Medical History

Reconstruction: period of Crohn's Disease
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Comments : This is a history reconstruction, based on correspondence between my physicians and my own memory. I know that some of the admissions are not reported here. But there were no surgery procedures done on these admissions, usually it were periods of 24h to 2 weeks for dehydration and/or malnutrition or Addison's syndrome due problems with diminishing Prednisondoses. Also, there were of course more checks and consultations but there were no major changes in therapy, and they were not related with admissions.

January 1986	Admission 1)	Final diagnosis : Morbus Crohn.
	Therapy 1)	Salofalk and Prednison.
February 1986	Transfer	To hospital "de Honte" at Terneuzen
June 1986	Dismissal	End admission.
November 1, 1986		Start relation with girlfriend Arabella Seegers.
November 1989	Admission & Surgery  2)	Resection sigmoid and part colon transversum.
March 1990	Check up 3)	Abscess at scartissue sigmoid.
December 6, 1990		Masters degree at University of Groningen
December 1991	Check up 3)	Painful fistulae 2nd quadrant abdomen + abscess + percutane drain.
January 1992	Colonscopy 3)	Active Crohn in colon descendens & ~ transversum.
	Therapy	Salofalk and Flagyl.
February 1992	Check up 3)	Very bad case of diarrhea.
March 1992	Admission & Surgery 3)	Perforations of colon, severe adenomatose vasculitis with secondary thrombosis. Resection of 25 cm. on valvula Bauhini, also 25 cm. of small intestines removed. Temporary double ileostoma constructed.
June 1992	Admission & Surgery 3)	Removing ileostoma.
August 1992	Check up 3)	Prednison.-depended complaints, also first signs of 2 or 3 peri-anal fistulae.
	Therapy	Flagyl, Prednison. and Salofalk.
September 1992	Consult 4)	Imuran-therapy for fistulae (unsuccessful).
	Therapy	Prednison.
September 25,  1992		Masters Dental degree University of Amsterdam
May 12, 1993	Admission 3)	Intensive care for malnutrition, dehydration and total exhaustion.
May 15, 1993		Acquisition and beginning of own dental clinic
May 29, 1993	Dismissal	End of admission.
May 31, 1993		First day of work in my own clinic
June 1993	Therapy	Start therapy with Cyclosporine.
January 1994	Admission 3)	Intensive care for malnutrition, dehydration and total exhaustion.
April 1994	Check up 3)	Malfunction of kidneys and mild hypertension.
	Therapy	Cyclosporine stopped.
June 1994	Diagnosis 3)	Osteoporosis due to Prednison.
	Therapy	Regular therapy with A.P.D. (daycare).
October 13, 1994		Last day in my own dental clinic
October 13, 1994	Admission 3)	Intensive care for internal bleeding (colon), malnutrition, dehydration and total exhaustion.
January 1995	Therapy	Cyclosporine (low dose) , Calcium, Etalfa and continue on Prednison.
January 1995	Admission & Surgery 4)	4e operation due to stenosis at sigmoid and "adhesions" in intestines. Ileo-coecaalresection of 20 cm., diagnosing active Crohn's in colon ascendens, therefor no closure with staples + end-to-side ileo-ascendostomy + stumb colostoma at colon descendens.
March 1995	Check up 3)	Very high output on ileostoma, electrolyte-disorders.
September1,  1995		Selling and finishing my own dental clinic
February 2, 1996	Gastroscopy 3)	Candida oesophagitis.
	Colonscopy via stoma 3)	Multiple fistulae and ulcers.
February 18, 1996	Admission 3)	Acute abdominal pains, 5 to 6 fistulae with output in stead of stoma.
February 20, 1996	Consult 5)	Discussing my cooperation on experiment anti-TNF (= TNF-alpha)
August 1996	Experiment 5)	Start with infusions (Result : closing of fistulae)
October 5, 1996		End of engagement and living together with Arabella Seegers..
November 1996	Experiment 5)	Finished.
December 1996	Check up 3)	Recidivating abdominal fistulae. (Result : social isolation.)
.January 1997	Admission & Surgery 3)	Colonresection (10 cm ileum) , excision peri-anal and enterocutane fistulae, construction ileostoma. (see Picture)
February 1997	Surgery 3)	Necrotomy with new ileostoma.
February 1997	Surgery 3)	Necrotomy.
February 1997	Surgery 3)	Excision skinflap and extensive woundreconstruction.
March 1997	Dismissal	Continue with private/homenurses for woundcare 1-5/day. (Result : more social isolation)
October 1997	Admission 3)	Gallstonecolics.
December 18, 1997	Admission & Surgery 3)	Cholecystectomy and removing ileostoma by end-to-end ileorestectomy.
December 1997	Surgery 3)	Relaparotomy because of perforation small intestines.
December 1997	Surgery 3)	2nd relaparotomy because of leakage at sutures.
December 1997	Surgery 3)	3th relaparotomy for lavage abdomen and placement of Vicryl abdominal wall.
December 1997	Post-surgery 3)	ARDS (coma) , artificial respiration.
January 1998		End of ARDS, start Dormicum-controled sleep.
February 1998		Waking up, phase out artificial respiration.
March 1998	Transfer 6)	To nursing/revalidationcenter "de Watersteeg".
April 1998	Admission 3)	Interruption of revalidation due to dehydration, nausea and retarded stomach passage.
May 1998	Transfer 6)	Continue with revalidation ( "de Watersteeg").
June 28, 1998	Dismissal 6)	Going home.
July 1998	Admission 3)	Replenishment magnesium and rehydrating .
August 1998	Admission 3)	Again dehydration and shortage of magnesium.
	Surgery 3)	Autolog skingraft transplant and construction of portacath left-collarbone.
	Colonscopy 3)	Active Crohn's with multiple aphtous ulcers, peri-anal a large ulcerous area and fistulae.
August 1998	Consult 5)	Discussing my cooperation on 2nd experiment anti-TNF (= TNF-alpha)
November 8, 1998	Admission 3)	Chestpains. Diagnosis: fractured sternum caused by reanimation in Dec-97. Also infected portacath.
December 3, 1998	Dismissal	After 26 days.
January 20, 1999	Admission 4)	Sepsis, Strept. Aureus.(2 ribs broken - spontaneous due to osteoporosis.) Starting antibiotic-therapy.
February 19, 1999	Dismissal	Continue therapy at home with medicine-pump (24h/day)
March 12,1999		Finishing antibiotic-therapy.
September 9, 1999	Surgery 3)	Removing portha-cath on suspicion of obstruction.
Februari 14, 2000		Start relation with Dorota.
Februari 11, 2003	Surgery 7)	Peri-anal abces, incision & excavation
July 14, 2003		Wedding Paul & Dorota
July 15, 2003	Surgery 7)	Peri-anal abces, incision & excavation
March 26, 2005		Birth of my son, Tim Robert
January 2, 2006	Admission 7)	Intensive care: anaphylactic shock by Immuran
June 2, 2006	Admission 7)	Dehydration, exhaustion, peri-anal abcess
June 6, 2007	Dismissal
December 6, 2006	Therapy 4)	Remicade
December 20, 2006	Therapy 4)	Remicade
Januari 31, 2007	A & D 4)	Endoscopy
Februari 26, 2007	Admission 7)	Dehydration, exhaustion
March 5, 2007	Transport	to hospital 4
March 5, 2007	Admission 4)	Dehydration, exhaustion
March 7, 2007	Dismissal
April 12, 2007	Admission 7)	Dehydration, exhaustion, research
April 18, 2007	Dismissal
May 4, 2007	Admission 4)	Dehydration, exhaustion, start with
May 17, 2007	Dismissal
October 10, 2007	Admission 4)	surgery - lancing multiple abcesses
October 25, 2007	Surgery 4)	IC: 2 operations - removing rest of colon
November 22, 2007		out of IC
November 26, 2007	Transport	to hospital 7
December 2, 2007	Dismissal 7)
December 31, 2007	Admission 7)	Dehydration, exhaustion. Placed a port-a-cath. Seriuous diet-research for future.
Januari 10, 2008	Dismissal 7)	Diet containing dayly intake of 22 grams of salt
September 11, 2008	Admission 7)	High fever. Contaminated/infected porth-a-cath obstructed by bloodcloth in vene cava superior. PAC removed, antibiotics and bloodthinners.
September 13, 2008	Dismissal 7)
Februari 2, 2009	Admission 7)	Dehydration. 36h IV with Potassium (K) and Magnesium (Mg)
Februari 4, 2009	Dismissal 7)
...

1) Academisch Ziekenhuis     at Groningen - NL	5) Academisch Ziekenhuis    at Amsterdam - NL
2) Rooms-Katholiek Ziekenhuis    at Groningen - NL	6) Revalidatiecentrum   "de Watersteeg"    at Veghel - NL
3) Ikazia Ziekenhuis    at Rotterdam - NL	7) Lievensberg Ziekenhuis    at Bergen op Zoom - NL
4) Academisch Ziekenhuis    at Rotterdam - NL

Comments : This is a history reconstruction, based on correspondence between my physisians and my own memory. I know that some of the admissions 9after finishing university) are not reported here. But there were no surgery procedures done on these admissions, usually it were periods of 24h to 2 weeks for dehydration and/or malnutrition or Addison's syndrome due problems with diminishing Prednisondoses. Furthere more, there were of course more checks and consultations but there were no major changes in therapy, and were not related with admissions.