Wednesday, December 4, 2013

{Crohn's Awareness} :: My Treatment

Currently, there is not a cure for Crohn's Disease. But a combination of treatment options can help you keep control of the disease and help you manage your symptoms. Just like every patient's symptoms are different, every patient's treatment options vary as well. What works for one person may not work for another. It's important to talk with your doctor and do your research on the best treatment option for you and your situation. I have a fantastic GI doctor that I trust and who is willing to work with me on the treatment options that I am comfortable with.

From all of the research I have done, I cannot seem to reconcile a diet change alone to treat my Crohn's symptoms. Some people have had success with that, and I cannot argue their experiences. But based on what I understand of the disease {an abnormal inflammatory response of the immune system} and my own Crohn's experience {pain despite already having a healthy diet}, I knew that my personal options needed to include some type of medication.

There are different types of medication options available for Crohn's patients. Medication is designed to supress your immune system's abnormal inflammatory response that causes symptoms. It can also help decrease the frequency of symptom flare ups, which helps maintain remission. Since there is no cure, achieving and maintaining remission are the goals in treating Crohn's.

My initial treatment was a combination of strong antibiotics and steroids; this was to get the inflammation and the initial flare symptoms to subside. But that was not a long-term treatment option, so I had to make some decisions on what would be the best course of treatment for me. A lot of factors went into the decision for me to decide to take medication, and which one. Part of the decision was based on the type of Crohn's disease I have: Crohn's Ileitis. Another part of the decision was my goal in trying to avoid surgery, since 70% of Crohn's patients require surgery at some point during their lives. Other factors included what medication has had the most success, what my insurance would cover, and what medication would be safest for when we start a family.

In the end, I decided to use biologic therapy. Biologics are genetically engineered medications that interfere with the body's inflammatory response by targeting specific specialized proteins that play a role in inflammation. The advantage of a biologic is that it is targeted; so rather than supressing the entire immune system like other medications, it acts selectively.

The specific medication I take is Humira. It is a synthetic protein that blocks tumor necrosis factor alpha (TNF-α), a protein in your body that can cause inflammation {and which researchers have found is present at high levels in people with Crohn's Disease}. I take the self-injectible pen, which is an every other week dose. It must be refrigerated, so I have to order it from a specialty pharmacy {I can't just go pick it up at Walgreens}. I have blogged before about how it HURTS. But I am learning to take it like a pro, even if a curse word still crosses my mind every time I take an injection ;)

Humira has worked for me. It has taken almost a year for the full effect of the medication to set in, but my flares are fewer and farther between. While I still have some bad days, I can say that my life is much better with Humira, than without it. It's crazy to think about where I was a year ago, but I never want to forget the pain I was in. It helps keep things in perspective, gives me the courage to continue my treatments, and reminds me of the need to take care of myself.

I believe very much in how much Humira has helped me achieve and maintain remission. But with any medication, there are no perfect answers and there are usually side effects. Because of the type of drug it is, Humira is considered a "designer drug" and is therefore very expensive. Unfortunately, there are not many other less expensive options, and it still makes me nervous about being able to afford it in the coming years, and especially over my lifetime.

The side effects I have experienced include burning/itching at the injection site {though this has improved over time}, hair loss, frequency of UTI's, and varying yeast infections {sorry- TMI, I know. Just trying to be honest}. Because Humira is an immunosupressant, I have to be careful with being around sick people. But thankfully, the Lord has protected me from a lot of illnesses floating around. Most of my sickness seems to be localized, which makes sense to me, considering that biologics target a specific area of my immune system, rather than the whole thing.

Again, while these side effects are not awesome and often frustrating, I still believe that the good outweighs the bad in taking Humira right now. It may not always be the most effective treatment for me, but right now I am very thankful for it. Treating Crohn's is very much a whole body strategy, so taking medication is really just one aspect of treatment. I will talk tomorrow and Friday about my diet and lifestyle.

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