Discouraging news from GI today....

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Apr 13, 2012
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Location
Long Island NY
Hi Everybody,
Well, we went to see GI today to obtain results from Liv's MRE (done yesterday). MRE is showing progression of CD and mild stricture at her resection site...her last MRE was done 9 months ago, and GI feels this one looks like disease is rearing it's ugly head again. Bloodwork was all normal-no sign of inflammation, but her fecal calprotectin level from last week more than doubled, going from 317 three months ago to 966 today. Even though Liv was unable to retain the contrast for her MRE (vomited entire ingested amount right before they laid her on the table), apparently radiologist was able to get some decent pictures, enough to know that things are getting worse. Now what? Our new GI has been patient with letting us trial LDN, but feels it is time to make a decision about changing her treatment regimen. Liv feels and looks great, which makes this so much more difficult...I hate this so much. I just feel sick to my stomach; we are in the same boat we were in a year ago, after Liv was diagnosed with thyroid cancer. The issue is that all of the GI's are nervous about restarting biologics..we have had many opinions. And now our current GI wants us to get more opinions...really? He feels methorexate will not hold her as her disease tends to be somewhat aggressive. He is thinking it is best to restart biologics, but which one? Humira again, or maybe retry Remicade with IV steroids before the infusion to prevent a reaction. On Monday I will call to get other opinions from 2 adult GI's in the area. In the meantime, GI is increasing her steroid dose, AGAIN...it is now 1 year that she has been on Entocort! I attempted to wean Liv off a few months back..she lasted 3 weeks than began bleeding again. So many things are going through my mind right now...I am terrified to restart biologics again because of the cancer, but I am more terrified of letting this inflammation fester. Liv is in her senior year of high school, she has so much to look forward to, applying to colleges, senior trip, senior prom, graduation ect...I do not want her getting sick again!!! I just dropped her off at her part-time job after her MD appointment, I held back my tears until now....these decisions are so heartbreaking...I know all of you know what I'm feeling....sorry for the long narrative. Thank you for letting me vent, you guys are the best. Kim
 
Hugs to you!
Our jobs are just so hard at times like these.
Sorry, no real advice, just support!
 
So sorry to hear the LDN isn't working for her! I hope whatever they decide makes a big difference quickly for her so that she can enjoy her busy year. I am also struggling with the meds as my son is looking and feeling well. This has to be the weirdest disease ever!
 
Sorry that the LDN isn't working for her and that her CD is active. I don't have any advice just wanted to send my support.
 
What is worst case scenario if she goes back on Humira plus methotrexate?

I'm assuming they removed thyroid. So worst case is another cancer?

Did Humira work before? Was it in in combo with MTX?

What does your daughter say?
 
I'm so sorry to hear this... I have no advice but I do hope that the two GIs you speak with can offer you some options that will help Liv and which do not make you uncomfortable :( Sending lots of hugs your way :ghug: :ghug:
 
Oh Kim...:hug:...my heart goes to you for and all that you are both facing.

I don't think there is anything harder than having to make these decisions when your daughter looks and feels well.

I don't know if having had cancer negates a Stem Cell Transplant but I wonder if that may be a possibility for Liv at some point if it doesn't? I will tag Mr Ziggy into this as he may know the answer to that question.

Thinking of you hun and sending you love, luck and healing thoughts, :heart:
Dusty. xxx
 
It sounds like it might help if your daughter's oncologist (or thyroid doctor) get together with a IBD gastroenterologist to figure out her best option(s).

Is enteral nutrition something she might consider trying? It is used extensively in other countries for maintenance, though often after children are put into remission with drugs.

Hugs!
 
I'm so sorry for you and your daughter.
I know all too well how hard these decisions can be.
I so hope you all can get some answers soon, and more so I hope that you can be at peace with whatever route you choose :hug::hug:

xoxoxox
 
Hello All! Thanks so much for your words of encouragement and warm support, I was having a tough time last evening. I actually feel a bit guilty for being upset and whiney in the wake of Hurricane Sandy...I am reeling from all the devastation and destruction surrounding my home. We were very lucky and fortunate through the storm, but some of my family and friends have not been. Two of my friends have lost their homes and cars, one called me sobbing 3 days ago. These friends have been there for me through my kids illnesses, let me vent and cry and held me up when I received the news that my daughter had developed cancer. I feel so blessed and fortunate for everything my family has...I know things could be worse, but I still felt so overwhelmed and a bit angry last evening. Watching the news and seeing pics of the disaster really puts all things into perspective. I know we will get through every obstacle regardless of the decisions we make. You all offer such good advice, thank you again.
At Patricia56... yes, Liv had complete thyroidectomy, so we have the same cancer risks that every other CD patient has with these meds. The Humira worked great for her CD, she was only on Humira, but she had problems with cellulitis/skin lesions the entire time she was on it. Not sure if we should retry Remicade and pray she does not develop a reaction...my son is doing very well on remicade. @xmdmom..you are right, I need to get all MD's to agree to a plan and be on the same page and yes, I did ask about EN yesterday-doc is willing to start it. but feels strongly that she needs to start biologics ASAP. EN may act as a bridge/temporary fix until we establish new treatment. Have to go take care of my little premature babies now...dealing with a 13 and 1/2 hour shift thanks to daylight savings! Kim
 
Hi Livilou. Sorry about the MRE and the hard choices ahead. I am on Long Island too and my home totally flooded ... I keep saying it is these health issues that puts things into perspective. Our children's health is so much more important than a house. (Maybe easier to say since we have family able to provide us shelter.)
 
Hi Kim,
Thinking of you guys. I was going to ask how you weathered the storm so I am glad you said things are ok. I am so sorry she is having active disease again. I was also thinking as Xmdmom said about trying EN along with the LDN. Also with caitlyn just now she went through a flare up and we had her on steroids to get things back under control and then weaned down to just the LDN. The entocort did not work though we had to go to prednisone. caitlyn has a colonoscopy in two weeks so I guess the we will know for sure how things look. Did your doctor suggest doing a colonoscopy to get a more accurate picture as an MRE only tells the so much.
 
Livilou -

Have you seen these articles?

http://www.ncbi.nlm.nih.gov/pubmed/22960136

http://www.ihaveuc.com/ulcerative-colitis/humira-remicade-psoriasis-eczema-study.pdf

http://www.scielo.br/scielo.php?scr...0004-28032012000200014&lng=en&nrm=iso&tlng=en

Looks likes switching to remicade may not offer any reduced risk of the skin lesions returning. rats.

If she will do EN then I would suggest she start it right away while the docs wrangle over how to proceed. Biologic with or without an immunomodulator (I'd do with and get the most bang for my buck) seems to me to be the optimum direction.

Glad you and your family are OK. Sorry to hear about your friends and extended family.This too shall pass - hopefully really fast.
 
So sorry to hear that the IBD is starting to flare. It's tough enough to make med choices when they show physical signs of illness, but so much tougher when they "look" fine! I hope that all of the Dr's get together with you to come up with a game plan you can all accept. I hate it that the LDN wasn't working!

Sorry also about Sandy. Even though your home was spared, you're still affected because you are in the middle of it all. I was that way when the tornado ran through our town last year. Praying for everyone affected!

I hope you get a plan soon so that she can get to enjoying her Senior year. What a fun and special time!
 
Big hugs to you Kim. its so hard to make these decisions, dont feel bad about venting. i dont have any advice just wanted to send support. Sharon
 

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