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Crohn's Disease
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Posted 10/7/2009 6:48 PM (GMT 0)
Hi everyone. I'm new to this site even though I have had Crohns for the past 23 yrs. I am hoping to find some answers and some others experiances with Crohns.

I have never had to have surgery and have been some what lucky in being in remission for quite sometime until about a month ago. I started experiencing the classic abdominal pain and some mild diarrhea. I had been taking Pentasa (400 mg x 2), Nexium, Fish oil, low dose bayer aspirin for my heart. When I began this bout my Dr. put my on Bentyl 10 mg before meals and at bedtime as needed. Worked for a while. This last weekend things flared up and by noon Monday I was in the ER for severe pain.

Usual X-rays and than a CT which showed inflammation in the small bowel in the section where they cannot scope.

Today I went to the Dr. and she decided the Pentasa wasn't working and now I have to decide whether to do Remicade or Humira. She mentioned Imuran but I'm not so sure with the side effects. To make matters worse I may be getting laid off at work thus losing my insurance. Have to talk to them before deciding what to do.

 I know that there is no way to tell which will work best with out trying them, but what side effects bothered you the worse with what treatment?

 Sorry for the long story

Thanks

Posted 10/7/2009 8:01 PM (GMT 0)
Quite a few people here -- including me -- have had very good long term results with the imuran/6mp family of immunosuppressants, with low side effect ratios. Before going on to biologic big guns, especially since you do not seem to be prone to fistulizing or obstrcutive disease after 23 years, I would sure investigate the imuran/6mp alternative. Worst case is that you have side effects or poor response, in which case you just discontinue the drug and move on to something else. I am also wondering if a short course of prednisone might not get you into immediate remission to let yuo move up to a next level maintenance drug. Overall your case sounds a lot like mine (mild to moderate CD without surgical complications, primarily in the temrinal ileum) and I have done very well on 6mp for some years now.

Posted 10/7/2009 8:28 PM (GMT 0)
I have been on Imuran since my diagnosis in 2007 and haven't had any issues with it. I have progressed to Remicade, although I am still on Imuran until Remicade fully kicks in.
Posted 10/7/2009 8:55 PM (GMT 0)
If you are laid off, you will probably be offered COBRA, continuing your health insurance, if you are based in the US.

So you would have the same coverage, but pay the entire premium yourself.

BUT if you are laid off between now and December 31, 2009, 65% of your COBRA premium WILL BE PAID for nine months after the layoff IF, married filing jointly, your adjusted gross income is under $250K.

More info at:

http://online.wsj.com/article/SB123500263888517825.html

http://www.nolo.com/legal-encyclopedia/article-30258.html

Posted 10/7/2009 9:58 PM (GMT 0)
I have been on 6MP for over a decade, with some prednisone thrown in at various doses. But it does take a while for the 6MP to kick in so you would probably want to have some pred until it kicked in. Both 6MP and Prednisone are cheaper than Remicade or Humira, so If getting laid off and the cost of medication is a consideration, this might be your first choice since it would be cheaper and then if it doesn't work you could move on up the ladder.
Posted 10/8/2009 4:34 AM (GMT 0)
.....Would just like to extend a warm HW welcome to you........as you very well can see ppl here are very friendly and helpful.......stick around u will not regret it.... lyn
Posted 10/8/2009 1:28 PM (GMT 0)
Hey Harley and welcome to Healingwell. One thing I wanted to comment on was the low dose aspirin. I tried that for a bit and it tore my stomach up. Maybe while in this flare you might want to stop it for awhile, as we are not supposed to take Ibruprofen or Aleve type products. They can cause bleeding in us.
Posted 10/8/2009 7:44 PM (GMT 0)
...Good info Nanners..that is so true and i was told exact same thing from Doc.....Thanks for the reminder...Lyn
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