Showing posts with label Remicade. Show all posts
Showing posts with label Remicade. Show all posts
Monday, January 11, 2016

Here is What is Happening Now! #Crohn'sFighter

This is the one where I update you on the Doodle AKA Super Sweet Sophie AKA Bad Ass Crohn's Fighter . . .

If you are new to the HWHAP bog, you can read Sophie's story here.
To get to the nuts and bolts of CD click here.

Sophie was diagnosed with CD when she was 4 years old, the 1st few years were spent out of remission searching for something that would get her into remission - she was on and off steroids and in and out of the hospital until we finally found what would work for her.  Sophie has been on Remicade since April of 2012 (she was 6 years old at the time) and we have had such great success.  She has been in Remission since that time minus a small set back in October of last year (2015) when she was unable to get her infusion on time.  Unfortunately, in October of 2014 she started suffering from psoriasis of the scalp that continued down her neck.  It was miserable but we kept it contained with creams and ointments.  We even upped her Probiotic (ProBio5) and added the Plexus Body Cream and that made it almost disappear.  Enough so that it was no longer an issue for her for almost a year.

But, sadly, it has come back with a vengeance on her face and in her ears which is miserable for her not to mention she is now almost 10 (WHAT?) and there is a cosmetic issue with it being all over her face.  She is self conscious and at the age of ten kids do not really have filters so she feels like she is answering questions about it all of the time and it is making her feel very embarrassed.  Beyond the cosmetics it is itchy, red, and painful so the girl is miserable.

The unfortunate part is that the Remicade is what is causing the problem.  Ironically, although Remicade is used to treat Crohn's Disease, Ulcerative Colitis, Rheumatoid Arthritis and Psoriasis it also in rare cases can cause Psoriasis

We have been working with her pediatric dermatologist and her GI team to try and get it cleared.  We met her with gastroenterologist this morning at Children's to discuss other GI options.  I was nervous going into the meeting because Sophie is doing SO well but her health is very volatile and changing just one small thing can throw her out of remission so quickly.

There is another anti-TNF drug that I was hoping would be an option but we found out today that Humira may cause the same issue and not solve the problem at all.  The other option that was offered was to put her back on Imuran or Methotrexate which did not work for her AT ALL when tried previously but they believe because she is older now and not sick there is a chance one of these could work at this time.  The problem is we won't know until we try and the unknown is incredibly scary.  When Sophie is sick she is very, very sick ---- I am certain none of us are ready to go through that again right now (or ever).  They would start her on steroids before making the change and then we will have to wean her off and take it one day at a time.  The thought of this is terrifying to me.  I have been sick all day.  The knot is my stomach is making me nauseous and I have been unable to eat all day.

There is a newer drug on the market but it is not FDA approved for young children.  Entyvio is another infusion drug but it works differently that the TNF blockers so there is a chance it could keep her in remission and prevent the Psoriasis.  The hospital's youngest patient to be approved is 16 and they were able to get her approved because she is "adult size".  Sophie weighing in at a whopping 40lbs most likely does not qualify but this is the route I am leaning towards if Remicade is no longer an option for her.

We meet with her dermatologist and gastroenterologist again on the 29th at 9a to make our final decision.  They drew labs today to see if she had developed antibodies to the Remicade so we will know more once those are back.  At this moment I am leaning towards trying to get her approved for the Entyvio but I may change my mind a few hundred times between now and the 29th.  Her next Remicade date is 2/1 so we have about until then to decide so that she doesn't get sick again.

Today while talking about the options for Sophie with the doctor and her dad I was looking at him and thinking this is it?  Us?  These are the 2 people chosen to make these huge medical decisions for this small human?  What?  Who thought that was a good idea?  There is absolutely nothing that qualifies us for this.  Who in the world thought this would be a good idea?

This is certainly not about me - it is about her BUT holy hell I feel so overwhelmed and inadequate.  The warnings on each drug are completely terrifying, the thought of her coming out of remission is also completely terrifying!

Life with a chronic disease is always such a fine balance of good and evil.
Or choosing the lesser of two evils.






Methotrexate can cause serious or life-threatening side effects on your liver, lungs, or kidneys. Tell your doctor if you have upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes), dry cough, shortness of breath, blood in your urine, or little or no urinating.

Long-term use of Imuran increases the risk of developing certain types of cancers (eg, leukemia, lymphoma, skin cancer). A rare type of cancer called hepatosplenic T-cell lymphoma (HSTCL) has been reported in patients treated with Imuran. These cases have been fatal. Most of these cases occurred in teenagers and young adults who had Crohn disease or ulcerative colitis. Some patients who developed this cancer were using Imuran along with certain other medicines called TNF blockers (eg, infliximab). Tell your doctor if you have or have ever had any type of cancer.
Imuran may also cause serious blood disorders (eg, anemias, low white blood cell or platelet levels). Discuss any questions or concerns with your doctor.
* A TNF inhibitor is a pharmaceutical drug that suppresses the physiologic response to tumor necrosis factor (TNF), which is part of the inflammatory response. TNF is involved in autoimmune and immune-mediated disorders such as rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease, psoriasis, hidradenitis suppurativa and refractory asthma, so TNF inhibitors may be used in their treatment. The important side effects of TNF inhibitors include lymphomas, infections (especially reactivation of latent tuberculosis), congestive heart failure, demyelinating disease, a lupus-like syndrome, induction of auto-antibodies, injection site reactions, and systemic side effects.

Entyvio is an integrin receptor antagonist. Integrin receptors are proteins expressed on the surface of certain cells. Integrin receptors function as bridges for cell-cell interactions. Entyvio blocks the interaction of a specific integrin receptor (expressed on circulating inflammatory cells) with a specific protein (expressed on cells in the interior wall of blood vessels), and thereby blocks the migration of those circulating inflammatory cells across those blood vessels and into areas of inflammation in the gastrointestinal tract. The most common side effects in patients treated with Entyvio include headache, joint pain, nausea, and fever. The most serious risks associated with Entyvio include serious infections, hypersensitivity and infusion-related reactions; and hepatotoxicity.


Wednesday, October 21, 2015

Seven Days

After 3.5 years of remission - it took 7 days for a full blown flare.  Seven Days.

I am not going to go into what a full blown flare looks like again.  If you are having trouble remembering or you are new to HWHAP - you can read: The Sh*t that is Crohn's Disease here! I don't mince words in that post.

Last Monday, the 12th was her Remicade appointment date but we found out the Friday beforehand that there was a lapse in her coverage and we were having trouble getting answers.  There were words like:  pre-existing condition, pre-authorization and you need to call financial services but ultimately they canceled her appointment and would not allow us to cash pay.  I was frustrated but not OVERLY concerned. #Mistake

I honestly had no idea she would get this sick so fast.  After 3.5 years you forget. You forget how completely awful it is.  It is so awful! I was even brazen enough to allow myself to believe that she would be ok.  Maybe she doesn't even need Remicade anymore!  Maybe, just maybe she can stay in remission without it!  Her doctor has told me countless times that they do NOT take children off of biologics - it just does not happen.  Why would I allow myself to think Sophie would be the exception? I don't know why.  I just know that it is hard, hard to know that your child will need this for the REST OF HER LIFE. It hit pretty hard. Again.  Which seems ridiculous but this disease is ridiculous so I think it is only fair that my emotions can be ridiculous too!

I left Sophie for a few minutes this morning to run to the gift shop and cafeteria.  While in the gift shop my emotions got the better of me and tears started flowing. Being here is hard. Coming through the ER was so hard.  We were in the same room that we had when Nate was diagnosed.  Being back on the GI floor brought back so many feelings.  Just ALL OF IT is hard.  Another mom came up to me and asked if she could hug me.  Not is a creepy, stalker way! She had tears too.  The mom bond is strong.  Being the mom of a chronically ill child somehow, if possible, makes the bond even stronger.   I didn't even get her name, or her story, but I could see the sadness in her eyes too. We are same same.

And now here we site in her comfy suite at Children's Medical Center Dallas overlooking downtown, an IV in her arm -- she is receiving the Remicade that was previously denied and we are hoping this kick starts her little body right back into remission.  She wants to go home and although her doctors wanted to observe her for one more night, they are granting her wish and letting her go home tonight! As long as everything goes well, of course.  She will miss school for the rest of the week as she rests and allows her body to recover.

2.5 years of hell was forgotten in the 3.5 years of remission but it only took 7 days to bring it all back and now I am hoping 7 days to get her back into the remission bubble.  It may take mommy a little longer to forget and will certainly take a while for the guilt to go away.   This sweet girl pays the price when things go wrong, when balls are dropped, and denials are made.  It hurts every fiber of my being to see her suffer.




This girl though is fierce, she is a fighter, a warrior and she will warrior on.
I am so honored to be this warrior's mom.  #SuperSweetSophie #CrohnsFighter #WarriorOnLittleOne

Thank you all for your calls, texts, and messages!  Thank you also for always allowing me to come here when times are tough.  When things are good I easily forget what comfort I find here, it is nice to always be able to come back when it is needed.



Monday, April 30, 2012

The Sh*t that is Crohn's Disease



On Monday, April 9th Sophie was admitted to Children's Hospital of Dallas for the 2nd time in less than a year for her Crohn's Disease.  


Looking back now I try make it less horrific than it was but it is still too fresh in my mind to be forgotten.  Sometimes time makes it better, sometimes it does not and in this case I'm pretty sure it will stick with me for quite a while.  


How did we get there?


On the 29th of February Sophie had her 3rd colonoscopy in less than 2 years --- you can read about it here.  The days before the procedure required a special diet and fasting.  During that time we took Sophie off of the steroids she has been on for 2 years and her Imuran (azathioprine).  After the scope her diagnosis was officially changed from Ulcerative Colitis to Crohn's Disease and we made the decision to keep her off of steroids and Imuran and move forward with a new treatment plan of Remicade as soon as possible.  Unfortunately, Sophie was diagnosed with Strep twice and then Scarlet Fever in just over a months time.  Each illness required antibiotics which always helps tremendously but each time caused her to have C-Diff.  Each time delaying further our being able to start her Remicade treatment.  


So, without the steroids Sophie got very sick very fast.  It's hard for me not to use a lot of curse words when I type out this post. So, I think I will start now.  Some people believe that people that curse are uneducated and/or can't think of more appropriate words to use.  I disagree, I believe sometimes situations such as these call for a lot of cursing 1) to portray how strongly I despise fucking Crohn's  2) to explain how truly fucking horrific this damn disease can be and 3) sometimes it makes me feel better just to fucking cuss!  You have been warned!


Thank you, Alexis for this awesome picture!


By the time Sophie was admitted to the hospital she was having 12-15 bloody stools a day.  Really, she was just pooping blood but there wasn't that much poop involved at that point.  Along with losing massive amounts of blood, she was having sever stomach cramps and pain, was dehydrated and her hemoglobin level was 7.3 (if I remember correctly).  It was fucking bad!  She felt terrible and as her mommy I was just emotionally overwhelmed watching her suffer. 


Jim left town Monday morning and Sophie was admitted that afternoon.  Although friends and family offered to go with me to the hospital I thought sure I could handle it alone. I dropped Nate off with my parents and had a friend pick up Em from school and Sophie and I headed to Dallas.  Just hours after arriving I felt overwhelmed.  Emotionally and physically.  The IV team couldn't seem to get the IV into her vien which caused a lot of tears and screaming, the constant trips with Sophie to the bathroom where I was literally holding her up on the toilet all while maneuvering her around with an IV, and heart monitor, plus feeling for the 1st time that I was totally alone with Sweet Sophie and her stupid, evil Crohn's Disease was pretty damn tough. 


Luckily, starting on evening 1 friends and family started streaming in which was a nice distraction for both me and for Sophie.  I literally would have not eaten or had anything to drink if it had not been for my friends and family bringing in food, diet coke and coffee for me.  With it just being me and the Doodle I was pretty much at her bedside the entire time and could not or would not leave her unless someone else was there with her.  


Instead of trying to remember each day I am going to import my Facebook statuses from each day as that was my main form of communication with everyone.  Which saved my sanity because I could not have given each and every person their own update so here we go . . . 



Checking in Sophie Doodle. Blood work needed - possible transfusion and lots of meds. Her labs came back very bad. She's a sick little little. :( — at Children's Medical Center.


I always forget how completely impossible it is to sleep here. — at Children's Medical Center.



Quick update. Sophie is enjoying some music therapy right now which has cheered her up a bit. She has not been able to eat since last night so she is a bit grumpy. She will go under for a scope today at 1:30. We are hoping that the infection in her colon is not too bad and that her current antibiotics will clear it quickly and we can still begin her Remicade treatment later this week. — at Children's Medical Center.





Sophie is back in OR ---- waiting, waiting, waiting, waiting! — with Helen at Childrens Hospital Dallas Tx.

Helen took this photo before they took Sophie back to the OR:


Sophie update --- we are awaiting biopsies from scope today and hoping the IV antibiotics are clearing her infection so that we can go forward with her Remicade infusion (possibly) Friday. The infusion is scheduled to take about 4 hours. We will make final decision on blood transfusion tomorrow. Sweets is a sick little little --- she's lost 5lbs and feels pretty yucky. Thank you all for all of the thoughts and prayers. I'm overwhelmed and still full of HOPE. ♥

There are so many things I would change about CMC (not complaining at all) ---- the 1st one would be to add Starbucks delivery to each room for the sleepy mommies! — at Children's Medical Center.

Sophie update: potassium and hemoglobin levels are both down. She is now getting potassium through her IV along with antibiotics. Her heart rate is still good so no blood transfusion today. We are still awaiting biopsy results from scope yesterday. Still HOPEful that she can begin Remicade on Friday. — atChildren's Medical Center.



Wednesday night late ---- Jim arrived home and spent the night with Sweet Sophie so that I could get some much needed wine, pizza and rest.  :)

Sophie update: Miss Priss is pretty sick today. She's now throwing up and unable to eat. Zofran ordered --- hoping it helps. Biopsies all came back ok so orders have been placed to begin Remicade today. They will give her steroids, Benadryl and Tylenol thru IV to counteract any reaction she may have to the drug. She will be monitored very closely for the entire 4 hours.

Someone this week called me a warrior mom. I like it. But I'm scared to death and hurting for my baby. Working today to keep calm and fight Crohn's.



And because I love and admire Ms. Meri so very much . . . this message meant the world to me.  
From one Warrior Mom to another:

According to the dictionary Warrior means: A person who shows great vigor or courage. You are a warrior mom, and she is a warrior little. Keep calm and warrior on! Love you!! Shooting prayers your way all the time. ♥


And Thursday afternoon we started Sophie's Remicade infusion around 5:30 or so. Finally. 
I was nervous and scared and relieved all at the same time.  I cried a lot during the infusion as Sophie lay there sleeping.  I didn't help that I repeatedly was reading the black box warning from the FDA ----

Some children, teenagers, and young adults who received infliximab injection or similar medications developed severe or life-threatening cancers including lymphoma (cancer that begins in the cells that fight infection). Some teenage and young adult males who took infliximab or similar medications developed hepatosplenic T-cell lymphoma (HSTCL), a very serious form of cancer that often causes death within a short period of time. Most of the people who developed HSTCL were being treated for Crohn's disease or ulcerative colitis with infliximab or a similar medication along with another medication called azathioprine (Imuran) or 6-mercaptopurine (Purinethol). Tell your child's doctor if your child has ever had any type of cancer. If your child develops any of these symptoms during his treatment, call his doctor immediately: unexplained weight loss; swollen glands in the neck, underarms, or groin; or easy bruising or bleeding. Talk to your child's doctor about the risks of giving infliximab injection to your child.

Finally, Jim took my iPad away.  Our decision was made, the infusion had begun and we hoped for the best.

Sophie update: We are done. We survived round one!! Sophie slept through the entire infusion. Her blood pressure dropped scary low but they slowed down the infusion and it came back up. She's not feeling great but she is resting again now. I'm totally drained. Ducking Frohn's.

Thank you again for all of the thoughts and prayers. ♥




Tired mama and spirited Doodle — with Laura Williams-DeJulius Houston at Children's Medical Center.



Hospital cafeteria sushi ---- good idea or bad idea? At least I'm in ... the hospital already! Oof.

And for the record . . . it was a very bad idea.

Friday, April 13 at 4:05pm via mobile 

Sophie is so excited and suddenly feeling better!!! Some wonderful friends sent her JULIE --- an American Girl doll.





Friday, April 13 at 6:15pm via mobile 

Sophie is BORED!!



Friday, April 13 at 8:25pm via mobile
Sophie update: tonight Sophie is running a fever (currently 102), severe headache and feeling nauseous. We are about to do a blood culture to check for an infection in her blood. She's pretty sickly and very upset about the 3rd blood draw of the day. :(



Sophie update: Fever is down with help from Tylenol. Her headache feels better and so does her tummy. She was up a couple of times over night. Overall showing signs of improvement. Still awaiting test results. As always thank you all for the love, prayers and support. ♥


Saturday, April 14 at 2:23pm via mobile
Slept, showered, and ate. Now back with the Doodle — at Children's Medical Center.


Saturday, April 14 at 3:18pm via mobile 

Sophie is SO HAPPY!!!
The hospital bed provides tons of entertainment for 6-year olds!!!
 



Saturday, April 14 at 3:57pm via mobile 

OMG ---- we are out of here. 150% Improvement!!



Saturday, April 14 at 6:13pm via mobile 

Sophie & her friend John with all of her loot. :)




Jim and I loaded up the Doodle and headed home to get the other littles.  




Once home we REALLY realized how much STUFF Sophie had accumulated over the 6 days in the hospital.




The Remicade worked quickly and Sophie is feeling much better.  The Crohn's symptoms are almost gone but we are dealing with a few side effects from the Remicade.  We went in today for her 2nd infusion.  I'll post about that experience tomorrow.

I am at this point very grateful for the quick healing effects of the Remicade but somewhat still pissed off in general that I've had to make a decision to put my sweet child on such a harsh medication at the age of 6.  The fear of the black box warning stays in the back of my mind and that my friends, is why Crohn's Disease fucking sucks the big one!  

Sometimes Keeping calm and sometimes freaking the fuck out . . . 

Just a Mom

I am NOT a doctor, nor do I play one on this blog.

I AM a wife.
I AM the mom of 3 wonderful children.
I AM my son's pancreas.

The information provided on this blog is from our personal experiences with Type 1 diabetes. Because something works for us does not mean it will work for you.

Please consult your doctor if you have any questions or concerns about your health care options.

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