need advice on my recent blood work

Hi everyone.  just a quick reminder of my case.  surgery 1/2010 to remove part of small and large intestines. Had crohn;s for about 12 years before srugery and was on cimzia prior to surgery.  SInce surgery, crohn's was back in less than 2 months-confirmed via colonoscopy with bioposy. tried 6mp twice got violently sick to stomach.  started remicade in august. by Oct was out of work again, lossing 17 lbs in three weeks.  Put on 50mg of pred and then spent 67 weeks tapering off of it.  Upped remicade to highest dosage, every 8 weeks. just had treatment last friday.  Now the blood work.  Nov went back to work, hemoglobin was 13.4.  since then it has slowly fallen. today got call that lastest hemoglobin is 10.4  down from 11.4 just 3 weeks ago.  Also, kidneys have been borderline high for creatinin (sp?).  been stoping and starting ace inhibitor (high blood preasure).  Now during this time, found out that i have Afib.  right now justtaking a full asprin a day which i started about a month ago.  next week meet with cardiologist to discuss blood thinners since I have high blood preassure that is dificult to control so i am hihger risk group. 

 SO here is the the question, is the asprin causing or making the crohn's bleeding worse?  I did ask my GI about taking these and his reaction was the brain is more important.  Or do I need to be concerned that the remicade is not working? Iwonder since the cimzia did not work.  What else should I do?  is another colonoscopy in order?  I have been having more pains in the stomach in the general area that i have had them i the past. they just last for a few mins then go away.  I just keep moving.....

I am just getting confused with all the problems I have and all the side effects of each treatment.  Sorry for the lenght of this post.

Thanks!!

I wouldn't think that low dose aspirin would cause a 1 pt drop in Hgb in 3 weeks - sounds like the GI doesn't think it's the problem. And I'm with the GI - the heart and brain are most important. You can always go on TPN if you have to but there is no substitute for a functioning brain.

Has anyone checked your adrenal function since you got off the prednisone??? Because that can cause kidney problems and high BP and other systemic problems. It can be hard to diagnose because so many things can cause these issues. Prednisone use, especially over a long period of time like you describe can lead to problems with the adrenal glands so you might talk with your doc about that.

You may want to try to go on an exclusive liquid diet of some kind of formula (enteral nutrition) to see if that helps your symptoms. Doing it for 2 weeks or so may help your symptoms. In our experience, if it does, you may be able to combine enteral nutrition and meds to keep you in remission, improve the quality of your remission or extend the time you benefit from the meds before you have to move on to a new one.

This is best done under doctor's supervision and with help from a nutritionist or dietician who has experience using enteral nutrition to treat IBD, short bowel syndrome and other absorption disorders.

Best wishes,

Patricia

I agree with Ivy, you should speak more with your doctor on these issues. Sending healing prayers that you start feeling better soon. Hugs!

thanks to all for the quick responses. I know I am the odd ball with all of these things, so Yes I talk weekly to all three doctors, and have blood drawn once to twice a week. I was more asking to see if others have had similar issues like me with the consistent internal bleeding. The taking of iron does not seem to make much of adifference and once I stop or reduce, the hemoglobin goes down within a day or two. My internist has referred me to a nephrologist. Tuesday I see the cardiologist to discuss coumadin for the afib to help prevent stroke. and then another follow up with the GI doc in three weeks. by then i should have been seen by the nephrologist. That makes 4 different doctors to coordinate