It has been a long time coming for me to switch from Dr. V. to a different gastro. I went from my pediatric gastro to Dr. V., so I've been his patient for over a decade. During that time, I have always had frustrations with the office staff and his numerous nurses over the years. They rarely return message and they often ignore requests (refills, prior authorizations, etc.) Their Patient Portal has made communication with them a little easier and kept them more accountable, but I'm still shocked whenever they get back to me. Recently, my nurse left for the day when she knew I was on my way to the office to get a test kit from her.
To make matters worse, Dr. V. has not been the Dr. I have needed. His style of care is probably the reason I have very little faith in health care. Most of the time, I don't think they can help me, I don't have the energy it takes to cut through all their bullshit to get answers, and I'd rather suffer than waste my time. When I am unwell, he pretty much will just lists medications and ask me what I want to do. I've been blindly throwing darts at the wall and that is not a very good strategy to manage Crohn's disease. Especially, when I am facing bowel resection surgery.
Thanks to a few family and friends that pushed me, I decided to get a second gastro opinion before I schedule surgery. My plan was that if I like the doctor that gave me the second opinion, I would switch to his practice as a new patient. Essentially, using the second opinion as an interview for a new gastro. Numerous people recommended different gastros. I narrowed my search to one practice because I was recommended to three different doctors within that practice.
A policy at this new practice in order to make an appointment for a second opinion required the doctor's approval to give a second opinion. After a few phone calls back and forth with the new practice and waiting around for responses, the first doctor on my list denied to give me a second opinion. Therefore, I could not make an appointment with him. It really pissed me off when the first doctor on my list denied me! Sure, there are two sides to every story, but the side I'm on makes him look like he lacks confidence in his specialty and only wants easy patients that come to him healthy. The second doctor on my list was booked out through October, so I didn't even try to get his approval. I was told the last doctor on my list does not typically approve second opinion appointments. The scheduling lady was very helpful and suggested that since this is time sensitive and I didn't want to wait a couple of months for an appointment, I seek approval from their newest gastro in the practice whom I've heard nothing about from friends. The scheduling lady told me he has approved every second opinion request she has brought to him. I agreed and Dr. K. approved me to make an appointment to see him. In my search, I learned a valuable lesson. Next time, I would not mention I was seeking a second opinion. Rather, I would just try to transfer as a new patient.
My appointment with Dr. K. was on Thursday, September 7th at 5:30PM. I was only on the second page of the paperwork they gave me to fill out when the nurse called me back at exactly 5:30PM. She weighed me (164 lbs.) and showed me to the room. I sent a quick text to Badass Doreen to let her know I was in the back already. Dr. K. came in the room at 5:32PM!!!! My first thought was that this guy wants to make a really good first impression. I let him know my friend was stuck in traffic, but would be there soon. We went ahead and got started by going through my history with Crohn's disease. Thankfully, Doreen didn't miss much. Dr. K. blew me away with his knowledge of the different medicines available and the science behind how they work. He really educated me and made sure I understood by answering our questions. He even stepped out of the room to consult his colleague to verify he was giving me the most accurate information he could. The bar was low going into this appointment, but Dr. K. significantly exceeded my expectations!
Dr. K. did confirm that no medicine available will heal the fistula and surgical correction is the only way to fix it. Based on his explanations, I believe him. My treatment regimen moving forward depends greatly on the results of the Remicade drug level and antibody test I had done on September 4th. Basically, if I have any antibodies towards Remicade, there is little we can do. We could try to hit the antibodies with 6MP or something similar to attempt to knock down the antibodies. The down side with that is that being on Remicade and 6MP or something similar increases my risk of getting cancer.
Before surgery, Dr. K. would pull me off Remicade anyway because Remicade would slow down the healing process and could complicate surgery. This actually surprised me. If I didn't have antibodies or had very few, I could stay on Remicade. However, by getting off Remicade for a period of time before, during, and after surgery, I could have an adverse reaction when/if I try to go back on it after surgery. By now, you know my sentiments towards Remicade. I am going to be shocked if I have antibodies. I just don't think I have antibodies because of how well I feel. If that's the case, I would be willing to try to go back on Remicade after surgery. Dr. K. mentioned that we could do the free blood test again if that's the case to get a better idea of whether or not I would have an adverse reaction.
If I do have antibodies, I will be disappointed and I will most likely have to decide to say goodbye to Remicade. In which case, I would probably have to get surgery sooner than I wanted to while I'm still relatively well. I wouldn't try new meds before surgery because these drugs are not something you can start and stop and start again on a whim. The meds fuck with my immune system that is already fucked up, so reactions are somewhat unpredictable. Considering that I have two solid medication options after Remicade, I cannot be blowing through them. I do not want to get to the point where I am waiting for different meds to be developed because I've tried and failed all of the ones currently available.
Dr. K. also questioned how I feel about my current colorectal specialist. I told him I had confidence in her. In case I want to get a second surgical opinion, he wrote me a referral anyway to a colorectal specialist that Dr. K. said specializes in surgeries on Crohn's patients at the Cleveland Clinic in South Florida. I was pretty confused by this referral. My one constant was my current colorectal specialist, but I don't know if I can ignore this recommendation to get a second opinion. I can at least see what this guy at the Cleveland Clinic has to say so that I can weigh all of my options before scheduling surgery.
I had no uneasy feelings leaving my old gastro behind (haha). I feel differently about the idea of ditching my current colorectal specialist though. She knows me, my ass, my bowels, and my fucking stricture better than anyone. She has seen it every few months since 2012. This new guy might be more specialized with more experience, but he does not know me like she does. My bottom is a disaster according to my current colorectal. She doesn't understand how I am doing so well or how I am able to control my bowels, but she knows I am doing well and that I control my bowels. The scariest thing going into surgery is the possibility of coming out of it with a stoma. My current colorectal said that she won't know if I need a stoma until she gets in there and sees how it looks. I don't think she will underestimate me and what my body can do because she has seen it do amazing things despite it being a disaster. For that reason, I believe I have a better chance coming out surgery without stoma with her as my surgeon. Whereas this new guy might see the disaster that my bottom is and underestimate my body because he doesn't know it was well as my current colorectal.
There are pros and cons to each decision. I'm really confused even though I have strong feelings about which route I am leaning towards. Currently, I'm awaiting the results of my drug and antibody levels. Dr. K.'s office is working on getting a prior authorization from my insurance, and then will have the Cleveland Clinic call me to schedule an appointment.
Now we wait!
Showing posts with label medications. Show all posts
Showing posts with label medications. Show all posts
Sunday, September 10, 2017
Sunday, October 12, 2014
Crohn's: In The Beginning
In the move, I found a bag containing patient info on prescriptions I took from 2003 to 2006, lab results from blood work within the same time period, and receipts from meds, lab work, and doctor appointments. It reminded me what I went through on my path to being diagnosed with Crohn's and my path after diagnoses. I'll have to write a post about the symptoms I experienced that led to me reaching out and telling my mom that I needed to go to the doctor. After that point, it began with my regular pediatric doctor who then referred me to an OBGYN. After several unpleasant visits with him involving long needles, biopsies, and pure misery he sent me back to my regular pediatric doctor, Dr. Q. I'm pretty sure I was still shitting blood at this point. Dr. Q. then referred me to a pediatric gastroenterologist. The pediatric gastro, Dr. S.B., ordered more tests that included stool samples, upper GI series, sonogram, and a colonoscopy where more biopsies were taken. I remember when I learned I had Crohn's disease November of 2003. I was fifteen. I had no clue what it was, but the fact that Dr. S.B. said there wasn't a cure absolutely terrified me. It still scares me, so I guess that means my faith in God is still a little shaky. When you're in that much pain and discomfort hearing there isn't a cure with medicine is devastating.
I became overwhelmed while going through the bag and seeing how many different prescriptions my young, sick self used to take after being diagnosed. I used to be very quiet around others regarding my health issues. I didn't want anyone to know I had a poop/butt disease. "Try to act normal," I used to tell myself. I hope now that I consider myself more open about the things I go through that it will help others understand me better. Even though I still catch myself trying to act normal so that I can lie and say that I'm fine on days when I'm not okay at all.
I became overwhelmed while going through the bag and seeing how many different prescriptions my young, sick self used to take after being diagnosed. I used to be very quiet around others regarding my health issues. I didn't want anyone to know I had a poop/butt disease. "Try to act normal," I used to tell myself. I hope now that I consider myself more open about the things I go through that it will help others understand me better. Even though I still catch myself trying to act normal so that I can lie and say that I'm fine on days when I'm not okay at all.
Tuesday, October 7, 2014
I Take the Good with the Bad
As if I have a choice I take the good with the bad. The good: The two antibiotics (Flagyl and Cipro) seem to have helped the abscess heal, which in turn means I narrowly escaped surgery for now. My butt doesn't hurt at all.
The bad: I finished my 10 days of Cipro yesterday and I still have three days left of Flagyl. Between the two of theses antibiotics I've been fighting nausea, loss of appetite, muscle weakness, , fatigue, brain fog, and extremely watery diarrhea. I have pretty much felt shitty for two weeks. I drove for the first time in 11 days today, so I'm guessing I can blame the confusion and brain fog on Cipro. I actually felt alive today. I'm not completely back to normal... whatever weird, misconstrued version of my normal I'm using to benchmark today might be.
The bad: I finished my 10 days of Cipro yesterday and I still have three days left of Flagyl. Between the two of theses antibiotics I've been fighting nausea, loss of appetite, muscle weakness, , fatigue, brain fog, and extremely watery diarrhea. I have pretty much felt shitty for two weeks. I drove for the first time in 11 days today, so I'm guessing I can blame the confusion and brain fog on Cipro. I actually felt alive today. I'm not completely back to normal... whatever weird, misconstrued version of my normal I'm using to benchmark today might be.
Sunday, September 28, 2014
My Medical Cocktail
First on the list of ingredients in my medical cocktail is a probiotic prescription. It's VSL#3 DS. You can get VSL#3 over the counter, but since I've got the DS (double strength) it requires a prescription. It comes it powder form and I mix it into juice twice a day to consume 900 billion live bacteria. It tastes like rubber gloves, but I've been managing to choke it down. The bacteria in my gut is messed up because my body attacks the good bacteria. This causes inflammation and Crohn's symptoms. Now that I'm on two antibiotics my gut is going through a rollercoaster of trying to sort the good and bad bacteria effectively to fight the right bacteria, so this probiotic is suppose to give it a boost. My honest opinion is that I should have been prescribed this probiotic a while ago regardless of whether I'm on antibiotics or not.
Second on the list of ingredients in my medical cocktail is an antibiotic called Flagyl (Metronidazole 500 MG). I'm taking it every eight hours, so three times a day. I used to take Flagyl about ten years ago when I was first diagnosed with Crohn's, so I have experience with it. It causes cancer in mice and rats. I'm not surprised because it seems like every drug I take causes cancer. Alcohol is forbidden while taking Flagyl and for at least three days after the last dose. Trust me, I'm not drinking anytime soon. Flagyl may affect certain lab test results. I've been known to feel dizzy while taking Flagyl, which is another side-effect. Because of that my mom has volunteered to drive me to school this week, and I'll hitch a ride to work with my sisters. Other possible side-effects include: persistent nerve problems, appetite loss, constipation, diarrhea, dizziness, headache, metallic taste, nausea, stomach upset or cramping, and trouble sleeping among others. The ones that I experience most are dizziness and nausea. Especially in a moving car.
The last ingredient in my medical cocktail is another antibiotic. This one is called Ciprofloxacin HCL 750 MG. I'm taking it every twelve hours, so twice a day. This drug came with eight pages of patient information. I've also taken Ciprofloxacin before, but I've never taken it at the same time as Flagyl. The key with this one is to drink plenty of water and to avoid caffeine. This drug scares me because it's known for it's increased risk of tendon problems. As a runner that's terrifying. These risks include pain, swelling, inflammation, and possible breakage of tendons. The Achilles tendon in the back of the foot/ankle is most often affected. This medicine may cause drowsiness, dizziness and lightheadedness. (yes, I feel like I'm experiencing brain fog. My mind isn't sharp and I'm finding it difficult to focus.) I'm supposed to avoid the sun while on this med because I'll burn more easily. Other side-effects include: diarrhea, dizziness, and nausea.
I've also been taking an Epson salt bath once a day to soak the tender area down below. Overall, my butt pain was relieved a little today. I'm moving a little better and the pain isn't as sharp. The swelling around my anus and to my panty line has gone down tremendously. The abscess is still releasing a discharge though. I'm not sure which drug is responsible for me actually remembering my dream last night, but I quite enjoyed it. I dreamt I was jumping on the bed with Jim Parsons, the guy who plays Sheldon on the Big Bang Theory. After jumping on the bed for what seemed like hours, we proceeded to run around a park in our PJs popping bubbles with the joy a puppy has at the sniff of a treat. Can't wait to see what tonight's dream will be.
Second on the list of ingredients in my medical cocktail is an antibiotic called Flagyl (Metronidazole 500 MG). I'm taking it every eight hours, so three times a day. I used to take Flagyl about ten years ago when I was first diagnosed with Crohn's, so I have experience with it. It causes cancer in mice and rats. I'm not surprised because it seems like every drug I take causes cancer. Alcohol is forbidden while taking Flagyl and for at least three days after the last dose. Trust me, I'm not drinking anytime soon. Flagyl may affect certain lab test results. I've been known to feel dizzy while taking Flagyl, which is another side-effect. Because of that my mom has volunteered to drive me to school this week, and I'll hitch a ride to work with my sisters. Other possible side-effects include: persistent nerve problems, appetite loss, constipation, diarrhea, dizziness, headache, metallic taste, nausea, stomach upset or cramping, and trouble sleeping among others. The ones that I experience most are dizziness and nausea. Especially in a moving car.
The last ingredient in my medical cocktail is another antibiotic. This one is called Ciprofloxacin HCL 750 MG. I'm taking it every twelve hours, so twice a day. This drug came with eight pages of patient information. I've also taken Ciprofloxacin before, but I've never taken it at the same time as Flagyl. The key with this one is to drink plenty of water and to avoid caffeine. This drug scares me because it's known for it's increased risk of tendon problems. As a runner that's terrifying. These risks include pain, swelling, inflammation, and possible breakage of tendons. The Achilles tendon in the back of the foot/ankle is most often affected. This medicine may cause drowsiness, dizziness and lightheadedness. (yes, I feel like I'm experiencing brain fog. My mind isn't sharp and I'm finding it difficult to focus.) I'm supposed to avoid the sun while on this med because I'll burn more easily. Other side-effects include: diarrhea, dizziness, and nausea.
I've also been taking an Epson salt bath once a day to soak the tender area down below. Overall, my butt pain was relieved a little today. I'm moving a little better and the pain isn't as sharp. The swelling around my anus and to my panty line has gone down tremendously. The abscess is still releasing a discharge though. I'm not sure which drug is responsible for me actually remembering my dream last night, but I quite enjoyed it. I dreamt I was jumping on the bed with Jim Parsons, the guy who plays Sheldon on the Big Bang Theory. After jumping on the bed for what seemed like hours, we proceeded to run around a park in our PJs popping bubbles with the joy a puppy has at the sniff of a treat. Can't wait to see what tonight's dream will be.
Friday, September 26, 2014
One Painful Day After Another
I woke up in a lot of pain and discomfort. It hurt to move. This morning I called my general physician's office to ask who I should see about my swollen and sore bottom. Naturally, the physician wasn't in today, but his nurse was and she recommended going to the OBGYN. I discussed this with my mom and we both had a gut feeling that wasn't the right answer, so I called my gastroenterologist's office to see what they thought. Naturally, my gastro wasn't in today either, but there was a nurse practitioner at the gastro office with an opening at 9:45am. So, I went to see him, Mike Jolly.
I don't care one way or the other about whether I have male or female doctors/nurses looking at me. I anticipated going into the appointment that I'd have to have a rectal exam done. I should be used to those by now, right? Nope, not really. His huge finger entered my strictured rectum and he said, "I believe you have a fistula."
He explained it more once I got dressed and he came back into the room. The news: I have an anal abscess, which is an infected cavity filled with pus found near the anus or rectum. Holy fucking shit, that explains why I'm experiencing so much pain. Just by feeling around my rectum with his finger he believes a fistula is forming because of the abscess. Also a huge contributor to the PAIN! He ordered the nurse to schedule an urgent appointment with my colorectal specialist/surgeon because be thinks I need surgery. I go to see the colorectal specialist on Tuesday... the same day as my Real Estate Appraisal mid-term, so we'll see how that goes. Jolly also prescribed two antibiotics, both with horrible side effects. However, at this point, I'll gladly take them over what I'm experiencing currently. And, he prescribed a high potent probiotic, which seems promising and insurance actually covered it.
I owe a big thank you to my mom. She has been amazing. Taking care of me and going above and beyond what I deserve. I cried hard today. I'm disappointed in my body. I'm trying to fight my tendency to slip into depression during rough health patches. Not sure if it's working. I don't want this body, but I want this life. So, I chug along. I'm grateful for the people praying for me. I'm still miserable. I'm scared about what news Tuesday will bring. I'm afraid of needing surgery. I'm afraid my body is starting to reject Cimza.
I don't care one way or the other about whether I have male or female doctors/nurses looking at me. I anticipated going into the appointment that I'd have to have a rectal exam done. I should be used to those by now, right? Nope, not really. His huge finger entered my strictured rectum and he said, "I believe you have a fistula."
He explained it more once I got dressed and he came back into the room. The news: I have an anal abscess, which is an infected cavity filled with pus found near the anus or rectum. Holy fucking shit, that explains why I'm experiencing so much pain. Just by feeling around my rectum with his finger he believes a fistula is forming because of the abscess. Also a huge contributor to the PAIN! He ordered the nurse to schedule an urgent appointment with my colorectal specialist/surgeon because be thinks I need surgery. I go to see the colorectal specialist on Tuesday... the same day as my Real Estate Appraisal mid-term, so we'll see how that goes. Jolly also prescribed two antibiotics, both with horrible side effects. However, at this point, I'll gladly take them over what I'm experiencing currently. And, he prescribed a high potent probiotic, which seems promising and insurance actually covered it.
Thursday, May 15, 2014
Cimzia - Part 2
During my big flare of 2012, my doctor pretty much listed and explained the different treatment options and told me to choose one. Shouldn't that be his job? I originally chose Humira, but insurance wouldn't cover it. So, basically it was insurance who picked how I would be treated and they happened to choose Cimzia because of some deal the insurance company has with the pharmaceutical company that makes the drug.
I went through blood tests, was tested for tuberculosis and my doctor quizzed me on other health issues to make sure it was safe for me to start Cimzia. This is a serious drug and for good reason. I educated myself on Cimzia by reading the medication guide and the fine print of the prescribing information before starting treatment. After reading what I read, I was scared to start Cimzia. It's a relatively new drug and long term affects are unknown. I knew I would be taking it long term as long as my body doesn't build antibodies and reject it. It's not a drug I can go on and off of as symptoms come and go because then it's a higher risk of my body building antibodies against it. The two things that scare me the most with taking Cimzia are the increased risk of developing serious infections that may lead to death and the chances of getting lymphoma or other cancers may increase.
Health wise, I was in a rough place when I first started Cimzia. Clearly, the risks of taking the drug were worth it as long as Cimzia could relieve me of the horrible Crohn's symptoms I was experiencing. Well, for the most part Cimzia has helped me, but the side effects are sometimes annoying. Which is worse the side effects of Cimzia or the symptoms of Crohn's? Side effects I've experienced have been minor ones compared to some of the ones listed on the medication guide. Some of the side effects listed are:
I went through blood tests, was tested for tuberculosis and my doctor quizzed me on other health issues to make sure it was safe for me to start Cimzia. This is a serious drug and for good reason. I educated myself on Cimzia by reading the medication guide and the fine print of the prescribing information before starting treatment. After reading what I read, I was scared to start Cimzia. It's a relatively new drug and long term affects are unknown. I knew I would be taking it long term as long as my body doesn't build antibodies and reject it. It's not a drug I can go on and off of as symptoms come and go because then it's a higher risk of my body building antibodies against it. The two things that scare me the most with taking Cimzia are the increased risk of developing serious infections that may lead to death and the chances of getting lymphoma or other cancers may increase.
Health wise, I was in a rough place when I first started Cimzia. Clearly, the risks of taking the drug were worth it as long as Cimzia could relieve me of the horrible Crohn's symptoms I was experiencing. Well, for the most part Cimzia has helped me, but the side effects are sometimes annoying. Which is worse the side effects of Cimzia or the symptoms of Crohn's? Side effects I've experienced have been minor ones compared to some of the ones listed on the medication guide. Some of the side effects listed are:
- Heart Failure (No, I haven't experienced this)
- Nervous System Problems. (No, I haven't experienced this)
- Allergic Reactions. (No, I haven't experienced this)
- Blood Problems (Yes, I'm anemic, but that could be from the disease)
- Upper respiratory infections (Yes, I've experienced this)
- Rash. (No, I haven't experienced this)
- Urinary tract infections (Yes, I've experienced this)
- Injection site reactions (Yes, I've experienced this)
Wednesday, May 14, 2014
Cimzia - Part 1
After a couple of weeks with some moderate, uncomfortable stomach pain, I woke up this morning with no pain at all. What a relief! I gave myself the Cimzia injections last night, but I didn't think they'd help this quickly. I was able to take deeper breaths, stand up taller, and walk with a pep in my step. I could...move! I felt like running, which I haven't had the desire to do for nearly two months. So, what is Cimzia and how does it treat Crohn's?
First, let's look at what Crohn's disease is. It's an autoimmune disease. Basically, my immune system mistakenly attacks bacteria that are naturally present in my gut. I like the paragraph below from http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/ because I think it simply explains it in more detail.
The GI tract normally contains harmless bacteria, many of which aid in digestion. The
immune system usually attacks and kills foreign invaders, such as bacteria, viruses,
fungi, and other microorganisms. Under normal circumstances, the harmless bacteria
in the intestines are protected from such an attack. In people with IBD, these bacteria
are mistaken for harmful invaders and the immune system mounts a response. Cells
travel out of the blood to the intestines and produce inflammation (a normal immune
system response). However, the inflammation does not subside, leading to chronic
inflammation, ulceration, thickening of the intestinal wall, and eventually causing
patient symptoms.
This is really all we need to understand about Crohn's in order to understand how Cimzia treats the disease.
Second, before I get into how Cimzia treats Crohn's, I want to make sure it's clear that Cimzia does not cure Crohn's it only treats the disease. I know it's crazy about $3,000 each month for a drug that doesn't even cure me. Luckily, with insurance and a co-pay card I get it for free. Cimzia is a biologic medication, which means its derived, in some way, from living organisms. As you can imagine, biologic meds are complex and I don't even begin to understand how they're made, but it's interesting to research even though the science behind it is way over my head. Cimzia is used to treat numerous autoimmune conditions, not just Crohn's. The easiest way to explain Cimzia is to cite from its website: http://www.cimzia.com/crohns-disease/crohns-symptoms/crohns-disease-medication-information.aspx
In people with Crohn's disease, the immune system produces too much of a protein
called tumor necrosis factor-alpha (TNF-alpha). TNF-alpha triggers inflammation,
which can lead to inconvenient and often painful symptoms, some of which can cause
damage to your gastrointestinal tract
CIMZIA blocks the action of TNF, a substance produced by cells of the immune
system to induce inflammation. CIMZIA is the first and only PEGylated biologic
treatment for Crohn's disease. PEGylation has been shown to help the medicine stay
in the body.
The way I understand it is that TNF is responsible for attacking the good bacteria and causes the inflammation. Cimzia is a TNF blocker, so it blocks the TNF, which reduces inflammation and reduces symptoms. One of the dangerous things about taking a drug that blocks TNF is that I have no immune system that will come to my rescue to fight foreign invaders, like infections.
In conclusion, sometimes I wonder how I can be okay with injecting such a powerful drug into my body. The body is a temple, right? Cimzia stops my body from working the way it's supposed to work. My reasoning is that if I left my body alone (without drugs) to work how it's supposed to work, it malfunctions and causes me pain. Sometimes I'm not okay with that reasoning. Especially, when I think of all the side effects and risk factors associated with the drug. I'll save that for the topic of part 2.
First, let's look at what Crohn's disease is. It's an autoimmune disease. Basically, my immune system mistakenly attacks bacteria that are naturally present in my gut. I like the paragraph below from http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/ because I think it simply explains it in more detail.
The GI tract normally contains harmless bacteria, many of which aid in digestion. The
immune system usually attacks and kills foreign invaders, such as bacteria, viruses,
fungi, and other microorganisms. Under normal circumstances, the harmless bacteria
in the intestines are protected from such an attack. In people with IBD, these bacteria
are mistaken for harmful invaders and the immune system mounts a response. Cells
travel out of the blood to the intestines and produce inflammation (a normal immune
system response). However, the inflammation does not subside, leading to chronic
inflammation, ulceration, thickening of the intestinal wall, and eventually causing
patient symptoms.
This is really all we need to understand about Crohn's in order to understand how Cimzia treats the disease.
Second, before I get into how Cimzia treats Crohn's, I want to make sure it's clear that Cimzia does not cure Crohn's it only treats the disease. I know it's crazy about $3,000 each month for a drug that doesn't even cure me. Luckily, with insurance and a co-pay card I get it for free. Cimzia is a biologic medication, which means its derived, in some way, from living organisms. As you can imagine, biologic meds are complex and I don't even begin to understand how they're made, but it's interesting to research even though the science behind it is way over my head. Cimzia is used to treat numerous autoimmune conditions, not just Crohn's. The easiest way to explain Cimzia is to cite from its website: http://www.cimzia.com/crohns-disease/crohns-symptoms/crohns-disease-medication-information.aspx
In people with Crohn's disease, the immune system produces too much of a protein
called tumor necrosis factor-alpha (TNF-alpha). TNF-alpha triggers inflammation,
which can lead to inconvenient and often painful symptoms, some of which can cause
damage to your gastrointestinal tract
CIMZIA blocks the action of TNF, a substance produced by cells of the immune
system to induce inflammation. CIMZIA is the first and only PEGylated biologic
treatment for Crohn's disease. PEGylation has been shown to help the medicine stay
in the body.
The way I understand it is that TNF is responsible for attacking the good bacteria and causes the inflammation. Cimzia is a TNF blocker, so it blocks the TNF, which reduces inflammation and reduces symptoms. One of the dangerous things about taking a drug that blocks TNF is that I have no immune system that will come to my rescue to fight foreign invaders, like infections.
In conclusion, sometimes I wonder how I can be okay with injecting such a powerful drug into my body. The body is a temple, right? Cimzia stops my body from working the way it's supposed to work. My reasoning is that if I left my body alone (without drugs) to work how it's supposed to work, it malfunctions and causes me pain. Sometimes I'm not okay with that reasoning. Especially, when I think of all the side effects and risk factors associated with the drug. I'll save that for the topic of part 2.
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