I was diagnosed with ulcerative colitis when I was 10. For the most of the next dozen years my UC was controlled very well with good old fashioned sulfasalazine. I was mostly off of medications unless I had a flare-up and then I'd take my sulfur pills for a while and taper back down to no meds. This worked well for me until a few months prior to my college graduation. I had a major flare-up that landed me in the hospital and almost delayed my graduation. From then on I decided it was safer to stay on medications to keep things under control.

This new strategy of mine worked for a few years and then the good old sulfur pills just weren't working so well anymore. My doctor started me on Asacol which didn't seem to work any better for me than the sulfur pills. He also started me on 6MP. On all of the medications I was generally feeling OK and going to the bathroom 3 - 4 times per day. No matter how good I felt though, my colon always looked very inflamed. My doctor's favorite saying to me during a colonoscopy was "How in the world can you say you feel so good when your colon looks so bad?"

As I approached 20 years with UC my doctor decided that to be safe he wanted me to have an annual colonoscopy. His opinion was that with the increasing cancer risk after 20 years with UC it was a matter of "when" I would have colon cancer, not "if" I would have colon cancer. He was determined to find it early. Being 30 years old and having to look forward to annual colonoscopies for the rest of my life was not a very fun thing. Waiting for colon cancer didn't make things any more delightful. The only bright spot was my doctor advising me twice a year to consider having my colon removed while I was healthy and before I developed colon cancer. This option didn't interest me since I'd rather take pills and have an annual colonoscopy than live with an appliance (an external bag due to a traditional ileostomy), which is what I thought my only options were.

As time went by and I grew tired of taking a lot of pills every day and having an annual colonoscopy I began to rethink the surgical option. At that time I researched the surgical options and came across the j-pouch. After doing a lot of reading and meeting with one of the best j-pouch surgeons in the Washington DC area I decided that, for me, life with a fully functioning j-pouch would be worse than my life with UC and if I had any of the expected complications my life would be much worse. My choice to continue with UC was an easy one for me as I continued to wait for cancer.

Then in 1999 I came across the BCIR. I did some research. I talked with a lot of patients. I got information for my local doctors and discussed it all with them and had them talk with Dr. Pollack at Palms of Pasadena Hospital in Florida. Everyone seemed to agree that the BCIR looked like a viable surgical option for me. My local doctors then started working on getting my HMO to approve the surgery. With the help of the great folks at Palms and my local doctors the surgery was approved and I had my BCIR surgery in 1999.

Even though my pre-BCIR life was not very much affected by UC, I did always have it in the back of mind and I always had to adjust my eating when I would travel to avoid having to find bathrooms on the way. Since the BCIR I have realized what freedom from the bathroom really means. I have finally felt free to travel and see the world like I never thought I would. Between the end of 2002 and the middle of 2004 I've seen the pyramids and temples Egypt; Stonehenge, London Bridge, and Crown Jewels in the UK; Loch Ness and the Highlands in Scotland; The Eiffel Tower and the Louvre in Paris; the Sistine Chapel, Coliseum, Pantheon and St. Peters in Rome; the Anne Frank House, a house where Rembrandt lived and worked, and fabulous works of Van Gogh in Amsterdam; and I've seen amazing Roman ruins in Plovdiv and lounged on the Black Sea coast in Bulgaria. Not once during any of these travels have I ever worried about finding a bathroom or having a flare-up or anything medical.

Considering how well maintained my UC was before my BCIR surgery and how it changed my life, I can't image how much life improves for most BCIR patients. No medical procedure is right for everyone, but if someone is considering surgery for UC related problems I urge everyone to look into the BCIR and see if it's the right option for you.

-- Richard Stern
rsternent@hotmail.com