Ulcerative Colitis, 4 years diagnosed, prednisone not controlling current flare.

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Hi everyone,

This is the first time I've tried asking about this kind of thing online so bear with me if I write too much or too little. I'm really at the end of my rope with UC and I've been through so many doctors now without getting anywhere. I was diagnosed a little over four years ago. Since then I have been on Prednisone with dosage starting at 40 mg/day then tapering down until I eventually start having symptoms again and have to jump back up. I'm also on 3.6 g/day of Asacol, one 4 g/day mensalamine enema retained overnight, and 1 g/day Folic Acid. My colitis is limited to the left side and I have been told by every single doctor I work with that it is minor and should quickly go into remission. My diet is clean, I eat literally nothing besides grilled/baked chicken, fish, and a healthy mix of vegetables. I drink two gallons of water daily. As of about two months ago I have stopped consuming alcohol entirely.

My last doctor tried putting me on Imuran, which I had a terrible reaction to. My symptoms got ten times worse, by 3 pm they were so bad I felt like I was drinking Trilyte. I was having crazy mood swings, memory loss. I had a night where I had a vodka rocks with dinner and completely blacked out after just one drink. We did a blood test and I had heavy liver toxicity from it so he took me off of it and we tried going back to Prednisone and starting a slow taper. I was finally down to 9 mg/day and started seeing a new doctor. This guy decided to put me on Methotrexate, 7.5 mg/week since I was starting to have some minor symptoms at the lower Prednisone dose and a dexa scan revealed that four years of Prednisone had caused bone deterioration. Two weeks later I was in full flare-up. I assumed the Methotrexate caused it and stopped taking it. It's been about three weeks since and I'm still in a horrible flare-up. I've bumped my Prednisone back to 40 mg/day and it's not controlling it at all. I wake up with symptoms at night, can barely sleep. In the morning I force down breakfast between sprints to the restroom so I can get the Prednisone down. Once I take it I'm alright until late afternoon/early evening. At this point I might as well be on colonoscopy prep because my day is done. HEAVY bleeding as well, more than I'm used to, and the urgency is far more than I remember from my last flare. I've been on 40 mg/day for about seven days now and I'm still not seeing improvement. I'm told Remicade is the next step but I'm terrified I'll be allergic like I was to Imuran and Methotrexate.

Has anyone out there had an experience similar to mine? I'm losing my mind here. I'm in my twenties and I have to skip several classes a week at college due to symptoms. I'm supposed to sit for the LSAT on October 6th and I honestly don't think I can make it through a four hour exam! This is ruining my life. If anyone has any advice or help or ANYTHING please let me know. I'm really fed up with doctors telling me how minor this is. It doesn't feel minor!

I know that was a long read... thanks if you stuck it out with me.

Cheers.


EDIT: I forgot to add, at one point my doctor tried switching me from Asacol to Apriso. This led to a nasty flare-up, but within a week of switching back to Asacol and 40 mg/day of Prednisone everything went back to normal.
 
My advice would be to go to the ER and let them do a ct scan and some x-rays to make sure there is not something major going on. You might be having some other damage going on with the amount of blood that you losing as well.

I know that you don't want to miss school but please go in tonight if you can and let them examine you. once they are able to get this current episode under control then you can ponder over the maintenance drug to use. you need immediate help right now.
 
I really appreciate the advice. I honestly thought about going to the ER but the problem is I've had some terrible experiences with hospitals up here. My campus has an urgent care facility that is excellent but unfortunately closed on weekends, so at this point I'm just waiting for Monday morning to go in.

I'm sure this is ill advised but I finally got fed up and this morning increased my Prednisone dose from 40 mg/day to 50 mg/day. I know self-medicating is a bad idea but honestly I just need some control right now and if this works I'll deal with the consequences. I have an appointment with my GI on the 12th and one with my GP on the 3rd. I'll discuss with them. It's frustrating how bad GI availability is up here.
 
Michael I can definitely relate to you on not having a good experience at the ER. I actually just had a really bad experience 2 weeks ago and got a post on here venting about it.

I get chronically dehydrated and end up needing iv fluids weekly so they think I am a frequent flyer for pain meds and treat me badly also.

last week I knew I was dehydrated but refused to go to the ER for IV meds.

well to make a long story short my husband got very ill and on the way to the er with him I had a turn for the worst and ended up in the er also. I ended up getting admitted because I was being stubborn I have been here for 5 days now and I am still not improving yet.

The one plus side is that I have been diagnosed with a rare disorder that i have probably had all my live but just was dismissing the symptoms. I cant control my dehydration orally because of this medical problem.

I know you may not want to go to the ER but please take it from a stubborn ol fool. you might just have to give it a go.

Please keep me updated on how things are going.
 
Suzie,

Thank you I really appreciate that.

Earnellzwifey,

I'm sorry to hear you're going through a tough time too! I hate being in the hospital, I feel like I lose myself in there. I'm a really active person, being stuck in a bed doing nothing drives me nuts! I hope you get out soon. That's a funny coincidence with your husband's name.. hah. I really hope he gets better soon too, all my best to you guys.
 
Well so far so good. still in here but at least I am getting some much needed answers. Please let me know how things turn out with you. I am worried with all the problems that you are experiencing.

Jeanna
 
Hi everyone,

This is the first time I've tried asking about this kind of thing online so bear with me if I write too much or too little. I'm really at the end of my rope with UC and I've been through so many doctors now without getting anywhere. I was diagnosed a little over four years ago. Since then I have been on Prednisone with dosage starting at 40 mg/day then tapering down until I eventually start having symptoms again and have to jump back up. I'm also on 3.6 g/day of Asacol, one 4 g/day mensalamine enema retained overnight, and 1 g/day Folic Acid. My colitis is limited to the left side and I have been told by every single doctor I work with that it is minor and should quickly go into remission. My diet is clean, I eat literally nothing besides grilled/baked chicken, fish, and a healthy mix of vegetables. I drink two gallons of water daily. As of about two months ago I have stopped consuming alcohol entirely.

My last doctor tried putting me on Imuran, which I had a terrible reaction to. My symptoms got ten times worse, by 3 pm they were so bad I felt like I was drinking Trilyte. I was having crazy mood swings, memory loss. I had a night where I had a vodka rocks with dinner and completely blacked out after just one drink. We did a blood test and I had heavy liver toxicity from it so he took me off of it and we tried going back to Prednisone and starting a slow taper. I was finally down to 9 mg/day and started seeing a new doctor. This guy decided to put me on Methotrexate, 7.5 mg/week since I was starting to have some minor symptoms at the lower Prednisone dose and a dexa scan revealed that four years of Prednisone had caused bone deterioration. Two weeks later I was in full flare-up. I assumed the Methotrexate caused it and stopped taking it. It's been about three weeks since and I'm still in a horrible flare-up. I've bumped my Prednisone back to 40 mg/day and it's not controlling it at all. I wake up with symptoms at night, can barely sleep. In the morning I force down breakfast between sprints to the restroom so I can get the Prednisone down. Once I take it I'm alright until late afternoon/early evening. At this point I might as well be on colonoscopy prep because my day is done. HEAVY bleeding as well, more than I'm used to, and the urgency is far more than I remember from my last flare. I've been on 40 mg/day for about seven days now and I'm still not seeing improvement. I'm told Remicade is the next step but I'm terrified I'll be allergic like I was to Imuran and Methotrexate.

Has anyone out there had an experience similar to mine? I'm losing my mind here. I'm in my twenties and I have to skip several classes a week at college due to symptoms. I'm supposed to sit for the LSAT on October 6th and I honestly don't think I can make it through a four hour exam! This is ruining my life. If anyone has any advice or help or ANYTHING please let me know. I'm really fed up with doctors telling me how minor this is. It doesn't feel minor!

I know that was a long read... thanks if you stuck it out with me.

Cheers.


EDIT: I forgot to add, at one point my doctor tried switching me from Asacol to Apriso. This led to a nasty flare-up, but within a week of switching back to Asacol and 40 mg/day of Prednisone everything went back to normal.

Hey Michael!

I'm so sorry to hear about your flare up, and four years?! I'm 22 and I have been in a flare up since I was diagnosed about a year and a half ago. I saw that you were supposed to take the October LSAT, did you end up doing that? I'm also supposed to take the LSAT in the coming months but am nervous about my trips to the bathroom taking up a good part of my test. I was looking into applying for extra breaks or a little extra time but now I'm hearing that the extra accommodations on the exam can hurt your chances of getting into a law school (even though legally they aren't allowed to hold that against you) I'm reading that often, they do. I was wondering if you have heard anything about this and what your experience was like on the day of the test. Please let me know! You have no idea how much I'd appreciate it, since our particular circumstances (having UC) are so different from other disabilities people apply for extra time for. Let me know what you think. Thank you so so much!

Best,
Julia
 
Hello Michael,


I agree with EarnellZwifey, you have to be your own advocate and be assertive about your care. Some of the doctors you might deal with will try to make it look like they know much more than you do about your condition and tell you that they are doing everything they can to help you. Unfortunately, even among the smartest doctors you might find that some of them have their head so far up their own ass that they aren’t able see what you are dealing with. My advice to you is keep looking around for another doctor GI doctor that is willing to take your condition seriously, because it is very serious. This is your life, if your GI doctor doesn’t understand that it’s time to find someone else who does.

My experience with UC is similar to yours. I was first diagnosed 15+ years ago when I was in my mid 20's. I still vividly remember the pain and the associated tenesmus. When the UC was at its worst, I would have to use the bathroom 20+ times a day, and that is no exaggeration. I remember that often after the 3rd or 4th visit to the bathroom there was nothing left to come out but I still had the incredible urge to go and bleed into the toilet multiple times through out the day. I probably spent more than 1/2 the time I was awake in a bathroom -- each visit would pin me to the toilet for 20 to 30 minutes.

The pain was overwhelming, and it would never stop. Like you, I would often be woken up from a dead sleep up in the middle of the night by terribly excruciating abdominal pain that sent me running from my bedroom to the toilet at 4am. Often times the pain had consumed me and caught me off guard -- I found myself screaming in agony on the toilet in the middle of the night, before I realized that I wasn't dreaming and this nightmare was really my reality.

I know you are in school and don’t want to miss classes and I am not sure exactly where you live but over the winter break you might want to consider going to the MAYO clinic. They have 3 sites, their main is campus in Minnesota and there are two other locations in Arizona and Florida. People travel from all around the world to be seen at the MAYO clinic and they have accommodations right on campus. If you apply to one of their locations and they don’t have room for you, try another location. Chances are once of their locations will have room to take your case, the sooner you apply the better, sometimes you might have to wait weeks or months to be seen so if you intend to go, apply soon.

It really shouldn’t cost you too much (if you live in the US), they take most insurance. The only thing you would have to pay for is airfare for a hotel if you are seen as an outpatient. I guess it all depends on how serious you think your condition actually is, if it gets bad enough, you might want to consider going to the MAYO clinic, or Johns Hopkins.

http://www.mayoclinic.org/patientinfo/appointments.html

http://www.hopkinsmedicine.org/


Welcome to the forum and good luck. Please keep us posted with your progress.
 
Hey everyone,

Wow it's been a while since I visited. Just been trying to forget about UC for a while after this flare, that was a really dark time for me. An update for you all: I'm better! I finally decided to try Remicade, I ended up self-medicating and jumping up to 60 mg on Pred and it did nothing. Plus my dexas were showing massive bone loss, in fact during a hockey game one night I cracked three ribs taking a small check that normally wouldn't phase me. So I figured my bones are more important than my fear of Remicade side effects. I just did my third infusion tonight, and so far so good! I'm off the Pred for the first time in years, my symptoms have mostly subsided. Keep your fingers crossed.

Julia: I did take the LSAT. I was still in flare when I took it, I had to walk out of two sections to run to the restroom. It hurt my score since neither ended up being experimental, but I ran like hell so it wasn't that bad. I ended up with a 172, all my practice exams were ranging from 176-179, so I definitely took a hit but it wasn't life ending. As for accommodations, I've heard bad things. I decided not to take that route, but to attach an addendum paper to all my applications explaining that my score suffered due to this. Go on the LSAC website and check out your top choice schools, most offer the option to attach optional papers where you can say whatever you want.

Also, just a general piece of advice for the test, CHOOSE YOUR LOCATION CAREFULLY! I go to UC Berkeley, and my campus was one of the offered locations. I checked with the proctors ahead of time and it turned out to be administrated in a huge hall with tiny desks, not even big enough for your answer sheet and booklet. Also the nearest bathroom was a significant walk from the hall. I searched online incessantly for days and found a test site at a community college with large desks and a bathroom on every floor with a classroom administering the test. You have NO IDEA how much this matters!

Woody: Thanks for the advice. I know about Mayo and I'm really considering doing it during the spring. I have some time off between graduation in December and the start of law school in September. I wanted to go work full time, but Mayo may be the better option. I really, sincerely dislike my GI doctor here in the bay area.
 
Michael,

I am so sorry for the delay, I had no idea you responded! I cannot thank you enough for answering that though, it helped a lot! I hope all is well with you! Thanks so much again :)

Best,
Julia
 

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