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My Story - Treatment seems to problem

Hi,

Ok i am new so please be gentle lol But please read further as it seems i am quite rare (i will get there).

In August i was eventually diagnosed with having UC after well over a year of being told it was things like haemorrhoids. Took a colonoscopy for them to eventually get it right.

I was going along trying their solutions of asacol tabs and asacol enemas etc. The enemas worked when i was on them, but when i stopped them it came back. They were then talking of putting me on Azathioprine, but apparently only a half dose because i have a low level of some enzyme (i'll come back to Azethioprine).

I eventually got admitted to hospital for 9 days and got out last Friday. That was an adventure! I was discharged on 40mg of prednisolone and 800mg of Asacol (although i was incorrectly being given 70mg prednisolone in hospital!!) They thought i was well enough to be discharged, but ever since i got out, i have basically got worse and almost back to where i was before i got admitted (yet now i am on steroids)

Now comes the fun bit. In 2000 i was discovered to have osteomyelitis in my ankle, and had surgery to clean it and lots of antibiotics. I've always just had occasional pain etc on that ankle, but its rare. Although a couple of years ago i flared up a bit, and was MRI'd and the Osteopathic surgeon diagnosed it as chronic osteomyelitis. I mentioned this is passing once to one of the consultants (not my main one) when he mentioned putting me on the Azathioprine, and his face just fell and he was stumped. And apparently it is really fortunate that i mentioned it to him, despite the MRI results being right there in my medical records in front of him!!!

So during my hospital visit and ever since, everyone has been fighting over how i can be treated. My gastroenterologist said i should be on Azathioprine and actually infleximab (i think) before that kicks in, but they can't do it because of the osteomyelitis!! Infectious Diseases want a biopsy and then to treat me with IV antibiotics to clear the osteomyelitis. But the Osteopaths are saying they don't want my ankle touched, and i should just be treated for the same thing as i was back in 2000. :(

Apparently my immune system is probably just dealing with the osteomyelitis and if they suppress that, then it will probably be very bad. It is also the first time they have ever had anyone with both these conditions.

When i go to see the gastroenterologist on Tuesday again, it will be four weeks, i'll be no further forward. Actually i'll be back to the state i was in before i went to hospital, not even the state i came out of it in :(

I would be more ok with the whole thing if I was on a waiting list for a procedure, but i'm not, i am waiting on someone making a bloody decision!

Does anyone know if in Tuesday nobody has made a decision and still dragging their heels, is there someone i can contact to escalate this further (it the NHS in the UK btw)? It's 4 weeks now, i face the prospect of going back into hospital. Even then, i will also be on at least 2 weeks of IV antibiotics before i can start any other treatment, so the more they delay, the more i am suffering :(

Sorry if you got bored reading this, i'm just frustrated and had to let it all out.
 
Okies... I can maybe help with some of this...
If you feel you're not getting sorted, speak to PALS, theres one at evey NHS hospital/ trust, and they can escalate complaints and bring forward appointments and stuff.
Having an infection and starting aza would be bad.... Having a normal immune system and starting aza is hard, so I kinda get why they're not starting you with that. Also theres something called NICE guidelines, which state you have to have x amount of disease and have tried x drugs before having biologic drugs.... I think one of the criteria is having tried immune supressant drugs so it does kinda sound like you're stuck between a rock and a hard place...
Hope this was helpful? I'm sure someone else has info...
Let us know how it goes with the doc this week!
 

Trysha

Moderator
Staff member
By now someone should have started antibiotic treatment for an active infection.This most certainly needs immediate attention.
It is understandable that the docs would not want to start immuno suppressants where there is an active infection.
It will also be a difficult decision how to proceed with any kind of treatment for the IBD
since they have not faced the combination of bone infection alongside an IBD.
As you say it is unusual for the docs to have to treat both conditions so it does need careful thinking and expertise.
This is no excuse for the foot dragging you appear to have been subjected to, and I am sorry for your extended suffering.
As Monkey has explained perhaps it is time to talk to PALS regarding the interminable delay regarding your treatment.
Have you asked the docs why this is, or do you feel they are not caring enough?
Feel better soon
Hugs and best wishes
Trysha
 
Hi,

Sorry I haven't replied sooner and thanks for your replies.

I had an appointment with my gastro consultant again today and have now been readmitted to hospital due to my symptoms again. Apparently when they thought they had the luxury of time they were hoping for a third opinion to make the final call on biopsies, but they don't have that luxury now so hopefully even though I am in hospital, they will move along a bit.

I can completely understand why they won't start meds to slow my immune system, but I can't understand the debates in treating my name, it's frustrating, seems the last month has been wasted.

As for PALs, I did look into it, but it seems it may only be an England and Wales thing, not in scotland :(
 

Trysha

Moderator
Staff member
Sorry to hear the saga is continuing for you.
Hope you will soon be made more comfortable and have some resolution in sight.
Please let us know how things go for you.
Feel better soon
Hugs and best wishes
Trysha
 
Hiya,

Well things seem to be moving along, I am on IV antibiotics now and tomorrow they are giving me the infliximab. Though I have been told I will know in a few days if it is working, and if it isn't working, then it is likely that I'll be getting my colon out.

If it does seem to work, I will be started on azathioprine, which apparently I'll only be on half dose and closely monitored as some enzyme I have is low (typical) and I'll also probably get surgery on the osteomyalistis, too.

As nervous as I am about the infliximab and the big list of side effects and consent form I got to sign today, I really hope it works, as I don't want to lose my colon, as much as it is annoying me just now.

So fingers cross for me pleaseeeee :)
 
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