Really rough week

[ak23]

I've been on Humira every other week for about a year now, but I have continued having stomach pain and bowel issues. My doctor recently did a blood test to see how much Humira was still in my system in that second week to see if it was working properly, and the test showed that there was NO Humira in my system by week 2, which is why I was flaring up so often and having issues the further away I got from my injection. He wants to bump up my Humira to once a week. However, my insurance company rejected it. Also, I should add that I've been on Remicade before, but had to discontinue it because I had bad reactions to the medicine.

Now, I'm just living with this horrible pain. My stomach is constantly cramping. I'm going to the bathroom a ton (which also causes significant pain) and there is blood in my stool. I've been taking Tramadol to ease the pain but when it gets this bad, the pills don't even touch it. This has been interrupting my work, relationships and quality of life.

Do I go to the ER? What do I do? I'm out of answers. Please, please help me.

I have no idea what to do. I try my best to stay optimistic while battling this horrible disease, but I truly feel hopeless right now. If my insurance company doesn't budge, this is my new life and I can't handle that.

EDIT: By the way, if it helps, I've had two surgeries: A bowel resection (7 inches, appendix and part of my colon) in 2012 and then an adhesion/hernia removal in 2013.

 

[Cat-a-Tonic]

Can your doctor contest it with the insurance company? My GI has said he can do that if my insurance denies anything for whatever reason - he said he can contact them directly and give them his reasons for wanting to do whatever (test, medication, etc) and he said that oftentimes, the insurance company will change their mind and give approval if the doctor has compelling reasons. So if it were me, I'd get in touch with the doctor and ask them to appeal to the insurance company and ask them to reconsider - if your doctor explains why, I would think you've got a decent chance of getting weekly Humira approved.

You could also try contacting the company that makes Humira. I think they offer some sort of savings card where each dose costs something like $5? They might be able to work something out with you outside of the insurance company.

 

[ak23]

Thanks for your support. I currently use the Humira savings card, but it doesn't seem like it would work for weekly Humira since my doctor said it isn't officially approved for weekly use yet. My next step is to do what you said and that's have my doctor fight, fight, fight for the every week dose. He has tried already, but he's going to continue trying.

The pain got so bad last night that I broke down and went to the ER. They did an X-Ray and gave me IV Prednisone along with some pain medicine there and for home. They didn't do a CT scan because I've had so many, but I'll be following up with GI soon.

 

[ronroush7]

Has your.doctor considered another biologic?

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[ak23]

I tried Remicade, but had some bad side effects so I had to switch to Humira. My doctor has said that some new biologics will be available soon if I need to switch, but I'm hoping I can just stick with the Humira long-term.