathroom. Controlling this disease takes a lot of faith in ourselves, and in our own abilities, because most of us find that our doctors are unable to provide us with the help that we need to achieve remission. We have to get that help from within ourselves.
Seeing an experienced doctor, with whom you've always had a good rapport, may be a very good idea. Many of us find that we get much better support from our PCP, than we get from our GI doc, because our PCP is concerned about our overall health, whereas a GI specialist is usually totally oblivious to anything outside the digestive system.
I hope you begin to see some significant improvement soon.
Tex
P. S. I agree with Zizzle, that requesting a special stain, and counting mast cells during the pathology analysis is a very good idea, if you can persuade your doctor to make that request. FYI, bananas are one of the foods that trigger the release of histamines, even in normal mast cell populations, so if you have mast cell involvement, that could explain why you did not see relief of symptoms from a bland diet that contained bananas.
This is not only a tough disease, but it often turns out to be a very complex disease, unfortunately.
Thanks for the clarification. I definitely understand what you've been dealing with. I spent several years with fatigue and brain fog so bad that I often found myself in a semi-conscious, or day-dreaming condition, while driving - not much fun, to be sure. Somewhere, in old posts, I have previously written descriptions of that phenomenon, and how it felt, at the time. I also know what it's like to have to deal with the disease without insurance, and without adequate money for testing, nor medical help - been there, done that, and I agree, it's definitely no fun.
With the added information, my perception of your GI doc is that he is ahead of many of his peers, in that he is well aware of the disease, and anxious to learn more about it, but unfortunately, he is totally lost, and wandering in the wilderness, if he is willing to recommend a second colonoscopy within a year or so of the last one, let alone 2 months after the previous one. If he had any experience, he would recognize your clinical symptoms as proof of the presence of inflammation due to MC, (without the need for a colonoscopy). The most disturbing part, though, to me, at least, is that he actually feels that "IBS" is a disease, and he's trying to "diagnose" you with it.
"IBS" does not exist as a disease. "IBS" is merely "doctorspeak" for "I can't figure out what's wrong with you". It probably stands for "I Be "Stymied". The drug companies are also behind the push to claim that "IBS" is a legitimate disease, because they are spending a lot of money on research, and they actually have established some prescribed drug treatments for "IBS". That's probably the motivation that's pushing him toward trying to diagnose "IBS" in your case. In the real world, though, "IBS" almost always turns out to be undiagnosed microscopic colitis, celiac disease, on non-celiac gluten-sensitivity. Trust me, there is no such thing as "IBS". It exists only in the minds of confused doctors, and drug reps pushing drugs to treat it.
If our intestines have been inflamed for years, it can take a long, long time for the damage to heal. It took me a year and a half on the GF diet before my gut healed enough, and I finally got all my ducks in a row, and cut out all of my food-sensitivities, and I finally reached remission. After that, I remained on a very limited diet for almost 2 years, to allow my gut to finish healing. Over 2 and a half years after I started the GF diet, (a little over a year after I was in remission), a fat malabsorption test at Enterolab showed that I still had residual small intestinal damage that hadn't healed.
This is a very tough disease. Defeating it takes a lot of determination, courage, and most of all, self-confidence. The ironic part is, self-confidence is probably the most difficult state of mind to even imagine, let alone maintain, when we're sick as a dog, and virtually chained to the bathroom. Controlling this disease takes a lot of faith in ourselves, and in our own abilities, because most of us find that our doctors are unable to provide us with the help that we need to achieve remission. We have to get that help from within ourselves.
Seeing an experienced doctor, with whom you've always had a good rapport, may be a very good idea. Many of us find that we get much better support from our PCP, than we get from our GI doc, because our PCP is concerned about our overall health, whereas a GI specialist is usually totally oblivious to anything outside the digestive system.
I hope you begin to see some significant improvement soon.
Tex
P. S. I agree with Zizzle, that requesting a special stain, and counting mast cells during the pathology analysis is a very good idea, if you can persuade your doctor to make that request. FYI, bananas are one of the foods that trigger the release of histamines, even in normal mast cell populations, so if you have mast cell involvement, that could explain why you did not see relief of symptoms from a bland diet that contained bananas.
This is not only a tough disease, but it often turns out to be a very complex disease, unfortunately.
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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crystal552000
- Little Blue Penguin
- Posts: 38
- Joined: Sat May 08, 2010 8:14 am
- Location: kansas city Mo
well I get a call from the GI nurse today and she says well you do have collagenous colitis, so I take that as still showing problems on the latest colonoscopy, I have an appointment scheduled for the 30th of this month Im sure to discuss the treatment of immuran. Im not quite sure what to do in this instance, should I take the medication and hope that it works or not take it and just stay the way that I am. Im so confused, this is the most aggravating disease so basically im not going to die if i dont get better I will just have this miserable long life. Wish they would just take it all out so that I wouldn't have to think about any of this, ok maybe that's not what I want but I feel like it sometimes
Oh Crystal,
Another colonoscopy to arrive right back where you started? I'm sorry you had to go through that. I'm not sure what to say about the immuran option, except that if it were me, I would continue the entocort and add the important dietery changes first (Gluten and dairy-free), before moving on to such a serious med. BTW, will your health coverage pay for all of it? That may be another factor in your decision. Good luck and please keep us posted.
Another colonoscopy to arrive right back where you started? I'm sorry you had to go through that. I'm not sure what to say about the immuran option, except that if it were me, I would continue the entocort and add the important dietery changes first (Gluten and dairy-free), before moving on to such a serious med. BTW, will your health coverage pay for all of it? That may be another factor in your decision. Good luck and please keep us posted.
Crystal,
I agree with Zizzle. I believe that most of us, if we were in your shoes, (which most of us are, sort of), would choose to continue taking the Entocort, and we would cut gluten and dairy products out of our diet, to see if that would resolve the symptoms. If that doesn't bring improvement, after several months or more, then we might consider the Imuran treatment, as sort of a last resort.
Whichever treatment you choose to try, please don't just continue to go on, without resolving your symptoms, because in the long-term, that carries an unacceptably high risk of adverse health consequences, and you are far too young to just cast the fate of your health to the winds. Most of us have been where you are now, and we did what we had to do, in order to get our life back. You can control your symptoms, if you are willing to take charge of your health, despite having an inexperienced GI specialist, who is "just learning"
Tex
I agree with Zizzle. I believe that most of us, if we were in your shoes, (which most of us are, sort of), would choose to continue taking the Entocort, and we would cut gluten and dairy products out of our diet, to see if that would resolve the symptoms. If that doesn't bring improvement, after several months or more, then we might consider the Imuran treatment, as sort of a last resort.
Whichever treatment you choose to try, please don't just continue to go on, without resolving your symptoms, because in the long-term, that carries an unacceptably high risk of adverse health consequences, and you are far too young to just cast the fate of your health to the winds. Most of us have been where you are now, and we did what we had to do, in order to get our life back. You can control your symptoms, if you are willing to take charge of your health, despite having an inexperienced GI specialist, who is "just learning"
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Joefnh
- Rockhopper Penguin
- Posts: 2478
- Joined: Wed Apr 21, 2010 8:25 pm
- Location: Southern New Hampshire
Hi Crystal, certainly diet has to be the first and most important element to be addressed as many can control the symptoms with little to no meds. I do find that diet is key for me even with the imuran that I take.
I have both MC in my colon and Crohns in my jenjunum (sp?) I recently had to have surgery to remove a segment of the middle part of my small intestine that had been damaged by crohns prior to darting the imuran. During the surgery time and a week afterwards I had to stop the imuran and at that point I really did see the benefit of that medication
I do have significant D even after the removal of the active section that has crohns when I was off the meds. MY GI doc feels the D is primarily from the MC (CC). I did notice that after stopping the imuran the d returned.
I am now back up to to speed with the imuran and I do notice that my energy is back as well the D has stopped.
As Tex mentioned there has been mixed results with this med, I bleieve currently myself and Celie have had success using it. There have been a few others that have tried it in the past that it did not work as a standalone med, they took it with steroids if memory serves
Imuran is a immunisuppressant and the decision to take this type of med should not be made lightly. As strongly suggested here, and I agree a thorough review of your dietary intolerances is the first order. I believe the decision to try imuran should be made after dietary testing and adjustments have been made and you have tried less powerful meds first
With all of that said in my case it did give me my life back, I have had significant fatigue, sore joints and muscles for about 10 years now and 80 - 90% of that has been resolved along with the MC and crohns symptoms with the use of the imuran. I should also be noted that imuran does take a good 3 to 4 months to really kick in. This seems to be the case for MC and other diseases it treats.
Best wishes Crystal and certainly work with the diet first.
Joe
I have both MC in my colon and Crohns in my jenjunum (sp?) I recently had to have surgery to remove a segment of the middle part of my small intestine that had been damaged by crohns prior to darting the imuran. During the surgery time and a week afterwards I had to stop the imuran and at that point I really did see the benefit of that medication
I do have significant D even after the removal of the active section that has crohns when I was off the meds. MY GI doc feels the D is primarily from the MC (CC). I did notice that after stopping the imuran the d returned.
I am now back up to to speed with the imuran and I do notice that my energy is back as well the D has stopped.
As Tex mentioned there has been mixed results with this med, I bleieve currently myself and Celie have had success using it. There have been a few others that have tried it in the past that it did not work as a standalone med, they took it with steroids if memory serves
Imuran is a immunisuppressant and the decision to take this type of med should not be made lightly. As strongly suggested here, and I agree a thorough review of your dietary intolerances is the first order. I believe the decision to try imuran should be made after dietary testing and adjustments have been made and you have tried less powerful meds first
With all of that said in my case it did give me my life back, I have had significant fatigue, sore joints and muscles for about 10 years now and 80 - 90% of that has been resolved along with the MC and crohns symptoms with the use of the imuran. I should also be noted that imuran does take a good 3 to 4 months to really kick in. This seems to be the case for MC and other diseases it treats.
Best wishes Crystal and certainly work with the diet first.
Joe
Joe
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crystal552000
- Little Blue Penguin
- Posts: 38
- Joined: Sat May 08, 2010 8:14 am
- Location: kansas city Mo
to be quite frank i am just worn out I have been dieting and taking god knows how many different drugs all of which none seem to work or help some even made me worse. I think that I am just at wits end mentally with this battle. It has been 7 years of torment. Everytime I try something new I see that glimmer of hope of this is going to work this time and in the end I get or got let down everytime. I just don't know if I have it in me to keep experimenting with myself. Food for me is hard after 3 years of changing everything and how and when I eat. I enjoy food always have my family is from the south and this is what has always brought us together, it brings comfort to me. That is probably the most hardest thing I struggle with it's not the tests, it's not the meds. It's looking at that fried chicken, jalepenos, and other things that I already know that I can't have, all of which I love. It's like being an alcoholic or a smoker who can't put down the bad stuff. I have been very refined in what I eat for years now, however I did go back to gluten after 3 months and no help there either maybe it wasn't enough time. Im not sure it is hard to do even do these things because I keep them in the house because I know that the kids need them to have a healthy diet and there's is more importnant to me than mine own. Today just took me as a shocker like reality hit home I knew before even going in to that test what the results were going to be but I still held out some shimmer of hope that it could be something else. I have read that the immuran can make it to where you can't have kids and that may be the deal breaker for me because I still want to have a lil boy. However at the current state of my health I don't know if that is even a possiblity as it stands. I wish I were to get pregnant some days just because I did not have one single problem while pregnant, it was after, after each child the symptoms got progressively worse, I am even willing to get worse just to have that boy. Maybe im crazy but some things just seem worth the sacrifice.
Crystal,
One thought is... gluten sensitivity is genetic. So if you have a big problem with it, it may not be as great for your kids as we are taught to believe it is. It is really hard to cut out all sources of gluten, especially if you have it in the house. I can eat jalapenos just fine, btw - probably I could overdo it, but some spiciness is not necessarily a problem, especially once you're a little more healed.
Along those lines... I don't have kids, and I believe it's quite possible all those miscarriages I had were a result of undiagnosed gluten sensitivity. As your symptoms get worse, unfortunately, your ability to conceive carry a child to term could be affected. It's a known connection to celiac disease, but because the diagnostic criteria for celiac are so stupid, many women (like me) have the possibility dismissed before it's even raised. This isn't just affecting our digestion - as you obviously know, since it's messing with your whole life... our whole bodies and brains are involved. YIKES.
I have to tell you one more little secret... we ALL love food. You aren't the only one who has favorite foods, special temptations, guilty pleasures, and foods that evoke memories. That's the human condition. Gluten is particularly addictive, unfortunately (like sugar for many people). Plenty of us are still enjoying fried chicken, once we find a way to make it that doesn't endanger our health. I'm eating totally differently now, and believe me - once you stop feeling ground-down tired exhausted and sick, and start enjoying life with some vitality, you really wouldn't trade that in for anything. (People ask me all the time, doesn't it kill you, looking at those cupcakes? Um, no. They don't even look edible to me.... because to me, they aren't.) You may almost have forgotten how good you can feel, but I promise, once you get there, it will come right back to you ;)
Hang in there,
Sara
One thought is... gluten sensitivity is genetic. So if you have a big problem with it, it may not be as great for your kids as we are taught to believe it is. It is really hard to cut out all sources of gluten, especially if you have it in the house. I can eat jalapenos just fine, btw - probably I could overdo it, but some spiciness is not necessarily a problem, especially once you're a little more healed.
Along those lines... I don't have kids, and I believe it's quite possible all those miscarriages I had were a result of undiagnosed gluten sensitivity. As your symptoms get worse, unfortunately, your ability to conceive carry a child to term could be affected. It's a known connection to celiac disease, but because the diagnostic criteria for celiac are so stupid, many women (like me) have the possibility dismissed before it's even raised. This isn't just affecting our digestion - as you obviously know, since it's messing with your whole life... our whole bodies and brains are involved. YIKES.
I have to tell you one more little secret... we ALL love food. You aren't the only one who has favorite foods, special temptations, guilty pleasures, and foods that evoke memories. That's the human condition. Gluten is particularly addictive, unfortunately (like sugar for many people). Plenty of us are still enjoying fried chicken, once we find a way to make it that doesn't endanger our health. I'm eating totally differently now, and believe me - once you stop feeling ground-down tired exhausted and sick, and start enjoying life with some vitality, you really wouldn't trade that in for anything. (People ask me all the time, doesn't it kill you, looking at those cupcakes? Um, no. They don't even look edible to me.... because to me, they aren't.) You may almost have forgotten how good you can feel, but I promise, once you get there, it will come right back to you ;)
Hang in there,
Sara