Is this an unreasonable medication request?

As I mentioned in a previous post, I've been having a hard time getting my hands on some SF Rowasa. It was back ordered but is now in stock and on its way to my house! However, having skipped so many days, I'm now starting to flare. 1-3 BM's in the AM. Not formed, no blood or mucus. My GI is on vacation but his partner prescribed Pred for 6 days and told me to look into 6mp and Humira as one of these would likely be the course of treatment going forward. The Pred helped but now that I've finished, I'm back to the same problem.

I left a message for the nurse asking for some rectal meds (again). Last flare Cortifoam really helped, as did Colocort and I at least want to try them before moving on to Humira or 6mp or Pred again. Does this sound like a reasonable course of treatment, given my symptoms, or am I just in denial?

I never posted about this before but my hesitation with going up the medication ladder has to do with a terrible experience with Imuran. It lowered my WBC (to almost non existant) and I caught a virus. 103 fever, uncontrollable D, and nausea, vomiting. I was hospitalized for 16 days, had 2 spinal taps, a scan/test of every major organ and they never did figure out what it was. I came off of Imuran and have been on Apriso and SF Rowasa ever since.

Not unreasonable. I think most of us would rather first try the steroid enemas/foams/suppositories as they have less side effects than prednisone does. Just try to remain open-minded, give them a few weeks and progress to stronger medications if you don't get the desired response. Nothing wrong with being absolutely sure it's necessary before going up the medication ladder.

Scary on the Imuran. Given that history, I'd avoid 6mp (very similar medication), and go straight to humira. Humira is a very different medication with a very different mechanism of action than Imuran, so I wouldn't anticipate the same result.

I'm going to find a new GI. While he was out of town his partners would not prescribe me any rectal meds. My choices were Predisone or Uceris. I ended up taking the Uceris. At my appt yesterday my GI didn't want to discuss other rectal medications and told me it should be fine to continue taking Uceris indefinitely, wrote me a prescription for a year and sent me on my way. He wasn't listening to my concerns AT ALL. So frustrating!!!

Yes time for a new GI group. Why would they not RX rectals? I find that so strange but yet would provide a years worth of Uceris? 1800 New GI. Hope you feel better soon!
B

Since the rectal meds you want are steroids, and since the one you got is a steroid (albeit oral), Quincy's questions is important.

We do not know your medical history in the detail your GI does, nor the specifics of you GI's practice. FOr example if you have inflammation that is beyond where the foam could reach, it could be harder to justify a foam. Or, if you are in a HMO, tey may be trying to use the oral for cost-control.

For this case/decision to be really understood, it would be important to know more.

Get a new doctor. There is no comparision between the side effects of a topical rectal med and a systemic oral med. Common side effects of Uceris include headache, nausea, abdominal pain, fatigue, flatulence, bloating, acne, urinary tract infection, joint pain, constipation, insomnia, sleep disorders, depression, decreased blood cortisol, adrenal insufficiency, and high blood sugar (hyperglycemia, another name for diabetes).

Makes no sense to me. It wouldn't hurt to use the following link to check if your doctor is receiving payments from the drug industry.
/projects.propublica.org/docdollars/

Gotta love that. How unfortunate that this goes on.... Get a Dr. that will Rx rectals for you....ridiculous if that is the reason.

I think it's best to yourself be an informed patient because when you're aware of the various treatment and diagnostic options, and when they're appropriate then you're a good overseer/check and balance. We can always say no, suggest another treatment, and change doctors when necessary.

My doctor was clean a couple years back, seems he's got more donations recently. Things change over time. He hasn't pushed anything on me though.

The majority of gastroenterologists will dismiss alternatives when mentioned. They're trained in diagnosing and prescribing medication not alternatives.

For me, diet modifications and alternatives have done absolutely nothing. Some swear by them. Uc is very individual in what treatment does or does not work for each person. No one size fits all solution. Go by what produces results for you. And certainly combine medication and alternatives. Good luck!

Thank you for all the input/support! Saw a new GI and he wanted me to try Lialda and Canasa before Colocort or Cortifoam. It is day three on the new meds and things are almost back to normal. I'm tapering off the Uceris and then I'll try going every other day with Canasa and then every third day. A bonus is that Lialda and Canasa are WAY cheaper with my insurance. New doc also tested ESR, CRP and Fecal Calprotectin.

I would get on RATEMDS.COM and write a review of your original doctor's office who tried to shove Uceris down your throat. His other patients deserve to know what is going on. Just give the facts and let them draw their own conclusions. His other patients may find your review very enlightening.

And maybe write a review about what a refreshing change your new doctor is.

I will probably stay on it nightly until I'm done nursing my little one. I had a surge of hormones when I stopped nursing my first baby. It is likely to happen again and I don't want it to lead to a flare. So I will probably take it nightly for another month and once I'm feeling back to normal, start to cut down. I'm going to take it slow for sure.