My doctor won't shut up about Remicade

I just recently was diagnosed with UC a few days ago. I've had undiagnosed UC for probably five years. Up until diagnosis a few days ago I had never taken medications. I'm currently taking Prednisone and Sulfasalazine, and they appear to be working. However, my doctor keeps having his people call me trying to get me to do Remicade. I don't understand why I would not try lesser drugs first. I've gone into remission doing nothing before, and had a few months of remission sticking to the SCD diet.

Anyone else experience doctors pushing the nuclear option way too soon? From my understanding Remicade is what a person tries as a last ditch effort before yanking the colon out entirely.

I would find another doctor who doesn't subscribe with the top-down approach when there are other meds that are working for you with much less drastic side effects. Prednisone is not a long term treatment.

It wouldn't hurt to check out
projects.propublica.org/docdollars/

to see if there are other reasons why your doc is pushing Remicade so hard. The following is an example of a doctor who insisted on prescribing Uceris to his patient even though rectal meds were working perfectly well, (he was receiving payments from the drug company).
www.healingwell.com/community/default.aspx?f=38&m=3646214

The bottom line is YOU decide what treatments you ultimately use. There's times we agree and other times we disagree with your doctors (we've all been there). The best doctors are partners in determining our treatment course (no doctor-dictator's allowed). Many of us with chronic illnesses find we know as much as our doctors, do a lot of research and reading about UC, it's treatment options, and when they are appropriate. We make treatment suggestions to our doctors and the doctors make suggestions, there's discussions and a decision is ultimately made. Often we'll ask why, what warrants a recommendation if we feel it is unexpected. It's good to hear the reasons and not just automatically assume he/she is bat-guano-crazy for suggesting something you might initially disagree with. UC is for life, so you want a doctor whom you work well together with, who listens, and works within what you see as your best treatment course. And if he/she isn't workable and reasonable then certainly shop around for another.

If you're doing well then there's not reason to change course, and rock the boat. Are you in a remission (having no UC symptoms, no urgency, no bleeding, having only several bms a day)? If you're struggling then you might need additional medications. UC prognosis can be wildly unpredictable, especially within the first 5-years of diagnosis. So, you never know what your future might hold and treatment might ultimately need to be. The top-down approach uses strong meds upfront and reduces the odds of relapses and having UC spread in extent and severity; essentially control it early and fast for the best quality of life and least relapses. Easier to tame and control a small fire then wait until you have a raging inferno to contend with. Different philosophy, and not everyone is onboard.

I wouldn't consider any one treatment to be the nuclear-option or full of side effects though. As an example, I've been on remicade since 2012 and I have yet to have a side effect from it, but did find a remission from it. It's an effective treatment whose benefits far outweighs its risks.

Post Edited (iPoop) : 12/15/2017 7:17:29 AM (GMT-7)

Sounds like you have a good plan and have made progress. Prednisone is rocketship fast in making us feel better but is temporary in usage. The million dollar question is can you successfully taper off of pred without relapsing? None of us know that answer for you or ourselves when in that situation. I'd follow your pred course and see if you get to a remission and can sustain it without the pred. Sometimes we can and other times we cannot. Always in the back of my mind when I'm on pred. If you cannot then you do need stronger meds. Hope for the best but plan for the worstcase, just in case you need it! Good luck!