Not much faith in GP or GI....need advice :(

Hey everyone, I am really in a situation and not sure what to do....
ive had crohns for many years and ive taken budesonide, prednisone, humira and imuran. Im allergic to pred, and humira gave me pml (although put me in remission) and I had to stop. So I flared again and had a hemicolectomy last summer. They were going to do a total colectomy but changed their mind at the last minute. I am now flaring bad again (scope to prove) and ive run out of treatment options. My last choice is methotrexate, but im so scared of being sick from it. Will it even be worth the side effects, but most importantly, will it reactivate my pml (and this time it may not retreat and I could die....this is a virus brought on from immunosuppression). Also, my gi and gp get I am in crippling pain but will not give me anything for pain (I am assuming bc it will mask signs of obstruction). So I cant have anything to manage pain (tylenol is a joke) and my last treatment left could be fatal (no joke) but my feels I should try it even though there is the risk (***?) ...so, do I ask for a referral back to the surgeon for a total colectomy? Or risk taking the methotrexate? Im scared bc if I keep leaving it, it will get worse, I will be hospitalized again, I could get fistulas etc. Could anyone pls help guide me...what was methotrexate like for u? Or should I push for surgery and just deal with pain for 4 plus months till it happenz (if). Also im getting married this august and would love to not be in pain or sitting on the toilet for my ceremony but I think now its unlikely lol...thx!!!!

Thx guy.. I appreciate the input! Does ur father get the nausea and vomiting from it? All I can find are horror stories on it on the internet, although I know they are biased.. as for other tests I do see a naturopath, but their 500month supplement regime hasnt worked for the lasr 5 months...other than that im not sure..thx!!

I went on methotrexate and the side-effects were not too bad; had a day or two of feeling a bit rough after the injection, but it was well within tolerable bounds. If you do decide to try methotrexate, ask for injections rather than tablets: apparently the nausea/vomiting is worse with tablets for some reason.

I don't know about the PML, sorry. That wasn't something I had to worry about :-/

If all of the immunosuppressives will put you at higher risk of PML and you have already had it, then I would try anything and everything else fist. (pmedic has some good suggestions) I think you need the best expert you can find to get advice about this, even if it costs a lot of money to do so...this is your life we are talking about! I'm so sorry for all you are going through!!!