Wednesday, September 5, 2012

Movin' on up to Cleveland Clinic, Main Campus

The next part of this journey is a blur because I was just getting sicker and sicker.  After my transfer, I was tapered down to a lower dose of prednisone (an oral steroid).  My symptoms subsided enough to be discharged following a two-week hospitalization.  Jeff secured a followup appointment with Dr. Lashner, a GI who was doing research with various IBD drug therapies.  He put me on a strong drug cocktail including Asacol, steroids, a mesalamine suppository, and an aggressive Remecaid infusion schedule. 

Briefly, med management for UC starts with anti-inflammatories.  If those don't work, you get moved up to corticosteroids, which usually work to induce a remission, after which one is weaned down to a much lower dose and maintained with the anti-inflammatories.  If the steroids don't provide relief, there are a variety of immuno-suppressors, then the biologics (Remecaid and Humira).  If none of those work, surgery is the last resort.  Here is a link to a more detailed description of UC therapies:  http://www.mayoclinic.com/health/ulcerative-colitis/DS00598/DSECTION=treatments-and-drugs

Dr. Lashner advised that I stay on this cocktail for at least 6 weeks to evaluate the drugs' effectiveness, then plan next steps from there.  I was elated.  Finally!  A cohesive plan that seemed to promise an alternative to disembowelment!

Over the next few weeks, I religiously followed the drug schedule and had two more Remecaid infusions.  However, my diarrhea episodes increased significantly in frequency and severity.  After 4 weeks of Dr. Lashner's happy hours,  I was back up to 15-20 bloody bathroom episodes/day and feeling more fatigued and nauseous.  Dr. Lashner's fellow ordered a blood test that revealed I had Colostrium Difficile, or C. Diff, a bacterium that infects the colon, creating symptoms similar to Ulcerative Colitis.  You get it after being in the hospital or from taking antibiotics for an extended period of time.  It is horrible.  Here's more info: 
http://www.mayoclinic.com/health/c-difficile/DS00736

Again, I was hopeful.  Maybe the C. Diff was at the root of my UC, and new drugs would take care of everything!

Uh, not so much.  After 5 days on Vacomyacin, a strong antibiotic, I was back up to 20-25 episodes, dizzy, weak, nauseous, cramping, fatigue, you name it.  Jeff had to practically carry me back into the Clinic's admitting area.  Round two......

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