Surgery vs Biologicals

I will say it again
People on biologics must constantly be on guard for infections.

iPoop said...

https://www.healingwell.com/community/default.aspx?f=38&m=3903555
Remicade weakens your immune system's response to infections. Another dose of remi might further strengthen an infection, make it harder to treat, and cause the infection to spread. If you have an active infection requiring antibiotics and you need remicade today or soon then call and they will likely delay your infusion until your course of antibiotics is complete and that infection is gone.


https://www.healingwell.com/community/default.aspx?f=38&m=3052111
is 6MP's potential to cause serious infections related to the degree of suppression to the WCC (white cell count)? Yes, 6mp/Aza/Imuran works by lowering your white blood cell count. A little background, your immune system uses white blood cells (more specifically T-cells, one of three types of Lymphocytes) to attack infected tissue within the body, which causes inflammation, and kills infected/diseased cells. 6mp lowers your white blood cel count so less inflammation is caused in your large intestine but the effect of 6mp is systematic (meaning it effects your whole body and not just the intestine). While on 6mp, you will undergo regular blood tests. A CBC blood test counts the white blood cells present among other things and makes sure it doesn't get below a certain level.

So if i get my bloods checked every month and make sure my WCC does not drop too low am i still at risk of these infections? Yes, even with monitoring your white blood cells are still decreased and therefore your body is less able to fight infections when they occur. That can mean an infection, cold, or flu lasts longer than normal. It can mean that you need to seek medicinal treatment sooner in the case of a UTI, bronchitis, or other such infection. Otherwise, those infections may spread or get worse much quicker than you'd otherwise expect.

The key thing is being more alert, cautious, and to seek treatment when early signs emerge of an infection. This is important as your immune system is suppressed and therefore less capable of fighting the infection on its own.

https://www.healingwell.com/community/default.aspx?f=38&m=3477408
Yes, immunosuppressive medications (Imuran, 6mp, aza) and biologics (remicade, humira, simponi) increase your odds of getting infections such as UTIs, bronchitis, sinus, etc. That's because those medications lower your body's capability to fight infections and cause inflammation.

https://www.healingwell.com/community/default.aspx?f=38&m=3037682
Remicade increases ones odds of getting infections, e.g., bronchitis, sinus, urinary tract infections, etc. This is because remi is systematic, and reduces the whole body's natural process of causing inflammation to target and clear out infected cells. Due to a weakened immune system, they can quickly become serious infections. You're best to be vigilant and see your doctor upon first signs of those sorts of infections. Take a course of medication early to treat them.

I take a few precautions: i wash my hands every time i come home, i try to remember not to touch my face if I've been shaking hands or touching door handles etc when out in public. I don't know if any of that helps apart from reducing my anxiety. Knock-on-wood I've been immunosuppressed for 2 years and no major infections yet. I do catch colds more often but i used to be one of those people who had a cold less than once a year - in the past 12 months i had 4 although all of those were when i was on entyvio.
I still have anxiety about this stuff but it's less than it used to be. It's just another thing on the list of things to deal with with colitis.

I disagree that people on biologics need to be constantly on guard. They have to take precautions, but it's not like they have to live in a bubble. Their immune systems aren't gone.

David1991 said...

poopydoop said...

You've been immunosuppressed for the last 2 years but according to your signature were in a recent 3 year flare? So none of the medications seemed to do much?

Correct. When that flare first started i managed to get things under control with vsl3, although i still had mild symptoms. I gradually got worse and I was sort of in denial, or at least trying a bunch of "alternative" methods, until i reached 20 times a day blood severe pain etc level of problems, about 6 months later. I then tried budesonide for a couple of months because I was scared of prednisone, which didn't do much, then i tried prednisone which was Awesome with Awesome Sauce on the high doses but i flared severely as soon as I got down to the low doses. So that took up the first year of the flare, at which point i was put back on high dose pred and started azathioprine. Then had a miserable 2 years trying all the different drugs at different doses, got stuck on prednisone for 2 years, finally weaned off it while taking entyvio but still had too many symptoms especially pain...then i started xeljanz which finally worked. That's why I'm so touchy about alternative methods, because I allowed my flare to escalate instead of getting the medical help that I needed. If i would have had a crystal ball i would have liked to start on the biologics much earlier and skipped the azathioprine experiment.

Thanks, my friend's husband took azathioprine for 5 years, it worked for him, and last year the hospital allowed him to wean off it completely. He is still doing well 1 year later as far as I know, although still has problems with urgency which have never gone away, even with a clear colonoscopy.

At this point if you still can't be convinced to go biologics before surgery, you've obviously already made up your mind. Just go for it.