Joshw- A lot of people have had success with Cimzia, so it might be worth a shot unless you have reasons you would like to avoid it? If so, I'm with Linn, don't give up. Insurance companies love to deny things the first time around, and force you to appeal. Often times appeals are approved when the original decision was denied. Best of luck!
Update on me- I know some of you (like Linn) will remember my last update, but here's a little background for those of you that might not... I qualified for an allogeneic stem cell transplant at Northwestern in Chicago in December 2011. I then spent the next 5 months or so fighting the insurance to approve the transplant. After my final denial we devised a new plan. Because I would be eligible for medicare in Jan. 2012 (due to SSDI), and they would cover a large portion of the cost, we would spend the next 7 months until then raising the portion that I could expect to pay. Taking in to account the $25k "downpayment", travel, and living expenses while we were there, and the 20% of some additional bills I could expect to pay, we set the goal at 40k, with Jan. 1, 2013 as our goal date. In the meantime, while we were fundraising, fistuals and abscesses became a big concern, and we decided I needed to try another medicine to "bridge the gap". Based on a recommendation from my Mayo Clinic doctor, my local GI and I decided to give Stelara a shot.
After some back and forth with the insurance, and debates over what dose to start me on, I began taking stelara injections at 90mg every 4 weeks. Each time I received an injection I had a worse reaction to it. Then, around November (approx 6 months on Stelara) I had to stop taking it, after the allergic reaction I was having to it became too severe. Well, at the time, I was having more better days than normal, but had not seen a significant increase in my well being symptom wise anyway. Even though my tests were showing some improvement I did not feel like my symptoms correlated with the test results, and given the scary reactions I quit taking it.
(As a side note, when I was in the hospital in October from a reaction I consulted with a neurologist who thought a separate problem I was having was one with my vestibular response. The long and short of it was that since I had noticed a pattern of activity making me more ill over the past couple of years, I had became very inactive. So, whenever I would do simple things like walking from one end of a room to the other, or standing in one place for 5 minutes, my heart would race, and I would feel out of breath, and often off balance and dizzy. He suggested Physical Therapy to recondition my vestibular response. I reluctantly agreed. I thought it would make my Crohn's flare more, but I knew that my ultimate goal was to go into the transplant as otherwise healthy as possible. So, in mid-November, I started PT)
Fast forward to the end of January this year. I went to Chicago for my pre-transplant testing. Overall I was feeling much more fit from physical therapy, and I was concerned going into the testing that I wouldn't be "sick enough". I was actually feeling better at that point then I had in a long time. I feared going there, and having them tell me that things looked too good to proceed. Although on the one hand I questioned keeping the appointment because I felt better than I had in a long time, on the other I knew I was still feeling way to sick to live a normal life, and that I didn't want to live "good enough", I wanted my life back. Ultimately, I decided to just go.
After meeting with Dr.Yun (GI at Northwestern), and discussing my current symptoms and quality of life, we both decided I should proceed with the transplant, given my testing correlated with my symptoms. It did not. My testing looked better than it has in a long time. Although part of me expected it, I was still shocked. I felt like the rug had been pulled out from underneath me. Here I was, finally in Chicago, money raised, the rest of my body conditioned, mentally ready, with my family all supporting me, my donor tested out perfectly...and for the first time in years, my Crohn's had truly improved. As stupid as it sounds, I was pissed. I knew how I felt on a daily basis. I knew I was still too sick to live like a person should, yet my tests told a different story.
The doctor and I discussed everything and he said that his best advice was just for me to come back when I felt worse. I honestly knew what he meant because I had been feeling an improvement... but as the same time it felt like a slap across the face because I felt like no one was understanding or believing me that I was still a very sick person, despite not being "as sick" as I had been 6 months prior. He said his best guess is that the Stelara had helped me significantly, and that as time went on without it, and it completely worked its way out of my system I would be back... "It could be 2 weeks, it could be 2 months or more, I don't know. Just let us know when you are feeling worse and we can retest you and hopefully proceed with the transplant at that point".
It has been 2 months now since my appointment and I am no worse off then I was then...maybe even a little better. And that's with NO prednisone!
Who knows, maybe the Stelara snapped my body out of it and I will progressively get better on my own now, even without being able to take it anymore. Maybe 6 months is all my body needed. Or, maybe it was the Physical Therapy, and custom tailored exercises that allowed me to be active without straining my stomach... I must say though, I am very thankful for every good day God gives me.
I still feel frustrated at my very limited diet, and my inability to do many activities, and feeling like I am just living in limbo... too sick to go back to nursing school like I want to, but too healthy to proceed with transplant. I am trying very hard to remind myself that everything happens for a reason, and maybe the transplant wasn't right for me...or at least right now. I know a lot of ppl on this forum would love to feel some sense of relief like I have, so I feel guilty complaining at all. But, I do feel like I am still waiting for the other shoe to drop as they say, and truly believe I will be back in Chicago in the future to proceed. In the meantime, I'll take what I can get, and enjoy the good days.
Sorry this was so long, I just wanted to post an in depth up date to explain things, and to say to the rest of you out there that are waiting for SOMETHING to finally help you... Stelara may have done it for me! Don't give up hope even if you don't feel a large response right away...give it some time. And most definitely don't give up before you give it a try just because it is a hassle to get approved.
Good luck everyone!
p.s. In regards to the debate over where it is less painful to inject... I have found whatever place on your body is the most fatty. At different stages of my disease my stomach has been fatter, and at others it has been my thighs. Which ever is the most chunky deserves the prick!:ylol: