Platelet Count and active inflammation

So I've finished my induction infusions of Remicade this past week. In a lot of ways I'm doing much better. I'm having formed bowel movements for the most part. Going once or twice a day. A lot less abdominal pain. Still having some joint/body pain, and well I don't think the fatigue will ever really go away. My B12 looks good, and I'm still taking 2000 IU of vitamin D a day. I'm sure that's still low yet.

My doctor sent me a letter about my latest blood work this week. White blood cell count is high from the steroids. Yes, we know that! But he always says my platelets are high, and this is due to still having active inflammation. Is that usually a good indicator of that alone? Without checking the CRP or Sed rate? I'm starting to feel frustrated if I'm still having that much inflammation in my body. I'm down to 10 mg of steroids on my taper. I feel it's nothing but a game of yoyo with steroids. If I only feel this good with having steroids then I'm back to square one. If I'm still having active inflammation then as soon as I'm off of them it's back to going down hill and landing myself in the hospital.

He said if this doesn't work he's sending me out of state to a big teaching hospital. Because he doesn't know what else to do with me.

I'm on 10 mg of Methotrexate orally right now. Should I see about bumping it up? Maybe I should ask for the shot form? I want to give Remicade and Methotrexate the proper shot at working here. But I'm starting to worry that it's as usual the steroids propping me up.

I wouldn't mind the second opinion, only it's in another state, probably a 4 hour drive. I'm not sure how my insurance is going to cover any of that. My husband's company bought the cheapest stuff they could get for insurance this year, with a $10,000 out of pocket max. So I'd like to try everything I can before I go that route. Hate that money has to be a factor, but it is!

Unless your platelet count is extremely high - or unless it has just recently risen significantly since you started the Remicade - then I wouldn't worry too much about what it is. As pointed out, it could be high from inflammation, and it could be high from the steroids as well. I wouldn't expect it to have returned to normal yet. And I don't think of it as being a reliable indicator of ongoing inflammation (CRP and ESR might be better indicators, but even they are not all that reliable).

I'd suggest giving the Remicade more time (another infusion or two) and see how things go.

Bumping up the methotrexate might be a good idea, if you can tolerate more, but really the studies on methotrexate plus Remicade are limited. A little more methotrexate might help Crohn's, and it also might help reduce the chance of you developing antibodies to Remicade, but I'm not sure what constitutes an "ideal" dose level of methotrexate as an adjunct to Remicade.

Taper the steroids slowly over the next several weeks, and hopefully the Remicade will help you get off them without a worsening of Crohn's symptoms.

My platelet count has been high for the past 10 years but my CRP is almost always normal. I've seen a hematologist and there is nothing wrong with me blood wise. I don't worry about it any longer. It's just me. The blood center is always after me to donate platelets instead of whole blood since my platelet count is so high.

I was having a similar problem when put back on Cimzia. After almost 5 months, my fecal calprotectin was 1538 so we added ldn and it dropped to 18 a week later. Maybe this is something to try as another option. If it doesn't help, you can drop it...