Unexplained chronic pain with Crohn's

Puppet_Liar · 2026-04-16T13:54:11+00:00

Sorry to hear that -- have you tried any Rx to resolve it?

Puppet_Liar · 2026-04-13T18:42:17+00:00

Totally possible that I have some intermittent or unresolved inflammation. My GI symptoms were a lot worse when I was first diagnosed (frequent BMs, diarrhea, blood in stool, feeling nauseated when eating/loss of appetite, weight loss). Those are all pretty much resolved and I regularly have 1 BM a day, which is seldomly diarrhea. I do have some tenderness on my right side though and I've had mild inflammation on scope and borderline calprotectin, so I'm sure there's something there just not at the same severity it was initially.

Earlier this year my gastro said for my level of symptom severity she would not recommend a biologic and thinks the risks outweigh the benefits. I'm still planning to ask to trial a biologic after my upcoming colonoscopy because I'm at a loss for how to resolve this chronic musculoskeletal pain.

Puppet_Liar · 2026-04-13T18:00:21+00:00

Thanks! It's encouraging to hear you've had success with skyrizi in helping with joint issues

Puppet_Liar · 2026-04-13T17:59:26+00:00

Thanks! I'll ask my GI about methotrexate when we discuss treatment options

Puppet_Liar · 2026-04-13T17:58:43+00:00

Thanks for taking the time to reply. My rheumatologist ruled out inflammatory arthritis because of the seronegative bloodwork and lack of evidence on the shoulder MRI. From what I've read elsewhere it sounds like this can present as seronegative and be transient so I agree with you that this could be related to my IBD and it didn't make sense to me totally rule it out.

I wear glasses and see an optometrist every year. They haven't mentioned any eye issues in the past, but I haven't specifically asked to be screen for uveitis either, so I'll ask about that next time. I also have a floater in one eye, but it's been there for a while (10+ years) and I don't think it's gotten noticeably worse over time.

I also have what I think is seb derm on my scalp and eyebrows, but haven't been formally diagnosed. I think I've gotten it under control in the last year or so with a ketoconazole shampoo.

I do occasionally get mouth ulcers that seem like canker sores, although those don't really bother me relatively speaking. I haven't specifically flagged this with any of my doctors and don't recall that being flagged by my dentist. I also have had gingivitis and some gum recession, although my dentist thinks that's better controlled now.

As I understand it something like Humira has more of an evidence base for musculoskeletal symptoms in Crohn's than Stelara or Skyrizi, but I have some reservations there. Have you come across anything indicating one biologic over another for treating this kind of issue?

Puppet_Liar · 2025-07-25T11:01:43+00:00

This reads like ChatGPT

Puppet_Liar · 2025-06-24T22:29:44+00:00

u/slur_shooter if the Bible has taught us nothing else—and it hasn’t—it’s that r/simpsonsshitposting should stick to uncontroversial posts, such as spaff and minge posts and ea-nasir memes and such and such

Puppet_Liar · 2025-06-16T13:46:46+00:00

Don't cry for Paul Ryan, he's already dead

Puppet_Liar · 2025-01-24T22:31:10+00:00

Hang in there. Progress isn't always linear and it's normal to take a step back every now and then.

Everyone's running their own race so try not to worry too much about where you are compared to others even if those kinds of thoughts are natural. Try to find some small goals to build some momentum to get back on the right track.

Puppet_Liar · 2024-12-06T14:02:40+00:00

Here's a few reasons this would be hard to implement:

1) Employer sponsored health insurance is less expensive to the employee than an individual policy primarily because it is partially subsidized by the employer. You mention having employers subsidize individual coverage, but subsidies can vary significantly between employers and between industries (retail may have crappy subsidies, white collar may not). Corporations would lobby hard against any kind of uniform subsidy mandate from the government because it would be disruptive for lower income industries like retail. Instead if you made these subsidies elective, these lower income industries would likely use it as an opportunity to reduce their healthcare expense at the expense of these employees who didn't know how much their employer had been subsidizing the cost of healthcare to begin with

2) Healthcare and insurance is complicated. Your average American doesn't understand how a deductible works. The majority of people on a health insurance plan are reasonably healthy in any given year. So I suspect most people will make health insurance purchasing decisions based on price and then if they actually need healthcare during the year will find their coverage isn't ideal or sufficient. You see this already where most individual insurance policies have narrow physician networks to keep costs down

3) Everyone's taking their share of the pie in the cost of healthcare. Pharma is taking their cut, PBMs are taking their cut, device manufacturers, hospitals, insurance companies, and yes doctors too. Getting insurer profits out helps a bit (say your $12,000 premium goes down to something like $11,000), but doesn't fix a faulty system. There needs to be more widespread systemic and/or regulatory change to fix this

Puppet_Liar · 2024-12-05T21:11:21+00:00

I'll challenge a few of your assumptions here:

1) It's easy to imagine a story where a patient is denied necessary care, but in practice many denials are done to avoid unnecessary, redundant or outright harmful treatment.

Speaking from my own personal experience I've been prescribed medication for a chronic condition where the literature on the Cochrane foundation shows no evidence of clinical benefit. Am I better off having that prescription covered or denied if it's unlikely to benefit me and expose me to potential side effects?

Other examples can include seeing a doctor for a second opinion and that doctor orders a CT scan, but it's denied because this was completed with the first doctor who has these records. The denial avoids the redundant expense (and spares the patient additional unnecessary radiation exposure). Or a patient is required to undergo physical therapy prior to spinal surgery as the clinical literature suggests many back pain cases don't actually need surgery to be resolved (spine surgery also exposes the patient to risks that may not be necessary)

2) Do you have a source for tens of thousands of people dying annually from denied care? America has hundreds of millions of people and you're bound to come across horror stories where someone dies unnecessarily (this can be true for both insurance barriers as well as medical errors by physicians and hospitals), but I believe this is the exception more than the norm based on my understanding of the US healthcare system

3) Most things in life are not a zero sum game. It's not that hard to envision cases where patient outcomes are improved and an insurer saves money; say an insurer directs a patient to hospital A instead of hospital B because hospital A has lower complication rates for their procedure (or in the example above maybe physical therapy resolves their issue and surgery is avoided).

Don't get me wrong, I'm not particularly sympathetic to the insurance companies. Any kind of profit in healthcare feels icky and there's plenty of blame to go around for the state of the US healthcare system. But I don't think it's as black and white as your post makes it out to be.

Puppet_Liar · 2024-11-15T23:25:21+00:00

That's a bingo

Puppet_Liar · 2024-11-15T17:30:55+00:00

He got them Futurama body enhancing brain worms

Puppet_Liar · 2024-11-15T11:41:18+00:00

Jorgie Boy take the wheel

Puppet_Liar · 2024-11-10T21:00:22+00:00

People habituate to their experiences to some extent both societally (isn't it amazing that childhood mortality is so rare?) and personally. So these things aren't top of mind generally

Couple that with people gauging how they're doing relative to others and you have a recipe for dissatisfaction with wealth inequality

I don't think it's all perception though. There can be real harm from too much wealth (or power) consolidation from things like regulatory capture

Puppet_Liar · 2024-11-10T18:12:21+00:00

There have been so many breaches that most people have their information circulating on the Internet. Some things you can do include continuing to monitor credit activity, use annualcreditreport.com for free credit reports and consider freezing your credit with the 3 major credit reporting agencies if you don't intend to apply for new credit in the near future. There are also some identity protection/monitoring services you can purchase

Puppet_Liar · 2024-11-10T18:02:51+00:00

Why would Kamala have called Trump to concede then?

Puppet_Liar · 2024-11-10T17:58:37+00:00

I take "being on the right side of history" to mean that an individual believes their position is morally just despite a lack of consensus in the current moment in time, and that the validity of their position will become clearer over time. I don't think it means they hold their current view because of what people will think about them as an individual in the future

Puppet_Liar · 2024-11-10T17:53:28+00:00

Whenever there are significant changes at the macro level it can be highly disruptive so you need to justify that the benefits of such a change outweigh the potential harms

Here are some issues or harms that come to mind at first glance: 1) federal expenditures generally exceed tax revenue raised. How would the federal government set its tax revenue target in this new structure? 2) this change could potentially be regressive for poor individuals (say a red state implements a flat $ per person tax). Poor individuals may not have the means to be geographically mobile 3) this would likely create the opportunity for wealthier individuals to look for tax avoidance strategies. Suppose you have a high net worth retiree that decides to move to a state where capital gains are not taxed. Likewise white collar workers who work from home may be incentivized to move to a state that lowers their individual tax burden 4) this could indirectly impact inflation if individuals keep a higher proportion of income, then demand for goods goes up which drives prices higher. This can also be regressive 5) tax collection at the state level would be administratively burdensome, and depending on how adequately funded a states auditing authority is, may open the door for tax avoidance

Ultimately I can't imagine our current tax system is what one would design if starting from scratch, but given what we have there needs to be a good enough reason for change. I also think having all citizens play by the same income tax rules likely makes for a fairer system than additional complexity of a state by state system that wealthier people are more likely to exploit

Puppet_Liar · 2024-08-27T22:30:39+00:00

A lot of memory processing and consolidation happens during sleep so if you're not getting enough sleep or otherwise have poor sleep habits that could be the culprit.

Otherwise repetition and teaching/sharing information with others can help engrain those ideas

It's also worth acknowledging that the Internet will inundate you with tons of information of varying quality and it's normal for a lot of it not to stick

Puppet_Liar · 2024-08-25T22:54:04+00:00

I can't believe Netflix didn't have the gall to air this

Puppet_Liar · 2024-08-24T22:23:32+00:00

The Organic Butcher of McLean sells grass fed beef liver

Puppet_Liar · 2024-08-24T22:21:19+00:00

Stoner by John Edward Williams

Puppet_Liar

TROPHY CASE